NeuroPace Reports First Quarter 2026 Financial Results and Raises 2026 Revenue Guidance

NeuroPace, Inc. (Nasdaq: NPCE), a medical device company focused on transforming the lives of people living with epilepsy, today reported financial results for the first quarter ended March 31, 2026, and provided a corporate update.

First Quarter 2026 Highlights

  • Total revenue of $22.1 million in the quarter. Excluding DIXI Medical, total revenue of $22.0 million representing 20.1% year over year growth

  • RNS System revenue of $21.7 million in the quarter, representing 19.5% year over year growth

  • GAAP net loss in the first quarter of 2026 was ($6.7) million compared to ($6.6) million in the first quarter of 2025

  • Adjusted EBITDA loss, excluding DIXI Medical, of ($3.3) million for the first quarter of 2026, an improvement of $0.8 million compared to a loss of ($4.1) million in the first quarter of 2025

  • Completed the FDA mid-cycle review meeting for the NAUTILUS PMA supplement, consistent with the expected regulatory timeline

  • Reached new all-time highs in active prescribers, accounts and patient pipeline

“First quarter results reflect continued execution against the strategic priorities we outlined earlier this year,” said Joel Becker, Chief Executive Officer of NeuroPace. “We remain focused on driving disciplined growth in our core RNS business, advancing our product roadmap, and progressing toward potential indication expansion, all while strengthening the operational foundation of the Company. We continue to progress NAUTILUS through the regulatory review process and remain encouraged by the totality of the dataset supporting the IGE indication expansion.”

First Quarter 2026 Financial Results

Non-GAAP revenue in the first quarter of 2026 grew 20.1% to $22.0 million, compared with $18.3 million in the first quarter of 2025. The Company’s revenue growth was primarily driven by increased sales of the RNS System which totaled $21.7 million in the first quarter of 2026, representing growth of 19.5% compared to the first quarter of 2025. On a GAAP basis, total revenue of $22.1 million included $0.1 million of revenue attributable to DIXI Medical.

Beginning this quarter, the Company reports gross margin and operating expenses on a non-GAAP basis, excluding DIXI Medical and stock-based compensation, for each respective line item. This presentation is intended to provide greater transparency into the underlying operating performance of the business, enhance visibility into operating leverage, and improve comparability across periods. Total stock-based compensation by line item, along with reconciliations to the most directly comparable GAAP measures, are included at the end of this press release.

Non-GAAP gross margin for the first quarter of 2026 was 82.5%, compared with 83.6% in the first quarter of 2025 which included a one-time benefit of 120 basis points from an inventory revaluation. The underlying year-over-year improvement, absent one-time items, is primarily due to improved manufacturing efficiency and increasing average selling price resulting from strong pricing conversion. Total GAAP gross margin in the first quarter of 2026 was 81.8%.

Non-GAAP operating expenses in the first quarter of 2026 were $21.5 million, compared with $19.4 million in the first quarter of 2025. GAAP operating expenses in the first quarter of 2026 were $23.6 million.

Non-GAAP sales and marketing expense, excluding DIXI Medical, in the first quarter of 2026 was $11.0 million, compared with $9.6 million in the first quarter of 2025. The year-over-year increase was largely due to personnel-related expenses associated with ongoing scaling of commercial activities, investment in direct-to-consumer marketing and other sales-related expenses.

Non-GAAP research and development expense in the first quarter of 2026 was $6.5 million, compared with $6.6 million in the first quarter of 2025. The year-over-year decrease was primarily driven by lower clinical study expense partially offset by an increase in personnel-related expenses associated with the development of a next-generation platform and AI-enabled tools.

Non-GAAP general and administrative expense in the first quarter of 2026 was $4.0 million compared with $3.3 million in the first quarter of 2025. This increase was primarily due to an increase in personnel-related expenses.

Non-GAAP loss from operations was ($3.3) million in the first quarter of 2026, compared with loss from operations of ($4.1) million in the first quarter of 2025. Non-GAAP net loss was ($4.4) million for the first quarter of 2026 compared with net loss of ($5.6) million in the first quarter of 2025. GAAP net loss in the first quarter of 2026 was ($6.7) million.

The Company’s cash, cash equivalents, short-term investments and restricted cash balance as of March 31, 2026 was $54.8 million compared with $61.2 million at the end of the prior quarter. Long-term borrowings totaled $59.0 million as of March 31, 2026.

