PROCEPT BioRobotics Corporation

What they do

PROCEPT develops, manufactures and sells the AquaBeam Robotic System and HYDROS Robotic System for minimally invasive urologic surgery, initially targeting BPH. Each system uses a single-use disposable handpiece to deliver Aquablation therapy, which combines real-time multi-dimensional imaging, treatment planning, automated robotics and heat-free waterjet ablation to remove prostate tissue. Manufacturing of systems, handpieces, integrated scopes and accessories occurs at the company's San Jose, California facility, with systems shipped with a third-party ultrasound system and probe and distributed through third-party logistics in the United States and the Netherlands.

Revenue drivers

• U.S. handpieces and consumables — Recurring revenue from single-use disposable handpieces sold per Aquablation procedure; U.S. handpiece and consumable revenue was $48.4 million in Q2 2026, up 12% year over year, and handpieces sold equaled approximately 98% of U.S. procedures.
• U.S. robotic systems — Capital sales of AquaBeam and HYDROS systems to hospitals; U.S. system revenue was $29.1 million in Q2 2026, up 32% year over year, with 65 U.S. HYDROS systems delivered including 14 replacements at an average selling price of approximately $495,000 for new HYDROS systems.
• International — Sales of systems and handpieces outside the United States; international revenue was $11.1 million in Q2 2026, up 15% year over year, and the company states global BPH incidence among men over 50 is similar to the United States.

Recent performance

Total revenue for the second quarter of 2026 was $94.5 million, an increase of 19% compared to the prior year period, with U.S. revenue of $83.4 million (up 20%) and international revenue of $11.1 million (up 15%). U.S. procedures exceeded 13,100, up approximately 21% year over year, and gross margin was 66% versus 65% in the prior year period, aided by higher U.S. system and consumable pricing and a $2.9 million tariff refund. Net loss was $26.9 million for the quarter compared with a $19.6 million loss in the prior year period, and adjusted EBITDA was a loss of $11.3 million versus an $8.0 million loss a year earlier. For the six months ended June 30, 2026, revenue was $177.6 million and net loss was $58.5 million, compared to revenue of $148.3 million and a net loss of $44.3 million in the first half of 2025.

Strategy

Management's stated priorities are growing the installed base of robotic systems, increasing utilization per system and expanding the direct capital sales team to target approximately 2,700 U.S. hospitals that perform resective BPH procedures. The company reported completing a commercial realignment in the second quarter of 2026 and executing a more robust replacement strategy for existing systems while maintaining pricing discipline. It continues to invest in its commercial organization, innovation across the BPH platform, and clinical work including the WATER IV prostate cancer study, which completed enrollment, and an updated American Urological Association guideline recommendation for Aquablation therapy. The company reiterates full year 2026 revenue guidance of $390 million to $410 million and expects full year gross margin of approximately 65%.

Risks

• History of losses — PROCEPT has incurred significant net losses since inception, including a $95.6 million net loss in 2025 and a $58.5 million net loss in the first half of 2026, and management expects to continue incurring operating losses for the foreseeable future.
• Product concentration — Revenue is primarily generated from sales of the AquaBeam and HYDROS robotic systems and accompanying single-use disposable handpieces, making results highly dependent on the success of those products.
• Loan covenants and debt restrictions — The terms of the company's loan and security agreement require meeting certain operating and financial covenants and place restrictions on operating and financial flexibility, with $51.7 million of long-term debt on the balance sheet as of June 30, 2026.
• Dependence on utilization and placements — Revenue is significantly affected by utilization of placed systems and by sales of capital systems, so slower hospital adoption or lower procedure volumes would pressure results.

Outlook

Management reiterates full year 2026 revenue guidance of $390 million to $410 million, representing growth of 27% to 33% compared to the prior year period. It now expects full year 2026 U.S. procedure volume of 54,000 to 56,000, growth of 25% to 29%, and reiterates full year 2026 gross margin of approximately 65%. The company now expects full year 2026 adjusted EBITDA loss in the range of $35 million to $30 million.