CONMED Corporation Q2 2026 Earnings Call

Please stand by. Hello and welcome to CONMED's second quarter of 2026 earnings conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. Please be advised that today's conference is being recorded. Before the conference call begins, let me remind you that during this call, management will be making comments and statements regarding its financial outlook, its plans, and objectives. These statements represent the forward-looking statements that involve risks and uncertainties as those terms are defined under the Federal securities laws. Investors are cautioned that any such forward-looking statements are not guarantees of future events, performance, or results. The company's actual results may differ materially from its current expectations.

Please refer to the risk and other uncertainties disclosed under the forward-looking information in today's press release, as well as the company's SEC filings for more details on the risks and uncertainties that may cause actual results to differ materially. The company disclaims any obligation to update any forward-looking statements that may be discussed during this call, except as may be required by applicable law. You will also hear management refer to non-GAAP or adjusted measurements during this discussion. While these figures are not a substitute for GAAP measurements, management uses these figures to aid in monitoring the company's ongoing financial performance from quarter-to-quarter and year-to-year on a regular basis, and for benchmarking against other medical technology companies.

Adjusted net income and adjusted earnings per share measure the income of the company, excluding credits or charges that are considered by the company to be special or outside of its normal ongoing operations. These adjusting items are specified in the reconciliation supporting the company's earnings releases posted to the company's website. I would now like to turn the call over to Mr. Pat Beyer, CONMED's President and Chief Executive Officer. Please go ahead, sir. Thank you, operator, and welcome everyone to our second quarter of 2026 earnings call.

I'm joined on the line by John Gallagher, our recently appointed Chief Financial Officer. Let me provide you with a quick agenda for today's call. I'll begin with a high-level overview of our quarterly financial results, followed by a discussion of the sales performance in our two product lines, and an update on the key product growth drivers within each. I'll then highlight a few areas of operational progress in recent months. I'll turn the call over to John, who will walk through our quarterly financial results in greater detail. I'll conclude by reviewing our financial guidance for 2026, which we updated in today's press release, before opening the call for questions. With that, let's get started with a review of our Quarter 2 financial performance.

For avoidance of doubt, all sales growth figures discussed are provided on a year-over-year and constant currency basis, unless noted otherwise. In the second quarter, we reported net sales of $343.5 million. Our net sales increased 0.3% year-over-year on an as-reported basis and decreased 0.5% on a constant currency basis. On an organic basis, our net sales increased 6% year-over-year, modestly exceeding the high end of our range of expectations we shared on our last earnings call. As a reminder, our organic growth excludes the sales of gastroenterology, or GI, products in our general surgery product line related to the strategic exits we announced previously as part of our portfolio optimization strategy. From a profitability perspective, we delivered adjusted diluted earnings per share of $1.38, an increase of 20% year-over-year.

These results were significantly better than the high end of our expectations, driven by a $0.21 benefit from tariff refunds that was not contemplated in our second quarter guidance range. Importantly, excluding this benefit, we delivered second quarter earnings per share that exceeded the high end of our guidance range by approximately $0.03. All in all, we were pleased to deliver strong financial performance in the second quarter. With our consolidated results as a backdrop, I'll now discuss the sales performance in our general and orthopedic surgery product lines and provide an update on our key product growth drivers in each. Starting with general surgery. General surgery sales increased 5.3% on an organic basis. By geography, general surgery organic sales increased mid-single digits in the U.S. and increased high single digits internationally.

From a product line standpoint, our general surgery sales growth was fueled primarily by contributions from AirSeal and Buffalo Filter. I'll now provide an update on these two key growth product offerings for CONMED, starting with AirSeal, our advanced insufflation platform. In the robotic surgery market, the team remains focused on driving adoption and utilization of AirSeal by leveraging the differentiated nature of our technology and its key role in supporting complex surgical procedure. Most notably, AirSeal's ability to deliver stable, low-pressure insufflation represents a key benefit for surgeons conducting high-acuity cases. Moreover, AirSeal has been clinically shown to reduce procedure times and improve visibilities while achieving impressive reductions in both patient postoperative pain and length of stay. These clinical and economic advantages continue to resonate with robotic surgeons and position AirSeal for continued growth as robotic surgery expands across subspecialties and into ambulatory surgery centers.