Discontinued Operations

The Company expects to report DIXI Medical related operating results as discontinued operations beginning with its second quarter 2026 financial results. In accordance with U.S. GAAP, the Company’s continuing operations results will exclude the impact of DIXI Medical for the 2026 reporting periods and applicable comparable periods presented.

Full Year 2026 Financial Guidance on a Continuing Operations Basis

  • Increase total revenue for full year 2026 to be between $99 million and $101 million, representing underlying RNS growth of 21% to 23% compared to full year 2025. This compares to previously issued guidance of $98 million to $100 million, representing underlying RNS growth of 20% to 22%, excludes any contribution from idiopathic generalized epilepsy (IGE) indication expansion.

  • Reiterate full year non-GAAP gross margin between 81.5% and 82.5%

  • Reiterate full year non-GAAP operating expenses to be between $90 million and $92 million, excluding approximately $10 million in stock-based compensation, a non-cash expense

  • Increase Adjusted EBITDA to be between ($8.5) and ($9.5) million compared to previous guidance between ($9.0) million to ($10.0) million

Non-GAAP Measure

To supplement NeuroPace’s condensed financial statements presented in accordance with GAAP, the Company uses non-GAAP measures of certain components of financial performance. These non-GAAP measures include Adjusted EBITDA, non-GAAP gross margin, non-GAAP cost of goods sold, non-GAAP sales and marketing expense, non-GAAP research and development expense, non-GAAP general and administrative expense, non-GAAP operating expenses, and non-GAAP loss from operations. NeuroPace believes the presentation of its non-GAAP financial measures enhances the user’s overall understanding of the Company’s historical financial performance. The presentation of the Company’s non-GAAP financial measures is not meant to be considered in isolation or as a substitute for the Company’s financial results prepared in accordance with GAAP, and the Company’s non-GAAP measures may be different from non-GAAP measures used by other companies.

Webcast and Conference Call Information

NeuroPace will host a conference call to discuss the first quarter and full year 2026 financial results after market close on Tuesday, May 12, 2026, at 4:30 P.M. Eastern Time. Investors interested in listening to the conference call may do so by accessing a live and archived webcast of the event at (click here). Individuals interested in participating in the call via telephone may access the call by dialing + 1 (800) 715-9871 and referencing Conference ID 8467256. The webcast will be archived on the Company’s investor relations website at https://investors.neuropace.com/news-and-events/events and will be available for replay for at least 90 days after the event.

About NeuroPace, Inc.

Based in Mountain View, Calif., NeuroPace is a medical device company focused on transforming the lives of people living with epilepsy by reducing or eliminating the occurrence of debilitating seizures. Its novel and differentiated RNS System is the first and only commercially available, brain-responsive platform that delivers personalized, real-time treatment at the seizure source. This platform can drive a better standard of care for patients living with drug-resistant epilepsy and has the potential to offer a more personalized solution and improved outcomes to the large population of patients suffering from other brain disorders.

Forward Looking Statements

This press release may contain forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These statements may be identified by words such as “aims,” “anticipates,” “believes,” “could,” “estimates,” “expects,” “forecasts,” “goal,” “intends,” “may,” “plans,” “possible,” “potential,” “seeks,” “will” and variations of these words or similar expressions that are intended to identify forward-looking statements, although not all forward-looking statements contain these words. NeuroPace may not actually achieve the plans, intentions or expectations disclosed in these forward-looking statements, and you should not place undue reliance on these forward-looking statements. Forward-looking statements in this press release include, but are not limited to, statements regarding: Expectations regarding the Company’s future revenue and growth based on a continued operations basis without DIXI Medical revenue; NeuroPace’s expectations, forecasts and beliefs with respect to potential indication expansion for its RNS System and its software, technology and other product development efforts; increasing access to and adoption of RNS therapy as the standard of care in drug-resistant epilepsy; NeuroPace’s continued execution on its long-term revenue growth strategy, including with respect to sustained revenue growth and long-term value creation. Actual results or events could differ materially from the plans, intentions and expectations disclosed in these forward-looking statements as a result of various factors, including: actual operating results may differ significantly from any guidance provided; uncertainties related to market acceptance and adoption of NeuroPace’s RNS System and impacts to NeuroPace’s revenue for 2026 and in the future; risks that NeuroPace’s operating expenses could be higher than anticipated and that it could use its cash resources sooner than expected; risks that NeuroPace’s gross margin may be lower than forecast; risks related to the pricing of the RNS System and availability of adequate reimbursement for the procedures to implant the RNS System and for clinicians to provide ongoing care for patients treated with the RNS System; risks related to regulatory compliance and expectations for regulatory approvals to expand the market for NeuroPace’s RNS System, including risks related to the NAUTILUS submission; risks related to product development, including risks related to the development of AI-powered software, including NeuroPace AI™ and the next generation device platform; risks related to NeuroPace’s reliance on contractors and other third parties, including single-source suppliers and vendors; and other important factors. These and other risks and uncertainties include those described more fully in the section titled “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and elsewhere in NeuroPace’s public filings with the U.S. Securities and Exchange Commission (SEC), including its Annual Report on Form 10-K for the year ended December 31, 2025, filed with the SEC on March 3, 2026, as well as any other reports that it may file with the SEC in the future. Forward-looking statements contained in this announcement are based on information available to NeuroPace as of the date hereof. NeuroPace undertakes no obligation to update such information except as required under applicable law. These forward-looking statements should not be relied upon as representing NeuroPace’s views as of any date subsequent to the date of this press release and should not be relied upon as a prediction of future events. In light of the foregoing, investors are urged not to rely on any forward-looking statement in reaching any conclusion or making any investment decision about any securities of NeuroPace.

