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Dec 31, 2025
Neuropace Q4 2025 Earnings Report
Neuropace Q4 2025 Earnings Report
Key Takeaways
NeuroPace delivered a strong fourth quarter with 24% revenue growth and significant gross margin expansion, reaching $26.6 million in total revenue. The company achieved its second consecutive quarter of positive Adjusted EBITDA and made strategic progress with FDA submissions for IGE indication and AI-driven tools.
Quarterly revenue grew 24% year-over-year to $26.6 million, driven by a 26% increase in RNS System sales.
GAAP gross margin improved to 77.4%, a 200-basis point increase from the prior year's quarter.
Submitted a PMA-Supplement to the FDA for the Idiopathic Generalized Epilepsy (IGE) indication following successful NAUTILUS trial results.
Ending commercial partnership with DIXI Medical as of December 31, 2025, to focus on core RNS business.
Revenue by Segment
Forward Guidance
NeuroPace expects 2026 to be a transformational year with core RNS growth of 20-22% and potential FDA approval for IGE indication expansion.
Positive Outlook
- Full year 2026 revenue guidance of $98 million to $100 million.
- Expected core RNS revenue growth of 20% to 22%.
- Anticipated GAAP gross margin expansion to between 81% and 82%.
- Significant Medicare reimbursement increases for RNS procedures effective Jan 2026.
- Potential NAUTILUS PMA-S approval in mid-2026 for IGE indication.
Challenges Ahead
- Projected Adjusted EBITDA loss of $9.0 million to $10.0 million for FY 2026.
- Q1 2026 revenue expected to be lower sequentially at $21 million to $22 million.
- Total GAAP operating expenses projected to rise to $100 million - $102 million.
- Cessation of DIXI Medical partnership will remove a revenue stream.
Revenue & Expenses
Visualization of income flow from segment revenue to net income
Historical Earnings Impact
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Avg. Return Before/After Earnings
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