With respect to ambulatory surgery centers, we saw early success in this area in the second quarter as we continue to focus on developing our value proposition. To that end, our team is focused on generating data specific to ASC economics that we believe will support our continued growth in this site of care. Our team also continues to focus on expanding adoption of AirSeal in the U.S. laparoscopic market, a significant market opportunity for CONMED going forward. Specifically, we estimate AirSeal is used in only 6%-7% of the more than three million laparoscopic procedures performed in the U.S. each year. Our portfolio of published clinical evidence continues to expand as well. In May, Nikhil Vasdev, Professor and Chair of Robotic Surgery at the University of Hertfordshire, published the results of a randomized controlled trial comparing AirSeal to a competitive system.

The trial found that patients treated with AirSeal saw less intraoperative pain, less blood loss, and shorter procedure times compared to those treated with the competitive system, continuing to strengthen our portfolio of clinical support. AirSeal was a top contributor to our general surgery growth in the second quarter. Our AirSeal growth in quarter two was driven by year-over-year growth in sales of both capital and single-use products. AirSeal sales trends also improved sequentially as expected. With that being said, the level of AirSeal growth in the quarter was lower than we had expected. Looking ahead, we continue to expect improving AirSeal growth trends in the second half of 2026, albeit at a lower rate than our prior guidance assumed.

Importantly, we remain confident in AirSeal's ability to deliver high single-digit to low double-digit growth long-term, given its compelling clinical and economic benefits across both robotic and laparoscopic procedures, the established advantages of low single-digit pressure in complex surgery, and the multiple opportunities we have to drive further expansion and utilization, including in the U.S. laparoscopic market, ambulatory surgery centers, and international markets, to name a few. Our confidence in the long-term outlook for AirSeal is further supported by a new clinical indication for our AirSeal Robotic Solution, which we announced publicly ahead of our participation in the Society of Robotic Surgery annual meeting. Our AirSeal Robotic Solution is now indicated for use with Intuitive's 8-millimeter hex cannulas in addition to its existing indication for their 8-millimeter round cannulas. The 8-millimeter hex cannulas were introduced with da Vinci 5 and are currently compatible across X, XI, and da Vinci 5.

This now means that AirSeal Robotic Solution can be used across Intuitive's multi-port portfolio. Securing this expanded indication represents an important milestone. It enables us to provide increased clarity in the market regarding the use of our product with Intuitive's complementary robotic technologies, specifically market AirSeal for use with Intuitive's hex cannulas, and support current and prospective customers with clear product communication and compatibility data. In collaboration with the team at Intuitive, our team conducted extensive engineering and technical compatibility testing throughout the first half of 2026 to support this expanded indication. Importantly, both companies are issuing letters to their respective customers to inform them of this indication and its implications. I'm proud of this collaborative achievement as we work to support surgeons through the continued evolution of robotic-assisted surgery.

Moving to an update on Buffalo Filter, our smoke evacuation platform and the other key driver in our general surgery growth. Sales of our direct smoke evacuation portfolio delivered year-over-year growth in the second quarter, exceeding the high single-digit to low double-digit range we continue to expect longer term. This performance more than offset modest declines in our OEM smoke evacuation portfolio. As a reminder, we continue to prioritize direct smoke evacuation, which puts us closer to the customer and carries a stronger margin profile than OEM. Buffalo Filter represents one of our most compelling long-term growth opportunities with multiple tailwinds, including expanding legislation requiring the use of surgical smoke evacuation systems. To that end, we were pleased to see the states of Michigan and Maryland recently enact legislation to this effect. Michigan's law applies to facilities that provide surgical procedures using heat-related equipment likely to generate surgical smoke.

It requires them to develop and implement a policy requiring the use of a smoke evacuation system by July 23, 2027. Maryland's law requires all healthcare facilities to adopt and implement smoke evacuation policies by January 1, 2028. With the addition of Michigan and Maryland, there are now a total of 22 U.S. states with smoke-free operating room laws, covering approximately 57% of the U.S. population. We also see evidence of continued activity on this front, including more than 10 additional states with bills on this subject entered and pending passage. This is a testament to the efforts of medical societies like AORN, which continue to advocate for legislation, as well as the clear benefits of surgical smoke evacuation. As a reminder, an estimated 90% of surgical procedures create smoke, and Buffalo Filter has been shown in clinical studies to filter 99.9997% of toxic smoke molecules.