NeuroPace, Inc.

Condensed Statements of Operations and Comprehensive Loss

(unaudited)

 

 

 

Three Months Ended March 31,

(in thousands, except for share and per share amounts)

 

2026

 

2025

Revenue

 

$

22,068

 

 

$

22,524

 

Cost of goods sold

 

 

4,020

 

 

 

5,182

 

Gross profit

 

 

18,048

 

 

 

17,342

 

Operating expenses:

 

 

 

 

Sales and marketing

 

 

11,583

 

 

 

11,003

 

Research and development

 

 

7,189

 

 

 

7,440

 

General and administrative

 

 

4,844

 

 

 

4,046

 

Total operating expenses

 

 

23,616

 

 

 

22,489

 

Loss from operations

 

 

(5,568

)

 

 

(5,147

)

Interest income

 

 

565

 

 

 

793

 

Interest expense

 

 

(1,521

)

 

 

(2,153

)

Other income (expense), net

 

 

(165

)

 

 

(82

)

Net loss and comprehensive loss

 

$

(6,689

)

 

$

(6,589

)

Net loss per share attributable to common stockholders, basic and diluted

 

$

(0.20

)

 

$

(0.21

)

Weighted-average shares used in computing net loss per share attributable to common stockholders, basic and diluted

 

 

33,716,813

 

 

 

31,480,911

 

NeuroPace, Inc.

Condensed Balance Sheets

(unaudited)

 

 

March 31,

 

December 31,

(in thousands)

2026

 

2025

Assets

 

 

 

Current assets:

 

 

 

Cash and cash equivalents

$

14,779

 

 

$

21,692

 

Short-term investments

 

39,202

 

 

 

39,366

 

Accounts receivable

 

14,788

 

 

 

14,681

 

Inventory

 

16,694

 

 

 

16,896

 

Prepaid expenses and other current assets

 

1,515

 

 

 

1,438

 

Total current assets

 

86,978

 

 

 

94,073

 

Property and equipment, net

 

1,283

 

 

 

1,125

 

Operating lease right-of-use asset

 

9,679

 

 

 

10,132

 

Restricted cash

 

852

 

 

 

122

 

Other assets

 

106

 

 

 

113

 

Total assets

$

98,898

 

 

$

105,565

 

Liabilities and Stockholders’ Equity

 

 

 

Current liabilities:

 

 

 

Accounts payable

$

4,512

 

 

$

2,217

 

Accrued liabilities.

 

9,344

 

 

 

13,339

 

Operating lease liability

 

2,186

 

 

 

2,117

 

Deferred revenue

 

126

 

 

 

141

 

Total current liabilities

 

16,168

 

 

 

17,814

 

Long-term debt

 

59,021

 

 

 

58,884

 

Operating lease liability, net of current portion

 

9,255

 

 

 

9,836

 

Total liabilities

 

84,444

 

 

 

86,534

 

Stockholders’ equity:

 

 

 

Common stock, $0.001 par value

 

34

 

 

 

34

 

Additional paid-in capital

 

573,524

 

 

 

571,412

 

Accumulated deficit

 

(559,104

)

 

 

(552,415

)

Total stockholders’ equity

 

14,454

 

 

 

19,031

 

Total liabilities and stockholders’ equity

$

98,898

 

 

$

105,565

 

NeuroPace, Inc.

