Alphatec Holdings, Inc. (ATEC)

Key figures

The last twelve months reported, with the latest price and balance sheet.

Revenue, last twelve months

$815.1M

Revenue growth

19.5%

Net income, last twelve months

-$110.0M

Earnings per share

-$0.71

Gross margin

70.8%

Operating margin

-6.0%

Net margin

-13.5%

Free cash flow

$2.3M

Market value

$1.8B

Cash

$118.7M

Debt

$575.8M

Shares outstanding

154.5M

Financial statements

Revenue, profit and cash flow by fiscal year, each year linked to its annual report.

By quarter

What the company said with its results

From the second quarter of fiscal 2026 results, filed 4 August 2026.

• Revenue rose 15% to $214 million. Total revenue was $214 million, up from $185.5 million a year earlier. Six-month revenue was $405.6 million against $354.7 million.
• Operating loss narrowed year-over-year. The operating loss was $1.9 million against $13.1 million a year earlier. The six-month operating loss was $24.5 million against $57.4 million.
• GAAP loss narrowed; non-GAAP income positive. GAAP net loss was $25.8 million, or $0.16 per share, against $41.1 million, or $0.27. Non-GAAP net income was $11.4 million, or $0.07 per share.
• Surgical revenue up 17%. Surgical revenue was $196 million, up $28 million year-over-year. Management attributed the increase to case volume growth.
• Surgeon users grew 24%. Net new surgeon users rose 24%. Management linked this to continued growth in its surgeon base.
• Procedural approach cited as differentiator. Management said its procedural approach gives the company a distinct position in the spine market.
• Adjusted EBITDA margin up 420 basis points. Adjusted EBITDA was $36 million, or 16.8% of revenue, against $23.5 million a year earlier.
• Six-month margin up 440 basis points. Six-month adjusted EBITDA was $56.7 million, or 14.0% of revenue, against $34.0 million a year earlier.
• Stock compensation added back to EBITDA. Stock-based compensation of $18.1 million was added back in reaching adjusted EBITDA, against $15.6 million a year earlier.
• GAAP gross margin 72.2%. GAAP gross margin was 72.2% against 69.6%. Non-GAAP gross margin was 72.5% against 69.9%.
• Non-GAAP operating expenses rose. Non-GAAP operating expenses were $134.6 million against $121.7 million, excluding stock-based compensation, amortization and litigation items.
• Sales, general and administrative expense rose. GAAP sales, general and administrative expense was $134.0 million against $118.5 million. Stock-based compensation within that line was $14.0 million.
• Litigation-related expenses fell. Litigation-related expenses were a credit of $0.1 million against a $1.6 million charge a year earlier. The six-month charge was $0.4 million against $13.8 million.
• Revenue expectation reaffirmed. Management reaffirmed its full-year revenue expectation and kept the surgical and EOS revenue components.

Revenue by segment

As the company reports it in the segment note of its annual report.

By region, FY2025

Company events

The newest 8-K filings of 270 held.

Every filing

The newest filings with the SEC of 564 held.

Insider trades

Form 4 trades by officers, directors and 10% owners, last 12 months.

Planned insider sales

Form 144 notices, filed when the sell order goes to the broker.

Large holders

Schedule 13D and 13G filings by holders of more than 5% of the voting shares.

Short interest

Shares sold short and not yet bought back, on each FINRA settlement date.

Funds that hold it

From each fund's latest Form 13F.

320 funds held it at 30 Jun 2026: 137 added and 82 trimmed in the quarter. The largest:

Peers

Companies in the same industry.

• Stryker Corp. (SYK): revenue $25.8B, market value $116.7B
• 3M Co. (MMM): revenue $25.2B, market value $89.3B
• Boston Scientific Corp. (BSX): revenue $21.0B, market value $61.4B
• Becton Dickinson & Co. (BDX): revenue $20.8B, market value $53.2B
• Resmed Inc. (RMD): revenue $5.7B, market value $36.1B
• Dexcom Inc. (DXCM): revenue $5.0B, market value $29.7B
• West Pharmaceutical Services Inc. (WST): revenue $3.3B, market value $28.4B
• Medline Inc. (MDLN): revenue –, market value $27.9B
• Solventum Corp. (SOLV): revenue $8.3B, market value $13.9B
• Baxter International Inc. (BAX): revenue $11.5B, market value $13.2B

What the company does

Alphatec Holdings, Inc. is a medical technology company headquartered in Carlsbad, California. It designs and develops technology for the surgical treatment of spine disorders, and says its focus is 100% on the spine. Its products are sold through exclusive independent sales agents and direct sales representatives. As of 31 December 2025 it had 913 employees. It is a Delaware corporation incorporated in March 2005.