We were pleased with our direct smoke performance internationally as well, and continue to see early commercial traction in Europe, Canada, and Australia. On the new product front, our next generation evacuator, PlumeSafe X5, continues to garner positive feedback for its smaller footprint, quieter operation, and faster smoke clearance, further strengthening our position in the market, including with the ambulatory and outpatient settings. As a reminder, we estimate that the global smoke evacuation market represents a $1 billion opportunity. Given our performance and continued progress globally, we expect our direct smoke evacuation portfolio to continue to deliver solid growth as we penetrate this market opportunity longer term. Shifting now to our orthopedic surgery product line. Orthopedic surgery sales increased 6.8%. By geography, our international orthopedic sales increased 10.8%, driven by broad-based growth in each of our major geographic regions, with particular strength in APAC and EMEA in the second quarter.

The domestic orthopedic sales were essentially flat in the second quarter, which was slower than expected. During the second quarter, we continued to strengthen our commercial organization. To be clear, our U.S. orthopedic team is back on offense and positioned to return to growth. By product, BioBrace, our reinforced bioinductive implant, was a top contributor to our total orthopedic surgery sales growth in the second quarter. I'll now provide a brief update on BioBrace. We are continuing to see BioBrace used across a wide range of orthopedic and foot and ankle procedures, most prominently in rotator cuff repairs. Rotator cuff repairs represent our largest single procedure opportunity, with an estimated 1 million rotator cuff surgeries performed in the United States annually. Published clinical research highlights that rotator cuff repair outcomes are still suboptimal, with re-tear rates estimated anywhere between 30% to above 50%.

Both the Academy of Orthopaedic Surgeons and the broader surgeon community agree that improving patient outcomes for rotator cuff procedures is an important unmet clinical need. No patient wants to go into an elective rotator cuff surgery knowing they have a one in three chance, or potentially worse, of requiring a second surgery after a re-tear. Bearing this in mind, using BioBrace for augmented rotator cuff repairs has clinically demonstrated a 94% healing rate in patients at high risk of re-tear. Our traction in this procedure category speaks to both the strength of our existing clinical data across 30 published studies, along with the updated AAOS guidelines strongly recommending augmentation in rotator cuff repair, both of which continue to support surgeon adoption. Additionally, we are now one year into the launch of BioBrace RC, which is designed to streamline the use of BioBrace in rotator cuff repairs.

Our observations over the past year of commercialization have reinforced that BioBrace RC enables surgeons to augment their rotator cuff repairs more consistently and efficiently, generating stronger surgeon interest in using BioBrace when an augment is needed. As a reminder, BioBrace is differentiated because it brings added mechanical strength and facilitates accelerated healing from its bioinductive properties. Other biologics and techniques that fail to provide this level of support can lead to re-tearing and incomplete healing. With these advantages in mind, our team continues to observe that surgeons who gain experience using BioBrace and see the benefits of its use in their cases tend to become dedicated long-term users. While we remain in the initial years of commercialization, we see BioBrace's potential to improve the standard of care in sports medicine procedures and believe it will remain an important driver of our long-term growth.

In addition to driving growth across our general and orthopedic surgery product lines and continuing to advance our key growth drivers, we also made important operational progress in other key areas this quarter, including executing our portfolio optimization strategy, improving our supply chain, bolstering our balance sheet, and strengthening both our leadership team and board of directors. I'll now take a moment to touch on each of these, starting with our portfolio optimization strategy and the completed exit from our gastroenterology product offerings. Following a comprehensive review of our portfolio, we announced our intent to exit our GI product offerings at the end of last year. In the first quarter of 2026, we closed the sale of certain GI assets, and in the second quarter, we completed the sale of the remaining GI portfolio.

