Latest Ratios: P/E Ratio -9.8x · EV/EBITDA 4319.2x · ROE -630.7%. (2004–2025 historical series)
Price-based multiples — how expensive the stock is relative to earnings, sales, book value, and cash flow
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Market Cap | $1.4B | $3.2B | $1.3B | $1.8B | $1.3B | $1.1B | $973M | $371M | $81M | $35M | $28M |
| Enterprise Value | $1.9B | $3.6B | $1.8B | $2.2B | $1.6B | $1.3B | $909M | $380M | $55M | $54M | $11M |
| P/E Ratio → | -9.77 | — | — | — | — | — | — | — | — | — | — |
| P/S Ratio | 1.86 | 4.13 | 2.15 | 3.80 | 3.64 | 4.60 | 6.72 | 3.27 | 0.88 | 0.35 | 0.23 |
| P/B Ratio | 39.07 | 87.63 | 139.10 | 18.01 | — | 14.07 | 6.18 | 5.13 | 4.60 | — | — |
| P/FCF | 511.43 | 1137.37 | — | — | — | — | — | — | — | — | — |
| P/OCF | 31.39 | 69.80 | — | — | — | — | — | — | — | — | — |
P/E links to full P/E history page with 30-year chart
Enterprise-value multiples — capital-structure-neutral measures of total business value
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| EV / Revenue | — | 4.73 | 2.92 | 4.46 | 4.53 | 5.29 | 6.27 | 3.35 | 0.60 | 0.53 | 0.09 |
| EV / EBITDA | 4319.24 | 8313.77 | — | — | — | — | — | — | — | — | — |
| EV / EBIT | — | — | — | — | — | — | — | — | — | 17.74 | — |
| EV / FCF | — | 1302.77 | — | — | — | — | — | — | — | — | — |
Margins and return-on-capital ratios measuring operating efficiency
Full margin charts and quarterly trend are on the Earnings History page
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Gross Margin | 69.6% | 69.6% | 69.4% | 64.3% | 66.4% | 64.9% | 70.8% | 68.4% | 69.0% | 61.3% | 63.3% |
| Operating Margin | -10.7% | -10.7% | -22.3% | -36.0% | -41.9% | -52.7% | -40.6% | -41.7% | -24.5% | -8.8% | -12.8% |
| Net Profit Margin | -18.8% | -18.8% | -26.5% | -38.7% | -43.1% | -58.8% | -54.5% | -50.3% | -31.6% | -2.3% | -25.2% |
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ROE | -630.7% | -630.7% | -291.7% | -556.7% | -676.1% | -120.8% | -68.8% | -126.9% | -164.9% | — | — |
| ROA | -18.3% | -18.3% | -20.5% | -28.1% | -27.7% | -34.2% | -35.9% | -37.4% | -27.1% | -2.6% | -25.2% |
| ROIC | -12.6% | -12.6% | -22.6% | -37.2% | -42.1% | -56.4% | -50.7% | -97.0% | — | — | — |
| ROCE | -13.7% | -13.7% | -21.4% | -33.7% | -34.5% | -37.8% | -34.1% | -39.8% | -29.2% | -16.6% | -41.0% |
Solvency and debt-coverage ratios — lower is generally safer
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Debt / Equity | 17.21 | 17.21 | 64.65 | 5.33 | — | 4.48 | 0.27 | 0.78 | 0.19 | — | — |
| Debt / EBITDA | 1425.17 | 1425.17 | — | — | — | — | — | — | — | — | — |
| Net Debt / Equity | — | 12.74 | 49.94 | 3.15 | — | 2.12 | -0.41 | 0.13 | -1.47 | — | — |
| Net Debt / EBITDA | 1055.50 | 1055.50 | — | — | — | — | — | — | — | — | — |
| Debt / FCF | — | 165.40 | — | — | — | — | — | — | — | — | — |
| Interest Coverage | -5.78 | -5.78 | -5.51 | -10.23 | -26.61 | -19.28 | -5.37 | — | -3.23 | 0.40 | -4.77 |
Short-term solvency ratios and asset-utilisation metrics
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Current Ratio | 2.06 | 2.06 | 2.73 | 2.86 | 1.84 | 3.28 | 3.16 | 2.98 | 2.47 | 2.24 | 1.80 |
| Quick Ratio | 1.28 | 1.28 | 1.58 | 1.99 | 1.11 | 2.37 | 2.37 | 2.02 | 1.53 | 1.32 | 1.05 |
| Cash Ratio | 0.73 | 0.73 | 0.91 | 1.40 | 0.61 | 1.85 | 1.85 | 1.29 | 0.95 | 0.76 | 0.48 |
| Asset Turnover | — | 0.97 | 0.79 | 0.60 | 0.67 | 0.43 | 0.55 | 0.65 | 0.71 | 1.20 | 1.28 |
| Inventory Turnover | 1.37 | 1.37 | 1.07 | 1.26 | 1.16 | 0.93 | 0.92 | 1.03 | 0.99 | 1.44 | 1.47 |
| Days Sales Outstanding | — | 46.48 | 49.53 | 54.96 | 62.48 | 62.87 | 61.99 | 51.97 | 61.48 | 53.18 | 56.19 |
Earnings, FCF, buyback, and dividend yields — total returns to shareholders
Full dividend history and growth charts are on the Dividend History page
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Dividend Yield | — | — | — | — | — | — | — | — | — | — | — |
| Payout Ratio | — | — | — | — | — | — | — | — | — | — | — |
| Metric | TTM | FY 2025 | FY 2024 | FY 2023 | FY 2022 | FY 2021 | FY 2020 | FY 2019 | FY 2018 | FY 2017 | FY 2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Earnings Yield | — | — | — | — | — | — | — | — | — | — | — |
| FCF Yield | 0.2% | 0.1% | — | — | — | — | — | — | — | — | — |
| Buyback Yield | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 2.8% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% |
| Total Shareholder Yield | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 2.8% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% |
| Shares Outstanding | — | $150M | $143M | $121M | $103M | $96M | $67M | $52M | $35M | $13M | $9M |
High leverage and insolvency
According to current market data, ATEC trades at a forward P/E of 29.06, which appears to price in aggressive long-term growth expectations that contrast sharply with the company's negative trailing P/E of -9.69 and the significant execution risks inherent in its current high-growth, low-profitability business model.