What it sells

The company earns its revenue mainly from spinal surgery implants and from medical imaging equipment. The implants include pedicle screws and complementary implants, interbody devices, plates and tissue-based materials. Its implants are made from materials including allograft, PEEK, porous titanium and 3D printed titanium. Invictus is its spinal fixation system, designed for open, minimally invasive or hybrid approaches.

Its biologics are allograft products meant to aid spinal fusion. They include 3D ProFuse Osteoconductive Bioscaffold, the AlphaGRAFT family, BioCORE Moldable Bioactive Graft and Amnioshield Amniotic Tissue Barrier. The company also offers procedure-specific access systems for PTP, LTP, ALIF, ACDF and TLIF procedures, and a patient positioning system built for the Prone TransPsoas ("PTP") approach.

The surgical approaches

Alphatec builds its products around complete surgical approaches rather than individual implants. PTP, launched in 2020, positions the patient face down and allows access to the spine from the side and the back in one position. The company later added the Lateral TransPsoas ("LTP") and Midline ALIF approaches, which it says were built to allow single-position surgery across the most commonly treated lumbar levels. It also sells products for adolescent idiopathic scoliosis and deformity, such as InVictus Direct Vertebral Rotation.

The InformatiX platform

The IX platform has four parts. The first is the EOS imaging system, which produces full-body, calibrated 3D images. The second is EOS Insight, a web and mobile platform for alignment assessment and surgical planning, launched in 2024. The third is SafeOp, which automates EMG, SSEP and MEP nerve monitoring during surgery. The fourth is Valence, a navigation-enabled robotics platform acquired in 2023. The company obtained regulatory clearance to place Invictus screws through Valence late in 2023.

Who buys and how it sells

Products are shipped and invoiced to hospitals and surgical centers. In the United States, surgeons typically decide which products to use, and the company generally invoices the hospital for the products used. Independent sales agents are paid commissions based on payment received from the hospital. Direct sales employees receive salaries and incentive bonuses. EOS equipment is sold by a capital sales team that focuses on hospital administrators. Services such as imaging equipment maintenance make up less than 10% of total revenue.

Most sales are made in the United States. Outside it, the company is building a surgical implant business in Australia, New Zealand and Japan. In the United States, hospitals depend on private insurers and on Medicare and Medicaid to pay for spine surgery, so reimbursement policies affect demand for its products.

Training surgeons

Surgeon education is a central part of how the company wins customers. The "ATEC Experience" is an educational program for visiting surgeons at the Carlsbad headquarters. It uses a 7-station cadaveric lab and a peer-to-peer teaching approach. The company also trains its independent sales agents and direct sales representatives.

How products are made

The company relies on third-party suppliers to manufacture all of its implants and instruments. Raw materials are principally titanium, titanium alloys, stainless steel, cobalt chrome, ceramic, allograft and PEEK. Invibio is one of a limited number of PEEK suppliers, and the company names it as a supply risk. For biologics, the company is FDA-registered and licensed in California, New York and Florida, the only states that currently require licenses. It opened a distribution facility in Memphis, Tennessee. Most product development takes place in Carlsbad, where it has a rapid prototyping cell, a cadaveric lab and a mechanical testing laboratory.

As of 31 December 2025, the company and its affiliates owned or exclusively licensed 178 issued U.S. patents, 51 pending U.S. patent applications and 268 issued or pending foreign patents.

Competition and regulation

It notes that many competitors have greater financial resources and more established distribution networks. The FDA regulates its products. Its current U.S. products include Class II spinal implants, instruments, neuromonitoring systems, robotic navigation systems, x-ray imaging systems and software marketed under 510(k) premarket clearance, along with Class I exempt instruments. Its tissue products are also regulated under the Public Health Service Act. The company is also subject to healthcare fraud and abuse laws, including the federal Anti-Kickback Statute and the False Claims Act.

Its people

Of the 913 employees, about 706 were in the United States and 207 were outside it. Of the U.S. employees, 411 worked at the Carlsbad headquarters, across functions from sales and clinical education to advanced manufacturing and regulatory affairs. The company reports no employees under collective bargaining agreements and says it has never had a work stoppage.

*From Alphatec's annual report on Form 10-K for the year ended 31 December 2025. [The filing](https://www.sec.gov/Archives/edgar/data/1350653/000119312526067393/atec-20251231.htm)*

From the company's 10-K.