In conjunction with the second quarter transaction, we've entered into a manufacturing services agreement to continue producing certain GI products for the buyer over the next 12 months, ensuring continuity for our customers through the transition. With this chapter now closed, we've sharpened our focus on our strongest growth opportunities, which lie in our core markets: minimally invasive, robotic and laparoscopic surgery, smoke evacuation, and the surgical treatment of orthopedic soft tissue repair, further positioning CONMED for long-term value creation. With respect to our efforts to improve our supply chain, our team has made clear progress over the last year. Specifically, we've strengthened our service levels, reduced back orders to their lowest levels in years, and reduced age-critical back orders while building greater stability across our network. I'm proud to say we've progressed from our former state of recovery and remediation.

We're now in a strong position to take care of our customers and grow our business, and our team is primarily focused on driving operational enhancements now. Looking ahead, we'll continue to invest in building an efficient and resilient supply chain for the future by continuing to enhance our planning, sourcing, service, and inventory systems with the goal of supporting growth, margin expansion, and reliable customer service over the long-term. In terms of strengthening our balance sheet, we refinanced our debt during the second quarter, consistent with the intention we communicated in our last earnings call. Specifically, in June, we secured a new senior secured term loan facility of $450 million that will expire in 2030. We used the proceeds from this facility, along with the borrowings from our revolving credit facility, to repurchase $645.2 million of convertible notes for $637.2 million that would have matured in June 2027.

Lastly, during the second quarter, we enhanced both our board of directors and leadership team with the addition of key personnel. In May, we announced the appointment of Celine Martin and Jeff Mirviss, who joined our board with deep global MedTech leadership experience and a track record of scaling complex businesses. Celine has had a more than 30-year career at Johnson & Johnson, most recently leading J&J's MedTech's Cardiovascular & Specialty Solutions group. Jeff spent nearly 30 years at Boston Scientific, most recently as EVP and Global President of Peripheral Interventions. In June, we were pleased to announce the appointment of John Gallagher as our Chief Financial Officer, effective July 15. During the first half of 2026, CONMED conducted a comprehensive search process supported by a leading executive search firm to identify our next CFO.

I was closely involved in this process alongside our board as we worked to identify a candidate with strong financial experience and leadership capabilities who would be a good steward of our stockholders' interests and a valuable resource to our senior leadership team. I'm pleased to say we found that in John Gallagher. John brings nearly three decades of financial leadership experience, most recently serving as CFO of two public healthcare companies, Certara and Cue Health. He also spent nine years at Becton Dickinson, including as SVP and CFO of BD's Medical segment. John's combination of public company financial leadership and healthcare expertise, along with his track record of leading global finance organizations, make him an excellent fit for CONMED. As a reminder, Todd Garner will remain with us as an advisor until November to ensure a smooth transition.

I'm proud of the level of talent we've been able to attract with our recent appointments. I'd like to take the opportunity on today's call to welcome Celine, Jeff, and John to our team. I'm excited to partner with them as we focus on delivering strong execution and creating long-term value for our shareholders. With that, I'll turn the call over to John, who will walk you through our second quarter financial results in greater detail.

Thank you, Pat. I'm excited to join the CONMED team and pleased to have strong quarterly performance to outline on today's call. Before I do that, I'd like to take a moment to talk about joining CONMED. For me, the decision to join CONMED was about products, culture, and people. My initial views on CONMED's products are favorable, particularly the growth drivers in AirSeal, Buffalo Filter, and BioBrace. I believe those key products are highly differentiated and target large market opportunities, which presents the potential for compelling growth as the company increases penetration. That's an opportunity for shareholder value creation and something that I want to be a part of. Culture and people were also part of the decision. During the vetting process, I spent considerable time with the board and members of the management team.

While I've only been in the seat for two weeks and haven't met everyone by any stretch, I can see the strong focus among the team on the opportunity to create shareholder value. Let's get into the numbers now. Given Pat's detailed discussion of our sales results in the second quarter, I will begin my remarks on the gross profit line. Unless otherwise noted, my commentary will focus on our non-GAAP results during the second quarter of 2026, with all growth rates on a year-over-year basis. Our earnings press release issued today includes reconciliations to the most comparable figures presented in accordance with GAAP. We also have included a supplemental slide deck reviewing our second quarter results and updated financial guidance on the investor relations section of our website. Second quarter adjusted gross profit increased 5.6%. Adjusted gross margin was 59.5%, an increase of 300 basis points.

