SI-BONE, Inc. (NASDAQ:SIBN) Q4 2022 Earnings Call Transcript

And then when we think about annual guidance, we thought it was appropriate to take a prudent stance here and sort of look at a risk-adjusted view of all the tailwinds that Laura highlighted in the preliminary remarks around procedure ASP trends, the pace of Granite adoption, how we think about OUS recovery from a business coming back perspective. And some of these factors could play out better than we anticipate. But given that we’re this early in the year and several of the tailwinds are in the nascent stages, like Granite is still being rolled out and the facility fees that went into effect in January, right, it’s too early to see what the potential impact of that could be. So we thought our guidance appropriately bracketed some of the risks and opportunities there.

And then the other aspect of our guidance was just a continuous focus on operating leverage that we expect to see as we progress through the year into 2023. Kyle asked the question around the gross margin. And look, our gross margin is at sort of that stabilizing at about 80% are still industry-leading and really dear to us, and we will continue to make sure we stay at pretty elevated gross margin levels. But we are increasingly focused on seeing that adjusted EBITDA leverage as well and feel good about that to go up coming into this year.

David Rescott: Okay. Great, thanks. So that just leads to the next question then. So I’m wondering, one, if the 80% gross margin in 2023 assumes that there is stabilization of gross margins brought on by that improved reimbursement rate or perhaps there may be is upside just as you progress through the year? And then the second part of that, just based on kind of our initial estimates, gross margins, a little bit lower than we were anticipating, but still expecting improving EBITDA through the year. So just wondering what the biggest driver of that improving profitability is and maybe how we should think about the cadence of that coming on through the rest of the year, especially since Q1 seems to be maybe a higher top line growth rate than the rest of the year? Thank you.

Anshul Maheshwari: Yes. David, that’s a great question. So let me just take the question on what’s going to drive operating leverage and EBITDA acceleration first and then go back to the gross margin side. So as we came into last year, David, we had talked about the business being at a natural inflection point to harvest all the investments that we made since going public and throughout the pandemic. And now we’ve had three consecutive quarters where revenue growth has exceeded operating expenses. And we’re really pleased with that trajectory. And it’s been pretty linear to revenue growth, right? So as our revenue growth accelerated, you sort of saw the leverage accelerate as well because we’ve got the foundational infrastructure in place.

And as we get into 2023, we do not think that, that trend is going to change. We are still going to make investments in R&D. We’re still going to make investments in trades, which will go as depreciation on the P&L. And we are going to selectively grow our sales force, but the foundational infrastructure is there to support a much higher level of revenue, right. So when you think about the year, as the revenue accelerates or as we progress through the year, you will see the leverage accelerate, and we expect year-over-year adjusted EBITDA to continue to improve. You might have some seasonality sequentially, but year-over-year, we should see an improvement.

David Rescott: Okay, thanks again.

Operator: Thank you. Our next question comes from the line of Craig Bijou with Bank of America.