Piper Sandler maintained an Overweight rating and a $25.00 price target on Alphatec Holdings (NASDAQ:ATEC) following the company’s latest quarterly disclosure. Management said fourth-quarter performance landed at the high end of its prior range and outpaced Piper Sandler’s internal forecasts for both sales and earnings.
The company recorded revenue growth of 25% over the trailing 12 months, though it remains unprofitable on a per-share basis with a reported loss of $0.96. Alphatec also reported adjusted earnings per share of $0.06 for the quarter, ahead of the consensus estimate of $0.04. Quarterly revenue came in at $213 million, beating the $209.22 million forecast and rising from $176 million in the year-ago period.
Surgical revenue specifically increased 21% year-over-year to $190 million, a gain management attributed to higher case volumes. The company noted it is onboarding new surgeons while boosting utilization among its existing clinician base. Alphatec also highlighted the commercial launch of Valence, which is now available on the market and cited as contributing to broad-based growth.
On the outlook, management reiterated its revenue and free cash flow targets for the year while raising expectations for adjusted EBITDA. Despite the better-than-expected quarterly metrics and an upgraded adjusted EBITDA outlook, the company’s full-year 2026 revenue guidance did not meet Wall Street expectations, a shortfall that preceded a 13.5% decline in after-hours trading tied to those forward targets.
Market reaction was mixed overall. The stock slid by double-digit percentages in aftermarket trading following the results announcement and is currently trading at $13.73, a 34% decline year-to-date and well below its 52-week high of $23.29. Independent analysis cited in reporting flagged ATEC as appearing overvalued at current levels. For investors seeking deeper context, a comprehensive pro research report covering ATEC and more than 1,400 U.S. equities is available.
Brokerage commentary diverged. Piper Sandler kept its Overweight stance and $25.00 target, while Lake Street Capital Markets reiterated a Buy rating and matched the $25.00 price target, pointing to Alphatec’s growth relative to larger challenges within the spine segment. Lake Street expressed perplexity at the negative market response after the preliminary fourth-quarter revenue beat and the initial FY2026 revenue outlook.
The combination of a near-term beat, raised adjusted EBITDA expectations and ongoing losses has left investors weighing operational momentum against continued unprofitability and valuation questions. The company’s recent commercial activity including Valence and the growth in surgical case volumes are positive operational signals, but guidance and market perception have contributed to heightened share-price volatility.
Summary - Alphatec posted a stronger-than-expected fourth quarter with notable revenue growth and a modest adjusted EPS beat, but its FY2026 revenue guidance fell short of analyst expectations, triggering volatile after-hours trading.
Key points:
- Piper Sandler reiterated an Overweight rating and a $25.00 price target on ATEC after Q4 results beat estimates.
- Alphatec reported 25% revenue growth over the past 12 months, $213 million in Q4 revenue and adjusted EPS of $0.06 versus a $0.04 consensus; surgical revenue rose 21% to $190 million.
- Despite the beat, full-year 2026 revenue guidance disappointed Wall Street, contributing to a 13.5% after-hours drop and broader double-digit declines in aftermarket trading; shares trade at $13.73, down 34% YTD from a 52-week high of $23.29.
Sectors impacted: Medical devices, healthcare equipment suppliers, and equity markets focused on growth-oriented healthcare names.
Risks and uncertainties:
- Continued unprofitability - The company remains loss-making on a GAAP per-share basis (loss of $0.96), which may pressure investor confidence and funding dynamics in the medical device sector.
- Guidance shortfall - FY2026 revenue guidance fell below Wall Street estimates, a development that produced a sharp negative market response and illustrates sensitivity to forward-looking targets in healthcare equities.
- Valuation concerns - Independent analysis flagged ATEC as appearing overvalued at current levels, a factor that may increase downside risk amid mixed operational and financial signals.
Taken together, Alphatec’s quarter reveals operational momentum in surgical revenues and product launches but also highlights the market’s sensitivity to guidance and valuation, leading to a polarized reception from analysts and investors.