The increase was driven primarily by an $8.5 million benefit from tariff refunds recognized during the quarter, representing approximately 250 basis points year-over-year. Excluding the tariff refund benefit, gross margin increased 50 basis points year-over-year, driven by favorable product mix and positive foreign currency impact. Adjusted operating expenses increased 1.5%. The increase in operating expenses was driven by a 1.5% increase in adjusted SG&A expense and a 2% increase in adjusted R&D expense. Our adjusted operating margin was 18.2%, compared to 15.7% in the prior year period, an increase of 250 basis points year-over-year. Excluding the aforementioned tariff refund benefit, our adjusted operating income and operating margin were essentially flat year-over-year, modestly better than our expectations. Adjusted interest expense was $6.8 million in the second quarter, compared to $6.4 million last year.

As Pat mentioned, we have completed a refinancing during the quarter, drawing on our new $450 million term loan and our existing revolving credit facility to repurchase $645.2 million of our $800 million 2.25% convertible notes ahead of their June 2027 maturity. This drawdown occurred on June 12th and therefore had an immaterial impact on interest expense in the second quarter. The adjusted effective tax rate in Q2 was 25.2%, modestly higher than we had expected. Adjusted net income was $41.7 million or $1.38 per diluted share, compared to $35.6 million or $1.15 per diluted share in 2025. As Pat mentioned earlier, second quarter adjusted EPS included a benefit of approximately $0.21 from the tariff refund received in the period. We generated $34.2 million of free cash flow in the second quarter of 2026. That represented an increase of 46% year-over-year.

Turning to a review of our balance sheet and financial condition. As of June 30th, 2026, CONMED had cash of $37.3 million, total debt obligations of $834.2 million, and additional available borrowing capacity of $455.5 million. This compares to cash in equivalent of $40.8 million, total debt obligations of $834.9 million, and available borrowing capacity of $648.5 million as of December 31st, 2025. Our leverage ratio on June 30th, 2026, was 2.9 times. CONMED has made significant progress in terms of deleveraging in recent years. This quarter's refinancing meaningfully reduces our exposure to our convertible debt obligations ahead of their 2027 maturity and gives us a more straightforward capital structure to manage. With respect to share repurchases, CONMED has returned a meaningful amount of cash to shareholders.

During the first six months of 2026, we repurchased approximately one million shares of common stock for a total of $43.7 million. We continue to expect to allocate approximately $61.8 million to share repurchase in 2026. I'll now turn the call back to Pat to discuss our financial guidance.

Thanks, John. Beginning with a review of our 2026 financial guidance, which we updated in today's press release. We updated our net sales guidance range to reflect our second quarter results, our updated expectations for revenue contributions from product sales and MSA agreements related to our strategic exits from our GI product offerings in 2026, and, to a lesser extent, updated assumptions regarding the impact on our revenue results from changes in foreign currency exchange rates. Specifically, our full year 2026 revenue guidance now assumes GI revenue in the range of $20 million to $22 million, compared to our prior guidance range of $14.5 million to $17.5 million. We now expect changes in foreign currency exchange rates to represent a tailwind to GAAP results of between $7 million to $7.5 million, compared to our prior expectation of a tailwind from FX of between $4.4 million to $7.4 million.

On an organic constant currency basis, we now expect net sales growth of 5%-6%, compared to our prior expectation of 5%-6.5%. Our updated full year 2026 revenue guidance reflects both our performance in the second quarter and updated outlook for the balance of the year. We have reaffirmed our low-end expectations of 5% organic constant currency growth this year, and our level of confidence in the team's ability to deliver at least 5% growth in 2026 has not wavered. The high end of our organic growth range continues to reflect the expectation that we'll see improving growth trends on a sequential basis in the third and fourth quarters respectively. However, our updated guidance now reflects a more measured pace of improvement in growth trends over the second half of the year.

