Financial Performance - Total revenue for Q3 2024 was $27.9 million, a 12% increase from $25.0 million in Q3 2023, and for the nine months ended September 30, 2024, revenue was $85.8 million, up 36% from $63.2 million in the same period last year[98] - Gross profit margin for Q3 2024 decreased to 58.4% from 61.3% in Q3 2023, while for the nine months it increased slightly to 60.9% from 60.7%[100] Cost and Expenses - Cost of sales increased by 20% to $11.6 million for Q3 2024, and by 35% to $33.6 million for the nine months ended September 30, 2024, primarily due to higher revenue[99] - General and administrative expenses rose 5% to $7.5 million for Q3 2024 and 35% to $23.0 million for the nine months ended September 30, 2024, driven by severance and stock-based compensation[101] - Sales and marketing expenses increased 7% to $11.9 million for Q3 2024 and 40% to $37.5 million for the nine months ended September 30, 2024, mainly due to higher commission expenses[102] - Research and development expenses were $0.7 million for Q3 2024, up from $0.5 million in Q3 2023, and $1.9 million for the nine months ended September 30, 2024, compared to $0.8 million in the prior year[103] - Interest expense for Q3 2024 was $1.2 million, up from $0.8 million in Q3 2023, and for the nine months it increased to $3.0 million from $2.1 million[104] Cash Flow and Working Capital - Net cash used in operating activities for the first nine months of 2024 was $12.6 million, compared to $8.6 million for the same period in 2023[107] - As of September 30, 2024, net working capital was $37.7 million, down from $41.9 million at the end of 2023[106] - The company has $7.1 million in cash and cash equivalents as of September 30, 2024, which, along with anticipated operating cash flows, is expected to meet cash requirements through at least November 2025[117] Financing and Debt - As of September 30, 2024, the company had $12.9 million outstanding and $3.8 million of availability under the Revolving Facility[114] - The effective interest rate for the Prior Term Credit Agreement was 14.42%, while the effective rate for the Prior Revolving Credit Agreement was 9.94% as of December 31, 2023[115] - The company maintained compliance with all covenants under the Credit Agreements as of September 30, 2024[116] - The company may seek additional financing through equity and debt financings, but there is no assurance that such financing will be available or sufficient[118] - If additional capital is raised through equity or convertible debt, current stockholders may face dilution and adverse terms[119] Acquisitions - The company made three acquisitions in 2023, including Surgalign SPV for $17.0 million, additional assets from Surgalign Holdings for $5 million, and nanOss production operations for $2 million[93][94][95] Accounting Estimates - There have been no changes in critical accounting estimates for the three months ended September 30, 2024, compared to the previous fiscal year[121]

Revenue Performance - Third quarter 2024 revenue was $27.9 million, representing a 12% increase compared to $25.0 million in the prior year quarter[2] - Year-to-date revenue reached $85.8 million, up 36% compared to the prior year period[2] - Full year 2024 revenue guidance is reaffirmed at $116 million to $120 million, indicating annual growth of 27% to 31%[10] - Revenue for the three months ended September 30, 2024, was $27,937,000, a 11.5% increase from $25,019,000 in the same period of 2023[17] Profitability and Loss - Gross margin for the third quarter of 2024 was 58.4%, down from 61.3% in the prior year quarter[5] - Net loss for the third quarter of 2024 was $5.0 million, compared to net income of $9.2 million in the prior year quarter[7] - Adjusted EBITDA for the third quarter of 2024 was a loss of $196,000, compared to a gain of $440,000 in the prior year[8] - Gross profit margin decreased to 58.4% in Q3 2024 from 61.3% in Q3 2023[17] - Net loss for the three months ended September 30, 2024, was $(5,024,000), compared to a net income of $9,231,000 in the same period of 2023[17] - Non-GAAP Adjusted EBITDA for the three months ended September 30, 2024, was $(196,000), a decrease from $440,000 in the same period of 2023[19] Operating Expenses - Operating expenses for the third quarter of 2024 totaled $20.1 million, an increase of 7.3% compared to $18.7 million for the third quarter of 2023[6] - Total operating expenses increased to $20,084,000 in Q3 2024, up from $18,719,000 in Q3 2023, representing a 7.3% increase[17] - Research and development expenses increased to $701,000 in Q3 2024 from $490,000 in Q3 2023, reflecting a focus on innovation[17] - The company incurred interest expenses of $1,199,000 in Q3 2024, compared to $760,000 in Q3 2023, indicating increased borrowing costs[17] Cash Position - Cash and cash equivalents as of September 30, 2024, were $6.6 million, up from $5.7 million as of December 31, 2023[9] - Cash used in operating activities for the nine months ended September 30, 2024, was $(12,561,000), compared to $(8,600,000) in the same period of 2023[18] - Net cash used in investing activities was $(3,163,000) for the three months ended September 30, 2024, compared to $(22,471,000) in Q3 2023[18] - The company reported a total cash and restricted cash of $7,086,000 at the end of the period, down from $8,749,000 at the end of Q3 2023[18] Product Development - The company launched two new products: OsteoVive+ and Cortera Posterior Fixation System during the third quarter[2] - A license agreement for Q-Codes and SimpliMax Dual Layer Amniotic Membrane is expected to generate a minimum of $5.25 million in licensing and royalty fees[2]

