Xtant Medical Holdings, Inc.
Rank #9Op. LeverageXTNT · NYSE · Healthcare
Xtant Medical Holdings, Inc. (XTNT) — Rank #9 by gross profitability (GP/assets 1.06) · ROE 12.4% · Piotroski F-Score 8 / 9.
As-of 2026-09-28 · CIK 0001453593 · all metrics point-in-time as of the filing date.
About
Xtant Medical Holdings, Inc. provides regenerative medicine products and medical devices for orthopedic and neurological surgeons in the United States and internationally.
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It offers OsteoSponge, a natural scaffold for cellular in-growth; OsteoSelect DBM Putty, a moldable demineralized bone matrix; OsteoSelect PLUS DBM Putty to deliver handling properties and ensure patient safety through validated and terminal sterilization; 3Demin, a family of allografts that maximizes osteoconductivity and the osteoinductive potential of human bone; OsteoFactor Pro, a processed allograft that contains retained growth factors found within the endosteum layer of allograft bone; OsteoVive Plus, an aseptically processed and viable bone allograft; and nanOss products that provide osteoconductive nano-structured hydroxyapatite and an engineered extracellular matrix bioscaffold collagen carrier. It also provides sports allografts for anterior and posterior cruciate ligament repairs, anterior cruciate ligament reconstruction, and meniscal repair; milled spinal allografts for cortical bone milled to desired shapes and dimensions; and traditional allografts for orthopedics, neurology, podiatry, oral/maxillofacial, genitourinary, and plastic/reconstructive applications. In addition, it offers cervical products comprising Spider cervical plating, Streamline OCT system, and CervAlign systems; thoracolumbar products, such as of Axle-X interspinous fusion, Streamline MIS spinal fixation, Streamline TL spinal fixation, and HPS 2.0 hybrid performance systems; Silex sacroiliac joint fusion systems; interbody products comprising Calix for cervical and thoracolumbar applications, Irix-C Cervical and Irix-A lumbar integrated dusion systems, and Fortilink implants; Contact ALP (Anterior Lumbar Plate) System; and interlaminar stabilization products, such as Coflex device for lumbar spinal stenosis; and CoFix implants for back and disc pain.
The company is headquartered in Belgrade, Montana.
- Industry
- Medical Devices
- Sector
- Healthcare
- State
- DE
- Filer Category
- Non-accelerated filerSmaller reporting company
- Fiscal Year End
- December 31
- Website
- xtantmedical.com
Company Snapshot
P/E and reverse DCF are the primary valuation lenses at this stage.
Market Cap
—
P/E (annual)
—
P/S (annual)
—
P/B
—
P/OCF (annual)
—
Shareholder Yield
—
Employees
151
Industry
Medical Devices
Exchange
NYSE
Signal Flags
Quality Profile
Profitability
1/1 passSafety
1/1 passCash Flow
3/3 passGrowth
1/2 passTerry Smith quality gate
Passes 2/5 Terry Smith thresholdsEarnings bubble check
Current margins may be above sustainable levels — a P/E based on peak earnings can overstate cheapness.
Operating margin expansion and free cash flow are the primary reads at this stage.
Profitability
Gross profitability (GP / assets)
1.06
Primary signal (Novy-Marx).
100th pctl of 20 SIC 3841 peers
Return on equity
12.4%
Gross margin
62.9%
42nd pctl of 20 SIC 3841 peers
Revenue growth (YoY)
14.2%
Gross margin improving
Margin trend vs prior year.
Operating Leverage
| 2022 | 2023 | 2024 | 2025 | |
|---|---|---|---|---|
| Revenue vs COGS | ||||
| Revenue vs OpEx | ||||
| Op. Income vs Revenue |
Growth
Revenue CAGR (3Y)
32.2%
Revenue CAGR (5Y)
20.2%
Earnings CAGR (3Y)
—
FCF CAGR (3Y)
—
Anti-fragile safety
Balance-sheet safety
Composite anti-fragile check.
Debt / equity
0.99
14th of 19 SIC 3841 peers (best = lowest)
Current ratio
2.16×
21st pctl of 20 SIC 3841 peers
Quick ratio
0.98×
Net cash
-$1.14M
Cash & equivalents minus total debt.
Recession resistance
Revenue through recessions
Worst single-year YoY revenue decline, 16 years of history
Cash-flow health
Free cash flow
$10.16M
Operating cash flow minus capex.
Positive free cash flow
FCF / net income
1.04
Cash-backing of earnings.
FCF/NI divergence
Unfavorable divergence (yellow flag).
Accruals healthy
Cash-backed earnings.
SBC / revenue
2.2%
Stock-based comp intensity.
Piotroski F-Score
F-Score
8 / 9
Fundamental-strength score (0-9).
Lifecycle Phase History
Lynch sell alert: Fast grower deceleration
Revenue growth decelerated to 14.2% after being classified hypergrowth as of 2024-12-31 -- Lynch's fast-grower rule: sell once growth slows below the pace that justified the label, not on price weakness.