With respect to profitability guidance for 2026, we now expect non-GAAP adjusted diluted earnings per share in the range of $4.48-$4.60 compared to our prior guidance range of $4.30-$4.45. The increase in our non-GAAP EPS guidance range was driven by the better-than-expected results in the second quarter, a lower expected headwind to EPS from our GI product line exits, and higher expected contribution to EPS from share repurchase activity to date, offset partially by higher interest expense and tax rate assumptions for the full year 2026 period. For modeling purposes, our updated financial guidance for 2026 includes the following assumptions. Adjusted gross margin of approximately 57.5%-58% inclusive of the tariff benefit. Adjusted interest expense of approximately $33 million in 2026 compared to our prior expectation of $25 million-$27 million. Adjusted effective tax rate of approximately 25%, compared to 24.5% previously.

We expect to generate free cash flow of approximately $115 million compared to approximately $125 million previously. Lastly, as it relates to the third quarter of 2026, we expect GAAP net sales of between $334 million and $339 million. Third quarter organic constant currency growth is expected to be in the range of 6.4%-7.6%, excluding expected GI revenue in the range of $3 million-$3.6 million, and an FX impact of approximately 10 basis points. We expect adjusted EPS in the third quarter to be between $0.98 and $1.03. Stepping back, this was a quarter of real progress. We delivered financial performance that exceeded our expectations, advanced our key growth platforms, completed the exit of our GI products, refinanced a portion of our debt, and added exceptional talent to our board and leadership team.

I'm proud of our team's accomplishments in quarter two, and I remain confident that our focused portfolio and differentiated growth drivers position CONMED to deliver durable long-term growth and value for our shareholders as we look forward. I'd like to conclude by thanking everyone on the CONMED team for their efforts this past quarter. Thanks as well to our customers, suppliers, shareholders, and those on today's call for your support. Operator, we will now open the call for questions.

Thank you. If you'd like to ask a question, please signal by pressing star one one on your telephone keypad. If you're using a speakerphone, please make sure your mute function is turned off to allow your signal to reach our equipment. We do ask that you limit yourself to one question and one follow-up. One moment for questions. Our first question comes from Lawrence Biegelson with Wells Fargo. You may proceed. Hi. Thanks for taking our questions.

Starting off, could you provide color on what you believe drove AirSeal below expectations? Based upon your comments, is it fair to assume high single growth this year versus low double digit?

Thanks for the question. I'm going to remind us, we're pleased with our gen surgery growth in quarter two, 5.3% year-over-year organic. I also commented in the script, AirSeal was our top contributor to our general surgery growth in the quarter. This is a growth franchise for us. We also shared we grew both capital and disposables in quarter two. Our AirSeal trends improved sequentially. I continue to expect sequential improvements in the second half. From a long-term growth trajectory of AirSeal, we continue to believe, I continue to believe, it is a high single-digit, low double-digit grower.

Okay. Understood. Maybe looking at BioBrace RC, is there any way you can quantify or at least qualitatively talk to the penetration level there? Do you have any insights on the retention rate for users that have used it a handful of times?

Yeah, here's what I would say on BioBrace RC. It improves the surgeon's ability to repeatedly deliver rotator cuff repairs consistently. We're continuing to see a strong uptake in it. We're continuing to see an increase in new users. We're continuing to see those users that use BioBrace RC have durable attachment with us. They continue to use it over and over again. We're pleased with the BioBrace RC's launch.

Thank you. Thank you. Our next question comes from Travis Steed with Bank of America Securities.

You may proceed. Hey, thanks for the question.

Maybe a higher-level question to start. You got a new CFO, you've announced some pretty well-regarded board members. Just kind of curious how you think that the strategy of CONMED might change or how you think about creating shareholder value differently going forward.

I think going forward, as I think about CONMED's strategy, we're focused on our strongest growth opportunities. Minimally invasive robotic and laparoscopic surgery, smoke evacuation, and surgical treatment of orthopedic soft tissue repair. I'm excited to have John as our new CFO. We talked about our balance sheet being strong and being able to look at both an M&A and an organic approach to an offense on innovation. Excited to have two new board members that bring strong, solid, intense industry experience with innovative technology medical device companies. I like where we're at. I'm excited about the discoveries we've made through our strategic review and like our path towards success.

Great. Makes sense. I did want to ask on kind of EPS margins in the second half. The tariff refund was $0.21 and the quarter beat earnings $0.06 ex the tariff refund, but the full-year guide only went up $0.17. I just want to make sure I understand kind of the delta between the beat tariff refund and the change in the full-year guide, and if the offset was just the AirSeal piece.