Financial Data and Key Metrics Changes - Total revenue for Q2 2024 was $29.9 million, a 48% increase from $20.2 million in Q2 2023, primarily driven by product sales from the recently acquired Surgalign Hardware and Biologics business [14] - Adjusted EBITDA for Q2 2024 was $0.5 million, compared to $0.1 million in the same period in 2023, marking the fifth consecutive quarter of positive adjusted EBITDA [5][16] - Net loss for Q2 2024 was $3.9 million or $0.03 per share, compared to a net loss of $2.2 million or $0.02 per share in Q2 2023 [16] Business Line Data and Key Metrics Changes - Organic growth for Q2 was flat compared to the prior year, mainly due to planned cannibalization of X-spine hardware and significant OEM sales in Q2 2023 [4] - The top 20 distributors grew 16.5% in revenue since the acquisition of Surgalign in Q3 2023 [6] - The company expanded its Biologics product offering from two categories to five, with the introduction of a sixth category, amniotic membrane allografts [7] Market Data and Key Metrics Changes - The distribution network now includes over 650 distributors, covering approximately 90% of all beds in the U.S. [9] - The company is focusing on increasing penetration into existing distributors rather than just adding new ones [9] Company Strategy and Development Direction - The company aims to achieve self-sustainability by controlling its supply chain and reducing reliance on external production [12] - Key growth pillars include new product introductions, distribution network expansion, adjacent market penetration, and strategic acquisitions [11] - The company is targeting undercapitalized or subscale companies for acquisitions to enhance capabilities and expand production capacity [11] Management's Comments on Operating Environment and Future Outlook - Management expects organic growth to accelerate in the second half of 2024 as supply chain challenges abate and new products are introduced [4] - The company anticipates positive operating cash flow by Q4 2024, driven by increased production of its own biologics [13][41] - Management is optimistic about the growth potential of the amniotic tissue products and the stem cell business [28][33] Other Important Information - The company entered into an agreement for a $5 million PIPE with an existing institutional investor to provide additional working capital [17] - Gross margin for Q2 2024 was 62.1%, an increase from 61.6% in Q2 2023, attributed to greater scale and improved production efficiency [14] Q&A Session Summary Question: Can you provide color on the revenue mix between orthobiologics and spinal implants? - Management noted that Surgalign hardware significantly contributed to revenue, helping to replace older X-spine hardware, and expects an increase in self-produced products in the second half of the year [18][19] Question: How does the guidance look for the balance of the year? - Management indicated an expected uptick in Q3 and a strong performance in Q4, particularly with the ramp-up of the Stem Cell business [21][22] Question: What are the expectations for gross margins moving forward? - Management expects gross margins to remain steady in Q3 and Q4, with a significant uptick anticipated in Q1 2025 as internal production increases [24] Question: Can you discuss the opportunities in the amniotic product line? - Management highlighted the OEM opportunities and the potential for high margins, noting that sourcing amniotic tissue is currently a limiting factor [28][30] Question: How quickly can the company ramp up production for stem cells? - Management indicated that production ramp-up would occur over the next three to four months, with a focus on fulfilling OEM opportunities first [34][36] Question: What is the outlook for sustainable cash flow? - Management does not expect cash flow breakeven in Q1 2025 but anticipates that it will be sustainable thereafter [39]

