Executive Summary

Q4 2024 revenue was $68.2M, up 57% YoY; gross margin expanded to 64% (from 49%); net loss improved to $18.9M (from $27.5M) as HYDROS system ASPs and international momentum drove mix benefits .
The launch of HYDROS drove 60 U.S. system sales at ~$460K blended ASP; U.S. handpiece revenue reached $29.3M despite an acute U.S. saline shortage that deferred an estimated 10–20% of Aquablation procedures in November .
2025 guidance: revenue ~$320M (+42% YoY), gross margin ~64.5%, OpEx ~$300M, adjusted EBITDA loss ~$35M; Q1 2025 revenue guide ~$65.5M with U.S. systems ~$18.7M and ~10,750 U.S. handpieces .
Stock reaction catalysts: margin trajectory into mid-60s, robust capital pipeline/greenfield focus, and clarity on FY25 volume drivers (HYDROS systems and handpieces) and international expansion (UK, Japan) .

What Went Well and What Went Wrong

What Went Well

HYDROS launch exceeded expectations: 95% of Q4 systems sold were HYDROS at ~$460K ASP; management highlighted FirstAssist AI adoption (“95% of procedures are using the AI”) and improved OR efficiency via integrated ultrasound and single-use digital scope .
Gross margin reached an all-time high of 64% in Q4 on higher ASPs and overhead leverage; full-year GM 61% vs 52% in 2023, reinforcing path-to-profitability narrative .
International inflected: Q4 OUS revenue $7.8M (+137% YoY) led by UK; FY25 OUS revenue guided to ~$32.5M (+36%), with Japan launches pending .

What Went Wrong

Acute U.S. saline shortage (Baxter facility disruption) deferred/cancelled 10–20% of expected Aquablation procedures (~up to 2,000) in Q4, pressuring handpiece ordering patterns; January saw lingering impacts, with February/March recovery .
Q4 OpEx of $63.4M was ~3.5% above internal expectations due to higher variable comp from HYDROS overachievement; FY25 OpEx guided up to ~$300M, including ~$10M front-loaded WATER IV spend and ~$19.5M incremental non-cash SBC .
FX losses offset some interest/other income in Q4; interest expense was $1.0M with $1.8M interest/other income; management cited FX headwinds .

Financial Results

Quarterly Trend (sequential)

Metric	Q2 2024	Q3 2024	Q4 2024
Revenue ($USD Millions)	$53.4	$58.37	$68.24
Gross Margin %	59%	63.2%	64%
Total Operating Expenses ($USD Millions)	$58.3	$59.3	$63.38
Net Loss ($USD Millions)	$(25.6)	$(20.97)	$(18.86)
Adjusted EBITDA ($USD Millions)	$(18.0)	$(12.43)	$(10.34)

Q4 Year-over-Year Comparison

Metric	Q4 2023	Q4 2024
Revenue ($USD Millions)	$43.58	$68.24
EPS (Basic & Diluted, $USD)	$(0.54)	$(0.35)
Gross Margin %	49%	64%
Total Operating Expenses ($USD Millions)	$50.81	$63.38
Net Loss ($USD Millions)	$(27.50)	$(18.86)
Adjusted EBITDA ($USD Millions)	$(23.28)	$(10.34)

Segment Breakdown (Q4 detail)

Segment	Q4 2023 ($USD ‘000s)	Q4 2024 ($USD ‘000s)
U.S. System Sales & Rentals	16,561	27,636
U.S. Handpieces & Consumables	21,633	29,325
U.S. Service	2,075	3,428
OUS System Sales & Rentals	1,398	3,711
OUS Handpieces & Consumables	1,645	3,689
OUS Service	269	447
Total Revenue	43,581	68,236

KPIs

KPI	Q3 2024	Q4 2024
U.S. installed base (systems)	445	505
U.S. systems sold in quarter (units)	45	60
Blended U.S. system ASP ($USD)	~$432,000	~$460,000
U.S. handpieces shipped (units)	~8,740	~8,750
U.S. handpiece ASP ($USD)	~$3,200	~$3,200
International revenue ($USD Millions)	$6.2	$7.8

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Total Revenue ($USD Millions)	FY 2025	N/A	~$320	Newly issued
Gross Margin %	FY 2025	N/A	~64.5%	Newly issued
Total Operating Expense ($USD Millions)	FY 2025	N/A	~$300	Newly issued
Adjusted EBITDA ($USD Millions)	FY 2025	N/A	~$(35)	Newly issued
Net Interest Income ($USD Millions)	FY 2025	N/A	~$13.5	Newly issued
Systems sold (units)	FY 2025	N/A	~210; ASP ~$430–$440K	Newly issued
U.S. handpieces (units)	FY 2025	N/A	~52,500; ASP ~$3,200	Newly issued
Other consumables ($USD Millions)	FY 2025	N/A	~$8	Newly issued
U.S. service ($USD Millions)	FY 2025	N/A	~$15.5	Newly issued
International revenue ($USD Millions)	FY 2025	N/A	~$32.5	Newly issued
Total Revenue ($USD Millions)	Q1 2025	N/A	~$65.5	Newly issued
U.S. System Revenue ($USD Millions)	Q1 2025	N/A	~$18.7	Newly issued
U.S. Handpieces (units)	Q1 2025	N/A	~10,750	Newly issued
Gross Margin %	Q1 2025	N/A	~64%	Newly issued
Total Operating Expense ($USD Millions)	Q1 2025	N/A	~$71	Newly issued
Gross Margin %	FY 2024	~59% (prior)	~61%	Raised in Q3

