Sanara MedTech (Nasdaq: SMTI) reported Q4 2025 GAAP EPS of -$0.13, missing the consensus estimate of +$0.11, while full-year 2025 revenue crossed the $100 million milestone at $103.1 million (+19% YoY). The stock declined approximately 2.73% in pre-market trading following the earnings announcement on March 24, 2026.
About Sanara MedTech Inc.
Sanara MedTech Inc. (Nasdaq: SMTI) is a Fort Worth, Texas-based medical technology company focused on developing and commercializing transformative technologies to improve clinical outcomes and reduce healthcare expenditures in the surgical market. Founded and listed on the Nasdaq exchange, the company develops, markets, and distributes surgical products to surgeons at hospitals and surgical centers across North America.
Its flagship products include CellerateRX Surgical Activated Collagen Powder, BIASURGE Advanced Surgical Solution, FORTIFY TRG Tissue Repair Graft, FORTIFY FLOWABLE Extracellular Matrix, and a portfolio of advanced biologic products targeting soft tissue repair and bone fusion. As of March 24, 2026, SMTI carried a market capitalization of approximately $159 million, with approximately 141 employees and annual revenue per employee of roughly $731,333.
The company operates with no dividend yield and no P/E ratio (given net losses from discontinued operations), but it maintains a forward P/E of approximately 26.94x based on 2026 earnings expectations. Analysts rated the stock a Strong Buy with a 12-month price target of $41.00. The company holds a five-year revenue CAGR of approximately 49%, reflecting its rapid commercial expansion since 2019.
Top Financial Highlights
Key data points from Q4 2025 and Full Year 2025 results (from continuing operations unless noted):
- Q4 2025 Total Revenue reached $27.5 million, a 5% increase year-over-year (13% increase excluding Hurricane Helene-related BIASURGE sales in Q4 2024)
- Full Year 2025 Revenue grew 19% to $103.1 million, compared to $86.7 million in 2024
- Q4 2025 Gross Profit was $25.7 million with gross margin expanding to 93% of net revenue, up from 91% in Q4 2024
- Full Year 2025 Gross Profit totaled $95.6 million, driven by lower CellerateRX Surgical manufacturing costs
- Q4 2025 EPS (GAAP, continuing ops) came in at -$0.13, missing the consensus estimate of +$0.11
- Full Year 2025 Net Loss (continuing ops) was -$0.4 million (significantly improved from -$1.9 million in 2024)
- Full Year 2025 Net Loss (total, including discontinued ops) was -$37.6 million, inflated by a $26.5 million noncash asset impairment tied to Tissue Health Plus (THP) discontinuation
- Soft Tissue Repair Products generated Q4 revenue of $24.7 million (+5% YoY); full-year revenue of $91.3 million (+20% YoY)
- Bone Fusion Products contributed $2.8 million in Q4 (+2% YoY) and $11.8 million for the full year (+12% YoY)
- Q4 2025 Adjusted EBITDA was $4.7 million, up from $4.1 million in Q4 2024
- Full Year 2025 Adjusted EBITDA was $17.0 million, nearly double the $9.1 million recorded in 2024
- Operating Cash Flow for full year 2025 was $6.8 million, a dramatic turnaround from -$23.8 thousand in 2024
- Cash on Hand as of December 31, 2025 was $16.6 million (up from $15.9 million in 2024)
- Full Year 2026 Revenue Guidance reaffirmed at $116 million to $121 million (13% to 17% growth)
Fourth Quarter and Full Year 2025 Revenue
Beat or Miss?
| Metric | Reported | Analyst Estimate | Difference / Analysis |
| Q4 2025 Revenue | $27.5M | $27.40M | Beat by ~$0.15M (+0.53%) |
| Q4 2025 GAAP EPS (continuing ops) | ($0.13) | $0.11 | Missed by $0.24 (-218%) |
| Full Year 2025 Revenue | $103.1M | ~$102.55M | Slightly beat |
| Full Year 2025 GAAP EPS | ($4.36) | $0.20 | Significant miss (THP impairment distortion) |
| Q4 2025 Adjusted EBITDA | $4.7M | N/A | No consensus estimate available |
| Full Year 2026 Revenue Guidance | $116M to $121M | N/A | In line with January 2026 pre-release guidance |
The GAAP full-year EPS miss was primarily driven by the $26.5 million noncash impairment charge from the discontinued Tissue Health Plus segment, which does not reflect core surgical business performance. Adjusted EPS from continuing operations (non-GAAP) came in at $0.04, still missing the Zacks consensus of $0.11.
What Leadership Is Saying?
