Carlsmed (CARL) Stock Fundamentals, Analysis & Risk Signals

Health score, price, valuation, risk signals, and key metrics at a glance.

Carlsmed

NasdaqGS•Healthcare•Health Information Services

$15.60+0.08(0.01%)Market closed

Market Cap

$418.47M

P/S

5.7x

P/B

5.0x

Carlsmed, Inc., a commercial-stage medical technology company, designs, manufactures, and markets AI-enabled personalized spine surgery solutions. The company develops aprevo, a comprehensive technology platform for spine fusion surgery procedures. Its aprevo platform includes proprietary surgical planning software, using outcomes-based algorithms that are aided with artificial intelligence, and resulting custom-built, anatomically designed vertebral interbody implants. The company was incorporated in 2018 and is based in Carlsbad, California.

How this company scores

WeakMetricSide Score: 39/100

Grade capped at D — Interest coverage below 1× (-35.5x) — earnings cannot cover interest. Strongest: Balance Sheet & Red Flags (15/25); weakest: Profitability (6/25).

Profitability6/25

Growth10/25

Balance Sheet & Red Flags15/25

Cash & Earnings Quality8/25

Strengths

Low leverageCash-backed earningsConsistent growthNet cash position

Grade capped at D

Interest coverage below 1× (-35.5x) — earnings cannot cover interest.

Valuation vs. 5-year range

Today's multiple positioned against its own trailing range — a visual premium/discount check.

P/S · 5.7x5y range 3.7x – 5.7x

P/B · 5.0x5y range 1.9x – 5.0x

Currently above its 4-quarter median.

Watch items

Data-driven signals worth keeping an eye on across the last 8 quarters

High Risk

Margin Pressure

Red Flag

The company posted negative operating margins in recent quarters — core operations are unprofitable.

Earnings Quality

Red Flag

Free cash flow has been negative in 5 of the last 5 quarters — earnings are not translating to cash.

Price & Volume

Market Cap $418.47M

Metrics at a Glance

as of June 2026

Revenue & Profit

Revenue, EBITDA, operating income, net income, EPS, and shares

TTM Revenue: $73.48M
Q. Revenue: $18.94M
TTM EBITDA: $-43.98M
TTM Op. Income: $-44.38M
Q. Op. Income: $-11.04M
TTM Net Income: $-42.07M
Q. Net Income: $-10.51M
EPS: $-0.39
Shares Out.: $27.19M

$73.48M in TTM revenue grew from zero YoY, reaching $18.94M last quarter. TTM EBITDA of $-43.98M and TTM operating income of $-44.38M show growth is flowing through to the bottom line. However, net income is negative at $42.07M — growth is not yet reaching the bottom line. Across the last 5 quarters, TTM revenue has risen for 2 consecutive quarters — an improving trend.

Margins

Gross, EBITDA, operating, and net margin trends

Gross Margin: 76.8%
EBITDA Margin: -57.6%
Op. Margin: -58.3%
Net Margin: -55.5%

Op. margin of -58.3% is down 4.5% YoY — costs are rising relative to revenue. Net margin at -55.5% and gross margin of 76.8% show how much of each revenue dollar survives to profit. Over the past year, operating margin is down 8% — a weakening trend.

Price Ratios

P/E, P/S, P/B, EV/EBITDA, FCF yield, and earnings yield

P/E Ratio: N/A
P/S Ratio: 5.7x
P/B Ratio: 5.0x

P/S of 5.7x and P/B of 5.0x.

Assets & Liabilities

Total assets, cash, debt, book value, and leverage

Total Assets: $118.20M
Cash: $46.24M
Long-Term Debt: $15.38M
Book Value: $84.25M
D/E Ratio: 0.2
Debt/EBITDA: N/A

With $118.20M in assets and $15.38M in long-term debt, D/E is 0.2and book value is $84.25M — a conservative capital structure with a cushion to weather downturns. Across the last 4 quarters, debt/equity has risen for 3 consecutive quarters — a weakening trend.

Cash Flow

Operating cash flow, free cash flow, FCF margin, and earnings quality

Op. Cash Flow: $-7.36M
TTM Free Cash Flow: $-34.58M
FCF Margin: -47.1%
FCF / Net Income: 0.8

TTM FCF of $-34.58M on $-7.36M in operating cash flow. The FCF / Net Income ratio of 0.8x means free cash flow covers net income — earnings are backed by cash. Over the past year, free cash flow is up 0% — an improving trend.