Zimmer Biomet Holdings, Inc. (ZBH) Q4 2025 Earnings Call Transcript
Access earnings results, analyst expectations, report, slides, earnings call, and transcript.
Overview
The earnings call reveals strong financial performance with a 10.9% increase in net sales and significant growth across various product lines. The Q&A section highlights strategic initiatives like sales force optimization and capital allocation towards share buybacks, reflecting confidence in future growth. Despite some pricing pressures and sales force transition disruptions, the guidance remains stable with optimistic long-term prospects. These factors suggest a positive stock price movement, supported by robust product performance and strategic focus on growth areas like ASCs and robotics.
Key Financial Performance
Organic constant currency sales growth 5.4% in Q4 2025, driven by new product momentum, strong robotic sales, and end-of-year customer purchases. U.S. business grew 5.7%, and international revenue grew 5%.
Adjusted earnings per share (EPS) $2.42 in Q4 2025, up 4.8% year-over-year, despite dilution from the Paragon 28 transaction, tariffs, and increased commercial investments.
Free cash flow $1.172 billion for the full year 2025, growing over 11% year-over-year, marking the third consecutive year of at least high single-digit free cash flow growth.
Adjusted gross margin 72.4% in Q4 2025, higher than Q4 2024 due to lower manufacturing costs and favorable mix.
Adjusted operating margin 29.1% in Q4 2025, lower than the prior year due to increased commercial investments and the addition of Paragon 28.
Net sales $2.244 billion in Q4 2025, an increase of 10.9% on a reported basis and 5.4% excluding foreign currency and Paragon 28 acquisition.
U.S. Knee growth 6% in Q4 2025, driven by increased penetration of Persona OsseoTi and Oxford Partial Cementless Knee.
U.S. Hip growth Nearly 8% in Q4 2025, fueled by Z1 triple-taper stem penetration.
U.S. technology and data, bone cement, and surgical sales Increased over 10% in Q4 2025, driven by the strongest robotic capital sales quarter in over 2 years.
U.S. CMFT (craniomaxillofacial thoracic) business Grew mid-teens in Q4 2025, led by a shift in external fixation from wires to plating.
Upper Extremities growth High single-digit growth in Q4 2025, driven by Identity Shoulder and OsseoFit Stemless Shoulder.
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Operating Highlights
Persona OsseoTi (total cementless knee): Achieved 35% penetration by the end of 2025, contributing to U.S. Knee growth of 6% in Q4.
Oxford Partial Cementless Knee: Exceeded expectations with high adoption rates and competitive account conversions.
Z1 (triple-taper stem): Drove nearly 8% U.S. hip growth in Q4, representing over 35% of U.S. hip stents.
ROSA Shoulder and mBos robotic system: Highlighted as part of the innovation cycle, with mBos being an AI-driven orthopedic robotic system acquired via Monogram acquisition.
U.S. market: Sales grew 5.7% in Q4, driven by new product momentum, robotics, and leadership additions.
International market: Sales grew 5% in Q4, supported by new product momentum and strong robotic sales.
U.S. sales channel transformation: Transition to a dedicated and specialized sales channel to be completed by 2027, focusing on high-growth areas like robotics and ASCs.
Cost management and capital allocation: Disciplined approach expected to drive EPS growth and free cash flow growth in the upper single-digit to double-digit range for 2026.
Innovation and diversification: Closed core portfolio gaps with the Magnificent 7 platform and launched products like the Oxford Partial Cementless Knee and iodine core devices in Japan.
Focus on high-growth segments: Targeting robotics, ASCs, and S.E.T. as key growth drivers, with plans to enhance competitiveness and productivity.
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Risk or Challenges
Tariff Headwinds: The company faced challenges due to tariff headwinds in 2025, which could continue to impact costs and profitability.
Integration of Acquisitions: Integrating three acquisitions within one year posed complexities, which could lead to operational disruptions or inefficiencies.
U.S. Sales Force Transition: The transition to a dedicated and specialized U.S. sales channel may create short-term disruptions in certain areas of the organization.