CEO Seth Yon on Strategy and Vision
“We are pleased to deliver strong sales performance in 2025, achieving our first full year of net revenue in excess of $100 million, with 19% growth year-over-year. Our sales performance reflected impressive commercial execution by our field sales team, who continued to develop our distributor relationships, while educating potential surgeon customers in both new and existing healthcare facilities.
As a result, we made notable progress in expanding our network of distributors, facility customers, and surgeon users. Importantly, we complemented our full year net revenue growth by expanding our gross margins and demonstrating operating leverage, enabling Sanara to achieve significant year-over-year improvements in our profitability profile, while generating $6.8 million of cash from operating activities.”
“Sanara enters 2026 as a pure play surgical business with a singular focus on the surgical operating setting, a proven commercial strategy, and a compelling margin profile. We are reaffirming our net revenue guidance today, which calls for full year net revenue growth of 13% to 17% year-over-year in 2026, and look forward to delivering against these expectations. Our team is focused this year on building on our recent progress and expanded market access by executing our commercial strategy, while investing in key strategic initiatives, including increasing R&D expenditure to support our existing products and pipeline.”
CFO Elizabeth Taylor’s Financial Context
Elizabeth Taylor, who joined Sanara as Chief Financial Officer in January 2025 with over 25 years of financial expertise and prior CFO experience at a medical device firm specializing in wound treatment, has been building out the company’s financial reporting infrastructure.
While the Q4 2025 press release did not include a separate CFO statement, the financial results themselves reflect improved balance sheet management: operating cash flow turned sharply positive to $6.8 million for the full year 2025, compared to essentially breakeven in 2024. Long-term debt increased to $46.0 million (from $30.7 million), partially due to the CRG term loan used to fund strategic investments.
Historical Performance (Q4 YoY)
| Category | Q4 2025 | Q4 2024 | Change (%) |
| Total Net Revenue | $27.5M | $26.3M | 5.00% |
| Soft Tissue Repair Revenue | $24.7M | $23.5M | 5.10% |
| Bone Fusion Revenue | $2.8M | $2.8M | 1.80% |
| Gross Profit | $25.7M | $24.1M | 6.60% |
| Gross Margin | 93% | 91% | +175 bps |
| Total Operating Expenses | $24.6M | $21.8M | 12.80% |
| Operating Income | $1.1M | $2.3M | -52.60% |
| Net Income (Loss) from Cont. Ops | -$1.1M | +$0.9M | N/M |
| Adjusted EBITDA | $4.7M | $4.1M | 14.60% |
| Operating Cash Flow (Q4) | $3.9M | $0.9M | 333% |
Competitor Performance
Comparison (Full Year 2025 vs 2024)
| Category | Sanara MedTech (SMTI) FY2025 | Organogenesis (ORGO) FY2025 | Smith and Nephew (SNN) FY2025 |
| Total Revenue | $103.1M (+19% YoY) | $563.0M (+17% YoY) | $6,164M (+6.1% YoY) |
| Net Income (Loss) | -$37.6M (incl. THP impairment) | +$37.0M | N/A (see trading profit) |
| Operating Expenses | $88.3M | $162.3M (Q4 alone) | N/A (uses trading profit metric) |
| Gross Margin | ~93% (Q4) | ~78% (Q4) | 19.7% trading margin |
| Adjusted EBITDA | $17.0M | $84.2M (Q4 alone) | $1,211M trading profit |
| 2026 Revenue Guidance | $116M to $121M | Revenue expected to decline 25% to 38% | 6% organic growth expected |
Organogenesis benefited from a CMS reimbursement tailwind in 2025 that significantly boosted its wound care revenue (+78% in Q4), but faces a sharp reversal in 2026 as that tailwind dissipates. Sanara MedTech’s surgical focus insulates it from those reimbursement dynamics. Smith and Nephew operates at an entirely different scale and diversification as a global med-tech leader.
How the Market Reacted?
Following the Q4 2025 earnings announcement released before market open on March 24, 2026, Sanara MedTech’s stock declined approximately 2.73% in premarket trading, reflecting investor disappointment over the GAAP EPS miss of $0.24 relative to consensus expectations. The stock was trading at approximately $17.74 on the announcement day, representing a -9.1% decline year-to-date in 2026 and a -21.5% decline since the beginning of 2025.
Despite the near-term selling pressure, the underlying report carried several bullish signals: gross margin expansion to 93%, a major turnaround in operating cash flow to positive $6.8 million, and reaffirmed 2026 guidance of $116 million to $121 million. Analysts maintained a Strong Buy rating with a 12-month price target of $41.00, implying more than 130% upside from current levels, suggesting the market may be pricing in concerns about leverage ($46 million in long-term debt) and the earnings miss rather than the company’s long-term surgical growth trajectory.
