Key Highlights

  • ATEC shares trading down 34.04% to $7.50, near the low end of their 52-week range of $6.82 to $23.29.
  • Third-quarter Revenue rose 13% to $221 million, which the company said fell short of its expectations.
  • Full-year 2026 revenue is now expected near $862 million, versus about $890 million in the February outlook.
  • Adjusted EBITDA guidance moved up to about $137 million, with a Q3 Margin of 17.3%.
  • Free Cash Flow is now guided to about $10 million, versus at least $20 million previously.

Lower Biologics Attachment Drives Third-Quarter Revenue Shortfall

Alphatec Holdings (NASDAQ:ATEC) shares are trading down 34.04% at $7.50 today after the company reported third-quarter results on October 29. Revenue rose 13% from a year earlier to $221 million, including $202 million of surgical revenue, up 14%. Management said revenue fell short of its expectations, mainly because of lower biologics attachment.

Alphatec is a spine-focused medical device company operating through Alphatec Spine, EOS imaging and SafeOp Surgical. It sells procedural solutions and a surgical technology platform to spine surgeons. Its fiscal third quarter ended September 30, 2026.

The company ended 2025 with annual revenue of $764.2 million, up 25%, after fourth-quarter sales of $213.0 million. Shares also fell more than 11% in after-hours trading in February when the 2026 outlook came in below consensus revenue estimates.

Profit Gains Overshadowed by a Reduced $862 Million Revenue Outlook

Adjusted EBITDA for the quarter was $38 million, a 17.3% margin that was up 400 basis points year over year. The GAAP net loss was $5 million, or $0.03 per share, while non-GAAP Net Income was $15 million. Ending cash was $80 million.

The company now expects 2026 revenue of about $862 million, roughly 13% growth, including about $789 million of surgical revenue and $73 million from EOS. That compares with about $890 million, or 17% growth, in the February outlook, which included roughly $805 million of surgical revenue and $85 million of EOS revenue.

Non-GAAP net income of $15 million contrasts with the GAAP loss, while top-line growth slowed to 13% from 20% in the fourth quarter of 2025. Guidance for surgical revenue growth of about 15% sits above the roughly 13% growth now expected for total revenue.

Higher EBITDA Guidance Offset by a Halved Free Cash Flow Target

Adjusted EBITDA guidance was lifted to about $137 million from about $134 million in February. However, free cash flow is now guided to about $10 million, down from a February outlook of at least $20 million.

At $7.50, and with about 154.5 million shares outstanding according to a data provider, the Market Value works out to roughly $1.16 billion. Trailing revenue was about $815 million. The average analyst price target listed by a data provider before today's drop was $15.79.

The company attributed the quarter's miss mainly to biologics attachment rather than to procedure demand, and its release does not quantify the revenue effect. The revised outlook also covers its EOS imaging systems business, now expected to contribute about $73 million this year.

Biologics Attachment and Fourth-Quarter Delivery Are the Next Tests

The shares are now trading close to the low end of their 52-week range after closing near $11.11 on October 23. Investors will watch whether biologics attachment recovers in the fourth quarter and whether the company delivers on its trimmed revenue and cash flow targets.