Financial Performance - Total revenue for Q2 2024 was $29.9 million, a 48% increase from $20.2 million in Q2 2023, and $57.8 million for the first half of 2024, up 51% from $38.2 million in the same period last year[84] - Cost of sales increased by 46% to $11.4 million for Q2 2024, and by 44% to $21.9 million for the first half of 2024, primarily due to increased revenue[85] - Gross profit margin improved to 62.1% for both Q2 and the first half of 2024, compared to 61.6% and 60.2% respectively in 2023, driven by greater scale and improved production efficiency[86] Expenses - General and administrative expenses rose 56% to $7.7 million in Q2 2024, and 58% to $15.5 million for the first half of 2024, largely due to increased headcount and compensation expenses[87] - Sales and marketing expenses increased by 51% to $13.2 million in Q2 2024, and by 63% to $25.6 million for the first half of 2024, mainly due to higher commission expenses from revenue growth[89] - Research and development expenses were $0.6 million for Q2 2024, up from $0.2 million in Q2 2023, and $1.2 million for the first half of 2024, compared to $0.4 million in the same period last year[90] Interest and Cash Flow - Interest expense for Q2 2024 was $1.0 million, compared to $0.8 million in Q2 2023, reflecting additional borrowings on the revolving line of credit[91] - Net cash used in operating activities for the first half of 2024 was $10.8 million, an increase from $4.8 million in the same period of 2023[94] Acquisitions - The company made three acquisitions in 2023, including Surgalign SPV for $17.0 million, additional assets from Surgalign Holdings for $5 million, and nanOss production operations from RTI Surgical for $2 million[79][80][81] Debt and Financing - As of June 30, 2024, the company had $11.9 million outstanding under its revolving credit facility, with $5.1 million available[98] - As of June 30, 2024, the company had $5.5 million in cash and cash equivalents, supplemented by a recent $5.0 million private placement, expected to meet cash requirements through at least August 2025[102] - The effective interest rate for the Prior Term Credit Agreement was 14.42%, while the effective rate for the Prior Revolving Credit Agreement was 9.94% as of December 31, 2023[100] - The company is in compliance with all covenants under the Credit Agreements as of June 30, 2024, which include maintaining net product revenue and minimum liquidity levels[101] - The company may seek additional financing through equity and debt financings, with no assurance that such funds will be available or sufficient to meet operational needs[103] - If additional capital is raised through equity or convertible debt, current stockholders may face dilution and adverse terms[104] Accounting and Compliance - There have been no changes in critical accounting estimates for the three months ended June 30, 2024, compared to the previous fiscal year[106] - The company may require additional capital to fund future operations and business strategy prior to August 2025[102] - The Credit Agreements impose restrictions on incurring additional indebtedness, engaging in mergers or acquisitions, and paying dividends[101] - The company’s financial statements are prepared in accordance with U.S. GAAP, requiring estimates and assumptions that may materially differ from actual results[105] - As a smaller reporting company, the company is not required to provide detailed market risk disclosures[107]

Exhibit 99.1 Xtant Medical Reports Second Quarter 2024 Revenue Growth of 48% BELGRADE, Mont., August 8, 2024 — Xtant Medical Holdings, Inc. (NYSE American: XTNT), a global medical technology company focused on surgical solutions for the treatment of spinal disorders, today reported financial and operating results for the second quarter ended June 30, 2024. Second Quarter 2024 Financial Highlights ● Revenue of $29.9 million, up 48%, compared to the prior year quarter ● Gross margin of 62.1%, up 50 basis poin ...

Xtant Medical Holdings, Inc. (NYSE:XTNT) Q1 2024 Results Conference Call May 15, 2024 4:30 PM ET Company Participants Brett Maas - Managing Partner, Hayden IR Sean Browne - President and Chief Executive Officer Scott Neils - Chief Financial Officer Conference Call Participants Ryan Zimmerman - BTIG Chase Knickerbocker - Craig-Hallum Operator Greetings. Welcome to the Xtant Medical Holdings, Inc. First Quarter 2024 Conference Call. At this time, all participants are in a listen-only mode. A question-and-answ ...

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-Q (Mark One) ☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the quarterly period ended March 31, 2024 or ☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from ___________ to ___________ Commission File Number: 001-34951 XTANT MEDICAL HOLDINGS, INC. (Exact name of registrant as specified in its charter) | Delaware | ...

Exhibit 99.1 Xtant Medical Reports First Quarter 2024 Revenue Growth of 55% and Raises Full Year 2024 Revenue Guidance ● Revenue of $27.9 million, up 55%, compared to the prior year quarter ● Gross margin of 62.1%, up 340 basis points, compared to the prior year quarter ● Net loss of $4.4 million compared to $2.1 million in the year ago quarter ● Positive Adjusted EBITDA; Adjusted EBITDA of $0.1 million compared to an Adjusted EBITDA loss of $0.3 million in the prior year quarter ● Launched two amniotic mem ...

Xtant Medical Holdings Inc. (NYSE:XTNT) Q4 2023 Earnings Conference Call April 1, 2024 9:00 AM ET Company Participants Matt Steinberg - FINN Partners, IR Sean Browne - President & CEO Scott Neils - CFO Conference Call Participants Ryan Zimmerman - BTIG Chase Knickerbocker - Craig-Hallum Operator Greetings, and welcome to the Xtant Medical Fourth Quarter and Full-Year 2023 Financial Results Conference Call. A question-and-answer session will follow the formal presentation. Currently, everyone is in a listen- ...

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-K (Mark One) ☒ ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended December 31, 2023 or ☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from ________________ to __________________ Commission file number: 001-34951 XTANT MEDICAL HOLDINGS, INC. (Exact name of registrant as specified in its charter) Delawa ...