Pricing Erosion: The company anticipates up to 100 basis points of pricing erosion in 2026, which could impact revenue and margins.
Interest Expense: Higher interest expenses due to the Paragon 28 acquisition and refinancing of debt could strain financial performance.
Workforce Restructuring: Restructuring charges related to workforce reductions could lead to short-term operational challenges.
Regulatory and Policy Environment: The guidance assumes a stable tariff and policy environment, but any changes could pose risks to operations and financials.
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Guidance & Outlook
2026 Revenue Growth: Zimmer Biomet expects full-year organic constant currency revenue growth for 2026 in the low single-digit range, specifically 1% to 3%.
Adjusted EPS for 2026: The company projects adjusted earnings per share (EPS) of $8.30 to $8.45 for 2026.
Free Cash Flow Growth: Zimmer Biomet anticipates free cash flow growth of 8% to 10% in 2026, marking the fourth consecutive year of high single-digit or greater free cash flow growth.
U.S. Sales Force Transition: The company plans to accelerate the transition to a dedicated and specialized U.S. sales channel, expecting the majority of the conversion to be completed by the end of 2027. This transition aims to enhance growth in high-growth areas such as robotics, ambulatory surgical centers (ASCs), and S.E.T. (surgical, sports medicine, and extremities).
Innovation and Product Launches: Zimmer Biomet plans to capitalize on its robust innovation cycle, including the launch of the mBos AI-driven robotic system and other disruptive technologies by 2027. The company also aims to strengthen its pipeline of new product launches, which is currently three times larger than a few years ago.
Long-Term Growth Strategy: The company aims to transform into a durable mid-single-digit plus growth company by completing its U.S. sales force transition and leveraging its innovation cycle. By 2028 and beyond, Zimmer Biomet expects to act as a significantly different company, focusing on higher growth market environments.
Operating Margins and Investments: Operating margins are expected to decrease by about 50 basis points in 2026 due to lower gross margins, dilution from the Paragon 28 acquisition, and increased investments in the U.S. commercial channel.
Share Buyback Program: Zimmer Biomet plans a share buyback program of up to $750 million in 2026.
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Shareholder Return Plan
Dividend Program: No specific mention of a dividend program or changes to dividend payouts was made during the call.
Share Repurchase Program: Zimmer Biomet executed $250 million in share repurchases during the fourth quarter of 2025. Additionally, the company announced a share buyback program of up to $750 million for 2026.
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Key Q&A
Q:Why is Zimmer Biomet implementing sales force optimization initiatives now, and what are the expected outcomes?
A:Zimmer Biomet is transitioning from a non-dedicated to a fully dedicated U.S. sales force to address productivity gaps and leverage new product cycles. The company aims to specialize its sales force to compete in higher-growth segments, adding over 200 sales reps in robotics and other areas. The transformation is expected to be completed by the end of 2027, with visible benefits starting to emerge towards the end of 2027.
Q:What factors are embedded in Zimmer Biomet's tempered guidance for 2026?
A:The guidance reflects three main factors: the U.S. sales force transition, the adoption of new products (e.g., the Magnificent 7), and international performance in key geographies. Disruption from the sales force transition is expected to be greater in the first half of 2026, with potential improvement in the second half.
Q:Why does Zimmer Biomet expect pricing to remain in negative territory in 2026?
A:Pricing is expected to erode by up to 100 basis points due to moderation in price increases in EMEA, biannual price decreases in Japan, and slight declines in China and the Americas. This is consistent with prior guidance and reflects a significant improvement compared to pre-pandemic pricing trends.
Q:What is the expected impact of the sales force reorganization on Zimmer Biomet's 2026 performance?
A:The sales force reorganization is expected to cause some disruption, particularly in the early stages, as contracts with distributors are renegotiated. The company has completed one-third of the transition and expects productivity increases to become evident towards the end of 2027.
Q:What drove Zimmer Biomet's strong fourth-quarter performance in 2025, particularly in the U.S.?
A:The strong performance was driven by new product acceleration, additional capital sales, and better execution. Internationally, growth in knees was supported by revenue shifts from Q3 to Q4 in the Middle East.