Earnings Call Themes & Trends

Topic	Previous Mentions (Q2 2024, Q3 2024)	Current Period (Q4 2024)	Trend
AI/Technology (HYDROS, FirstAssist AI)	FDA 510(k) clearance in Aug; elevated ASPs; integrated workflow; strong surgeon interest	95% of procedures using AI; minimal plan adjustments; positive staff and CFO feedback	Strengthening adoption
Supply Chain (Saline)	Early commentary on hurricane-linked IV solution pressures beginning in Oct; modest cancellations	Acute shortage in Nov → 10–20% procedure deferrals; Jan lingering, Feb/March recovery	Headwind dissipating
Macro/Hospital CapEx	Stable-to-improving CFO dialogue; prioritization of Aquablation	Robust capital pipeline; greenfield focus; ASP guide $430–$440K	Positive momentum
Product Performance	Q3 gross margin record 63.2%; HYDROS ASP lift	Q4 gross margin 64%; handpiece volumes resilient post-shortage	Sustained margin expansion
Regional Trends (UK/Japan)	UK momentum; first 2 systems sold to Japan; NICE support; ASPs comparable to U.S.	Q4 OUS +137% YoY; FY25 OUS ~$32.5M; UK utilization strong; Japan launches pending	Building internationally
Regulatory/Clinical	WATER IV PCa IDE approval; breakthrough device designation; CPT Cat I (effective 2026)	WATER IV enrollment acceleration planned; AUA 2025 data preview (PRCT-001/002)	Executing clinical strategy
R&D Execution	Elevated R&D spend for HYDROS; focus on ease-of-use/AI	~$10M 2025 spend front-loaded for WATER IV; R&D ~25% of revenue	Front-loaded 2025 investments

Management Commentary

“Total revenue for the fourth quarter of 2024 was $68.2 million… Growth… driven by increased robot sales and increased procedures, both at higher average selling prices and record international revenues.” — CEO Reza Zadno .
“In the fourth quarter, we sold 60 new robotic systems at a blended average selling price of approximately $460,000… over 95% of our U.S. system sales were comprised of HYDROS Systems.” — CFO Kevin Waters .
“FirstAssist AI… enables precise targeting… By tailoring the tissue removal plan… aims to enhance procedural accuracy and outcomes.” — CEO Reza Zadno .
“Given this acute macro challenge, we estimate a lack of saline resulted in a delay or cancellation of between 10% to 20% or up to 2,000 of our expected procedures in the fourth quarter.” — CCO Sham Shiblaq .
“We expect full year 2025 gross margins to be approximately 64.5%… and full year 2025 adjusted EBITDA loss to be approximately $35 million.” — CFO Kevin Waters .

Q&A Highlights

Saline shortage quantification and recovery: up to ~2,000 procedures deferred; February strong, March visibility; Q1 guidance assumes majority, not all, deferred cases return .
Pricing: Handpiece ASP steady at ~$3,200; HYDROS handpiece ASP expected to be higher over time but still early; system ASP guided $430–$440K with variability .
OpEx and clinical spend: FY25 OpEx up to ~$300M; ~$10M front-loaded for WATER IV; excluding incremental SBC, core OpEx growth ~20% YoY .
Replacement cycle: ~~10 replacements (~~$3M incremental FY25 revenue) modeled; longer-term replacements closer to greenfield ASP for older AquaBeam systems .
International: UK led strength; FY25 OUS ~$32.5M expected; Japan greenfield focus and reimbursement established .

Estimates Context

Wall Street consensus (S&P Global) for EPS and revenue could not be retrieved due to SPGI request limit at the time of analysis; estimate comparisons are unavailable for this recap. If desired, we can refresh and insert the consensus vs. reported metrics once access is restored.

Key Takeaways for Investors

HYDROS pricing power and feature set (AI-assisted planning, integrated ultrasound/digital scope) are driving capital momentum and mid-60s gross margin — supportive of a clearer path to profitability as volume scales .
Temporary saline headwind masked underlying utilization strength; early Q1 cadence suggests normalization with record account launches in March, supporting FY25 handpiece guidance (~52.5K) .
FY25 guide implies balanced growth: ~210 U.S. systems at ~$430–$440K ASP, ~63% unit growth in handpieces, and OUS expansion (UK/Japan) — diversified revenue drivers beyond U.S. greenfield .
Operating leverage: revenue outpacing OpEx (65% revenue growth vs 30% OpEx in FY24) and interest income tailwinds (~$13.5M FY25) offset some expense ramp; adjusted EBITDA loss narrowing to ~$35M .
Clinical/regulatory pipeline (WATER IV PCa randomized IDE, AUA 2025 data) creates medium-term optionality; near-term commercialization remains focused on BPH standard-of-care positioning .
Watch replacement cycle mix: near-term minimal dilution modeled (~10 units); longer-term replacements likely at near-greenfield pricing for older AquaBeam customers, supporting margin outlook .
Trading lens: monitor Q1 actuals vs guide (revenue ~$65.5M; handpieces ~10,750; GM ~64%) and HYDROS ASP realization quarter-to-quarter; upside if saline recovery accelerates and OUS outperforms .

Sources: Q4 2024 8-K and press release with full financials and guidance ; Q4 2024 earnings call (prepared remarks and Q&A) ; Prior quarters for trend analysis: Q3 2024 press release and call ; Q2 2024 call .

PROCEPT BioRobotics Corp (PRCT)·Q4 2024 Earnings Summary