The valuation multiples suggest that investors are prioritizing top-line expansion over near-term earnings, effectively betting on the company's ability to scale into profitability. However, the extreme EV/EBITDA ratio of 4291.41 indicates that the market is currently ignoring traditional valuation metrics in favor of revenue-based growth narratives, which warrants caution if growth rates begin to normalize.
Based on reported figures, ATEC's ROIC has remained consistently negative, reaching -3.5% in 2026Q1, which suggests that the company is currently destroying shareholder value as it deploys capital into instrument sets and market expansion efforts that have yet to generate returns exceeding the cost of capital.
The persistent negative ROIC highlights the difficulty of achieving scale in the spine device market, where high upfront capital investment is required to secure surgeon adoption. Until the company can demonstrate a clear path to positive returns on its invested capital, the current strategy of aggressive asset deployment appears to be a drag on long-term value creation.
As reported in financial statements, ATEC's cash conversion cycle remains elevated, with days inventory outstanding reaching 187 days in 2025Q4, indicating that the company's reliance on placing surgical instrument sets at hospitals creates a significant drag on working capital efficiency compared to less capital-intensive medical device peers.
The high inventory levels are a structural byproduct of the 'razor/razor-blade' model, but they also expose the company to significant obsolescence risk if product iterations outpace the turnover of existing sets. Investors should monitor whether the company can optimize its logistics and instrument utilization to improve cash flow conversion as the installed base matures.
According to recent SEC filings, ATEC's debt-to-equity ratio has surged to 33.03 in 2026Q1, a level that appears increasingly unsustainable and suggests that the company's reliance on external financing to fund its operations has created a precarious balance sheet that is highly sensitive to interest rate fluctuations.
The negative interest coverage ratio of -4.56 confirms that the company is not currently generating sufficient operating income to service its debt obligations, forcing a continued reliance on capital markets. This leverage profile significantly limits management's strategic flexibility and increases the risk of dilution or distressed financing if operational targets are missed.
The price-to-sales ratio is frequently misapplied to ATEC, as it obscures the underlying capital intensity of the business model and fails to account for the significant non-cash expenses, such as stock-based compensation, that distort the company's true path toward GAAP profitability and long-term cash flow sustainability.
Investors should instead focus on the ratio of free cash flow to revenue, which provides a more accurate picture of the company's ability to self-fund its growth. Relying on P/S multiples in this context risks ignoring the high cost of maintaining the surgical instrument base and the ongoing dilution required to retain top-tier sales talent.
Includes 30+ ratios · 22 years · Updated daily
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Quick answers to the most common questions about buying ATEC stock.
Alphatec Holdings, Inc.'s current P/E ratio is -9.8x. This places it at the 50th percentile of its historical range.
Alphatec Holdings, Inc.'s current EV/EBITDA is 4319.2x. This enterprise value multiple compares the company's total value (equity + debt - cash) to its EBITDA. The historical average is 19.2x.
Alphatec Holdings, Inc.'s return on equity (ROE) is -630.7%. The historical average is -81.0%.
Based on historical data, Alphatec Holdings, Inc. is trading at a P/E of -9.8x. This is at the 50th percentile of its historical P/E range. Compare with industry peers and growth rates for a complete picture.
Alphatec Holdings, Inc. has 69.6% gross margin and -10.7% operating margin.
Alphatec Holdings, Inc.'s Debt/EBITDA ratio is 1425.2x, indicating high leverage. A ratio above 4x may signal elevated financial risk.