Condensed Statements of Cash Flows

(unaudited)

 

 

Three Months Ended March 31,

(in thousands)

2026

 

2025

Cash flows from operating activities

 

 

 

Net loss

$

(6,689

)

 

$

(6,589

)

Adjustments to reconcile net loss to net cash used in operating activities:

 

 

 

Stock-based compensation expense

 

2,278

 

 

 

2,626

 

Depreciation

 

60

 

 

 

49

 

Amortization of debt discount and issuance costs

 

68

 

 

 

49

 

Non-cash interest expense

 

77

 

 

 

213

 

Amortization of right-of-use asset

 

453

 

 

 

413

 

Unrealized loss on short-term investments

 

165

 

 

 

82

 

Inventory write-downs

 

76

 

 

 

44

 

Loss on disposal of property and equipment

 

 

 

 

2

 

Changes in operating assets and liabilities:

 

 

 

Accounts receivable

 

(108

)

 

 

(2,585

)

Inventory

 

125

 

 

 

(243

)

Prepaid expenses and other assets

 

(77

)

 

 

150

 

Accounts payable

 

2,195

 

 

 

966

 

Accrued liabilities

 

(3,995

)

 

 

(2,333

)

Deferred revenue

 

(15

)

 

 

124

 

Operating lease liabilities

 

(513

)

 

 

(450

)

Net cash used in operating activities

 

(5,900

)

 

 

(7,482

)

Cash flows from investing activities

 

 

 

Acquisition of property and equipment

 

(117

)

 

 

(37

)

Net cash used in investing activities

 

(117

)

 

 

(37

)

Cash flows from financing activities

 

 

 

Proceeds from issuance of common stock in follow-on offering, net of underwriting discounts and commissions

 

 

 

 

70,265

 

Repurchase of common stock from KCK Ltd

 

 

 

 

(49,546

)

Proceeds from issuance of common stock under employee plans

 

10

 

 

 

385

 

Taxes withheld and paid related to net share settlement of equity awards

 

(176

)

 

 

(228

)

Proceeds from At-The-Market offering, net of sales commission

 

 

 

 

232

 

Net cash (used in) provided by financing activities

 

(166

)

 

 

21,108

 

Net increase (decrease) in cash and cash equivalents

 

(6,183

)

 

 

13,589

 

Cash, cash equivalents and restricted cash at the Beginning of Period

 

21,814

 

 

 

13,552

 

Cash, cash equivalents and restricted cash at the End of Period

$

15,631

 

 

$

27,141

 

Reconciliation of cash, cash equivalents and restricted cash to balance sheets:

 

 

 

Cash and cash equivalents

$

14,779

 

 

$

27,019

 

Restricted cash

 

852

 

 

 

122

 

Cash, cash equivalents and restricted cash in balance sheets

$

15,631

 

 

$

27,141

 

NeuroPace, Inc.

Table 1. GAAP to Non-GAAP Reconciliations (excluding DIXI)1

(unaudited)

 

 

Three Months Ended March 31,

(in thousands)

2026

 

2025

GAAP revenue

$

22,068

 

 

$

22,524

 

Less: DIXI revenue

 

65

 

 

 

4,203

 

Non-GAAP revenue (excluding DIXI)

$

22,003

 

 

$

18,321

 

 

 

 

 

GAAP cost of goods sold

$

4,020

 

 

$

5,182

 

Less: DIXI cost of goods sold

 

28

 

 

 

1,992

 

Stock-based compensation

 

138

 

 

 

178

 

Non-GAAP cost of goods sold (excluding DIXI)

$

3,854

 

 

$

3,012

 

 

 

 

 

GAAP sales and marketing expense

$

11,583

 

 

$

11,003

 

Less: DIXI sales and marketing expense

 

 

 

 

598

 

Stock-based compensation

 

595

 

 

 

783

 

Non-GAAP sales and marketing expense (excluding DIXI)

$

10,988

 

 

$

9,622

 

 

 

 

 

GAAP research and development expense

$

7,189

 

 

$

7,440

 

Stock-based compensation

 

713

 

 

 

872

 

Non-GAAP research and development expense1

$

6,476

 

 

$

6,568

 

 

 

 

 

GAAP general and administrative expense

$

4,844

 

 

$

4,046

 

Stock-based compensation

 

832

 

 

 

793

 

Non-GAAP general and administrative expense1

$

4,012

 

 

$

3,253

 

 

 

 

 