Q:What are the key drivers of Zimmer Biomet's gross margin outlook for 2026?
A:Gross margins are expected to decline to 70%-71% due to lower growth rates, reduced FX hedge gains, pricing and geographic mix headwinds, and tariff impacts. The company plans to offset some of these declines through SG&A efficiencies and restructuring.
Q:What is the outlook for Paragon 28's contribution to Zimmer Biomet's growth?
A:Paragon 28 is expected to deliver double-digit growth in 2026. While revenue in 2025 was slightly below expectations, integration costs and EPS dilution were better than expected. The company remains optimistic about the business, supported by new product launches and strong ASC momentum.
Q:How does Zimmer Biomet view the ASC (Ambulatory Surgery Center) market as part of its U.S. strategy?
A:Zimmer Biomet sees ASCs as a key growth area, with 20%-22% penetration in hips and knees by the end of 2025. The company is investing in dedicated personnel, expanding its portfolio, and forming partnerships to strengthen its position in the ASC market.
Q:What is Zimmer Biomet's capital allocation strategy for 2026?
A:The company is prioritizing share buybacks over M&A in 2026, with up to $1.5 billion authorized for buybacks. This decision reflects a focus on integrating recent acquisitions and managing the U.S. sales force transformation. M&A activity may resume in the future.
Q:What are the key highlights of Zimmer Biomet's upcoming AAOS meeting?
A:The company plans to showcase its mBos robotic platform, which offers fully autonomous and semi-autonomous capabilities, along with other new products. The mBos system is expected to set a new standard in robotics with its ease of use, accuracy, and streamlined workflow.
Q:Review of Unclear Management Responses
A:Management avoided providing specific details on the expected growth rate for 2027, stating that they would address it later in the year. Additionally, while they mentioned the ASC penetration rate for hips and knees, they did not provide a specific number for shoulders, citing uncertainty.
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Earnings Word Cloud
The most frequently occurring keywords in this quarter's earning call
ASC channel
ASCs driver
CVH employee
Cementless Knee
Chain limitation
Extremities digit
Hips franchise
Instructions
Knee expectation
Knee iodine
Knee penetration
Magnificent platform
Paragon acquisition
Paragon anniversary
Paragon interest
Paragon transaction
Shoulder
Suky
anniversary deal
campaign
capital sale
contribution Paragon
core
deal closing
digit cash
dilution Paragon
disruption
evolution sale
expense Paragon
flow digit
initiative
mBos
point tailwind
product momentum
sale cash
sale channel
sale force
share count
strength cycle
transformation
transition evolution
ZBH Transcript
Zimmer Biomet Holdings, Inc. (ZBH) Q4 2025 Earnings Call Transcript
Positive2-10
The earnings call reveals strong financial performance with a 10.9% increase in net sales and significant growth across various product lines. The Q&A section highlights strategic initiatives like sales force optimization and capital allocation towards share buybacks, reflecting confidence in future growth. Despite some pricing pressures and sales force transition disruptions, the guidance remains stable with optimistic long-term prospects. These factors suggest a positive stock price movement, supported by robust product performance and strategic focus on growth areas like ASCs and robotics.
Zimmer Biomet Holdings, Inc. (ZBH) Presents at 44th Annual J.P. Morgan Healthcare Conference Transcript
Neutral1-13
Zimmer Biomet Holdings, Inc. (ZBH) Presents at Jefferies London Healthcare Conference 2025 Transcript
Neutral11-18
Zimmer Biomet Holdings, Inc. (ZBH) Q3 2025 Earnings Call Transcript
Unknown11-5
The earnings call summary presents mixed signals. While there are positive elements like raised EPS guidance and new product launches, concerns arise from declining operating margins and uncertainties in international markets. The Q&A reveals cautious management responses, a choppy U.S. revision market, and market share loss in U.S. knees. Although optimistic guidance and potential premium pricing for iodine-coated implants are positive, the lack of specific guidance for 2026 and cautious capital allocation strategy tempers expectations. Overall, the sentiment is neutral, with potential upside from innovation and strategic acquisitions.
ZBH Report
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