TransMedics (TMDX) Down 20.3% Since Last Earnings Report: Can It Rebound?

It has been about a month since the last earnings report for TransMedics (TMDX). Shares have lost about 20.3% in that time frame, underperforming the S&P 500.

Will the recent negative trend continue leading up to its next earnings release, or is TransMedics due for a breakout? Well, first let's take a quick look at its latest earnings report in order to get a better handle on the recent catalysts for TransMedics Group, Inc. before we dive into how investors and analysts have reacted as of late.

TransMedics Q4 Earnings Beat Estimates, Revenues Up Y/Y

TransMedics delivered earnings per share of 57 cents in the fourth quarter of 2025, excluding a one-time benefit related to deferred tax assets, which surged 200% year over year. The figure surpassed the Zacks Consensus Estimate by 39%.

TransMedics reported an earnings per share of $2.85 for 2025, excluding a one-time benefit related to deferred tax assets, against an EPS of $1.01 for 2024.

TMDX’s Q4 Revenues in Detail

TransMedics registered revenues of $160.8 million in the fourth quarter, up 32% year over year. The figure surpassed the Zacks Consensus Estimate by 3.1%.

Per management, the uptick was driven by the increased utilization of the Organ Care System, primarily in liver and heart, under the National OCS Program, along with higher NOP service revenues stemming from the continued expansion and utilization of the aviation fleet.

During the reported quarter, TMDX was able to cover 80% of its NOP missions requiring air transport compared with approximately 75% in the fourth quarter of 2024.

For 2025, TMDX registered total revenues of $605.5 million, up 37% compared with 2024.

TransMedics’ Segment Details

TMDX derives revenues via two sources — Net product revenues and Service revenues.

In the fourth quarter of 2025, Net product revenues totaled $100.4 million, up 34% year over year. Growth was driven by continued momentum across both liver and heart programs.

Service revenues totaled $60.4 million, up 29% year over year, driven primarily by logistics.

Transplant Logistics’ services revenues for fourth-quarter 2025 were $28.6 million, up 32% year over year. This resulted from the continued expansion and strong utilization of TransMedics’ aviation fleet.

TMDX’s Margin Trend

In the quarter under review, TransMedics’ gross profit increased 29.7% year over year to $93.4 million. The gross margin contracted 110 basis points (bps) to 58%.

Selling, general and administrative expenses rose 9.7% year over year to $51.4 million. Research, development and clinical trials expenses surged 25.7% year over year to $20.7 million. Total operating expenses of $72.1 million increased 13.8% year over year.

Operating profit totaled $21.3 million, reflecting a 146% jump from the prior-year quarter. The operating margin in the fourth quarter expanded 600 bps to 13%.

TransMedics’ Financial Position

TransMedics exited fourth-quarter 2025 with cash of $488.4 million compared with $466.2 million at the end of third-quarter 2025. Total long-term debt at the end of fourth-quarter 2025 was $49.6 million compared with $54.6 million at the end of third-quarter 2025.

Cumulative net cash provided by operations at the end of 2025 was $192.8 million compared with $158.3 million at the end of the third quarter of 2025.

TMDX’s 2026 Guidance

TransMedics provided its revenue outlook for 2026.

For 2026, the company expects revenues in the range of $727-$757 million, reflecting growth of 20-25% from the 2025 level. The Zacks Consensus Estimate is pegged at $723.8 million.

How Have Estimates Been Moving Since Then?

It turns out, estimates review flatlined during the past month.

The consensus estimate has shifted -6.36% due to these changes.

VGM Scores

Currently, TransMedics has a great Growth Score of A, a grade with the same score on the momentum front. However, the stock has a grade of D on the value side, putting it in the bottom 40% for this investment strategy.

Overall, the stock has an aggregate VGM Score of B. If you aren't focused on one strategy, this score is the one you should be interested in.

Outlook

TransMedics has a Zacks Rank #3 (Hold). We expect an in-line return from the stock in the next few months.

Performance of an Industry Player

TransMedics is part of the Zacks Medical - Instruments industry. Over the past month, Integer (ITGR), a stock from the same industry, has gained 0.3%. The company reported its results for the quarter ended December 2025 more than a month ago.

Integer reported revenues of $472.06 million in the last reported quarter, representing a year-over-year change of +5%. EPS of $1.76 for the same period compares with $1.43 a year ago.

For the current quarter, Integer is expected to post earnings of $1.21 per share, indicating a change of -7.6% from the year-ago quarter. The Zacks Consensus Estimate has changed -9.2% over the last 30 days.

Integer has a Zacks Rank #3 (Hold) based on the overall direction and magnitude of estimate revisions. Additionally, the stock has a VGM Score of C.

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