GAAP operating expenses

$

23,616

 

 

$

22,489

 

Less: DIXI sales and marketing expense

 

 

 

 

598

 

Stock-based compensation

 

2,140

 

 

 

2,448

 

Non-GAAP operating expenses (excluding DIXI)

$

21,476

 

 

$

19,443

 

 

 

 

 

GAAP loss from operations

$

(5,568

)

 

$

(5,147

)

Less: DIXI income from operations

 

37

 

 

 

1,613

 

Stock-based compensation

 

2,278

 

 

 

2,626

 

Non-GAAP loss from operations (excluding DIXI)

$

(3,327

)

 

$

(4,134

)

Depreciation

 

60

 

 

 

49

 

Adjusted EBITDA (Non-GAAP) (excluding DIXI)

$

(3,267

)

 

$

(4,085

)

 

 

 

 

GAAP net loss

$

(6,689

)

 

$

(6,589

)

Less: DIXI income from operations

 

37

 

 

 

1,613

 

Stock-based compensation

 

2,278

 

 

 

2,626

 

Non-GAAP net loss (excluding DIXI)

$

(4,448

)

 

$

(5,576

)

__________________________________________________________________________

1

The Company did not allocate research and development or general and administrative expenses to its DIXI operations.

NeuroPace, Inc.

Table 2. GAAP to Non-GAAP Reconciliations

2026 Revised Guidance

 

(in thousands)

 

 

2026 Guidance

 

 

 

 

GAAP gross margin

 

 

81% to 82%

Stock-based compensation

 

 

~50 bps

Non-GAAP gross margin

 

 

81.5% to 82.5%

 

 

 

 

GAAP sales and marketing expense

 

 

$49,000 to $51,000

Stock-based compensation

 

 

~$3,000

Non-GAAP sales and marketing expense

 

 

$46,000 to $48,000

 

 

 

 

GAAP research and development expense

 

 

~$30,000

Stock-based compensation

 

 

~$3,000

Non-GAAP research and development expense

 

 

~$27,000

 

 

 

 

GAAP general and administrative expense

 

 

~$21,000

Stock-based compensation

 

 

~$4,000

Non-GAAP general and administrative expense

 

 

~$17,000

 

 

 

 

GAAP operating expenses

 

 

$100,000 to $102,000

Stock-based compensation

 

 

~$10,000

Non-GAAP operating expenses

 

 

$90,000 to $92,000

 

 

 

 

GAAP loss from operations

 

 

($19,500) to ($20,500)

Stock-based compensation (including gross margin)

 

 

~$10,500

Non-GAAP loss from operations

 

 

($9,000) to ($10,000)

 

 

 

 

Depreciation

 

 

~$500

 

 

 

 

Adjusted EBITDA (Non-GAAP)

 

 

($8,500) to ($9,500)

NeuroPace, Inc.

Table 3. DIXI Operating Results1

(unaudited)

 

 

Three Months Ended March 31,

(in thousands)

2026

 

2025

Revenue

$

65

 

$

4,203

Cost of goods sold

 

28

 

 

1,992

Gross Profit

 

37

 

 

2,211

Operating expenses:

 

 

 

Sales and marketing

 

 

 

598

DIXI income from operations

$

37

 

$

1,613

_______________________

1

The Company did not allocate research and development or general and administrative expenses to its DIXI operations.

NeuroPace, Inc.

Table 4. Historical Revenue Breakout

(unaudited)

 

 

Three Months Ended

 

Year Ended

 

Three

Months

Ended

 

2026 Guidance

(in thousands)

March 31,

2025

 

June 30,

2025

 

September 30,

2025

 

December 31,

2025

 

December 31,

2025

 

March 31,

2026

 

RNS revenue

$

18,151

 

$

18,564

 

$

22,580

 

$

22,374

 

$

81,669

 

$

21,689

 

$98,500 to $100,500

Service revenue

 

170

 

 

937

 

 

771

 

 

887

 

 

2,765

 

 

314

 

500

Non-GAAP revenue (excluding DIXI)

$

18,321

 

$

19,501

 

$

23,351

 

$

23,261

 

$

84,434

 

$

22,003

 

$99,000 to $101,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DIXI revenue

 

4,203

 

 

4,019

 

 

4,003

 

 

3,328

 

 

15,553

 

 

65

 

GAAP revenue

$

22,524

 

$

23,520

 

$

27,354

 

$

26,589

 

$

99,987

 

$

22,068

 

$99,000 to $101,000

 

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