This is John. Happy to be here, of course, and thanks for your question that included me as a part of it. Let me do the bridge on EPS. At the low end, what we're seeing is an $0.18 increase, and the stairsteps on that are $0.21 related to the tariff refund, as you called out. We have better-than-expected operational results in Q2, which is worth about $0.08. On the GI product line, we have less of a headwind there, so that's worth $0.05 of an increase, as well as some tailwind from share repo activity of $0.02. Partially offsetting that is interest expense, which is a -$0.15, as well as we made an adjustment to the tax rate a little bit higher, which is worth about $0.03.

Great. That's helpful. That's what bridges it.

It's not related to AirSeal. It's more related to financing activities.

Makes sense. That's helpful. Thank you. I look forward to working with you.

Likewise. Thank you. Thank you.

Our next question comes from Young Li with Jefferies. You may proceed. All right, great.

Thanks for taking our questions. I guess, John, looking forward to working with you. Congrats. First question is, AirSeal, you mentioned there's a lot of different channels and opportunities that you can expand into, U.S. lab, ASCs, OUS channels. I guess I'm kind of curious, what do you need to do to get those markets going? More data, more rep training, things like that? When can we see some inflections and growth from those differentiated channels?

Yeah, Yung, again, I'm going to remind you, and I know you know this, we grew in Q1, we grew faster in Q2. We have multiple growth trajectories in AirSeal. First of all, robotic. We have AirSeal insufflators around the world in multiple robotic companies' systems and in the United States in ASCs. The advancing of the robotic opportunity is in practice. In addition, we're continuing to advance that cause in laparoscopy, and we've stated we're in between 6% and 7% of the 3 million laparoscopic procedures. What we're advancing is stronger clinical relationships and data in those key areas of laparoscopy like colorectal and gynecology, which can benefit from the advancement of clinical insufflation. We're advancing those strongly, and you're going to continue to see AirSeal to continue to grow faster and more consistently going forward along that trajectory.

All right. Got it. Very helpful. I guess another question, just some kind of higher level, just a utilization question in general. It's a topic of debate, but just kind of curious. Are you seeing any impacts from lower ACA exchange enrollments or trade-downs in some of the plans? Do you have expectations of some impacts in second half of the year or beyond?

We are not seeing our procedure volumes and patient volumes changing, quite honestly. They're consistent to procedures we support and the approach of patients globally to come to us through their healthcare system. We have not seen any volume changes.

All right. Great. Thank you.

Thank you. Our next question comes from Vik Chopra with BMO Capital Markets. You may proceed. Good evening, Pat.

Hi, John. It's Anton on for Vik. Thanks for taking our questions. Maybe first, hey, Pat. Maybe first on AirSeal. Maybe just help us think through this now expanded compatibility with DV5 a bit more. How meaningful is the expanded DV5 Hex Cannula indication from a revenue standpoint? Will this increase your current kind of 10%-20% attachment rate on DV5, and how quickly could that happen?

First of all, I'd say we are excited for this new indication. It is a positive signal to customers, patients, and clinicians around the world that these two companies, CONMED and Intuitive, are focused on surgeon choice and patient outcomes. We're excited about that. I would also say we knew this was coming, and it has been included in our guidance. It is a good thing. It's in our guidance, and it's one of the many things that's going to help us continue to grow our business faster in the AirSeal franchise.

Great. Maybe another question on international. The performance was really impressive, better than we were kind of expecting across the board. Can you talk a bit more about what was driving the performance there? Is there anything one-time, and how should we be thinking about that momentum heading into the second half as comps get a little bit more challenging?

Yeah. A couple of things I would say. You'd remember we had a very strong Q4 2025. Correspondingly, we had a slower quarter internationally in Q1, and we've had a really strong quarter here. It was across both general surgery and orthopedics. The growth drivers internationally are the same as they are in the U.S., AirSeal, BioBrace, and smoke evacuation. We have a really strong team internationally, excited about where we're at and where we're going. We know it can be a little more dynamic with growth rates as we work through distributors and some of their own supply chain challenges as they order products from us in a different timeframe can cause our sales to go up and down a little bit more. Quarterly, directionally, we feel good about the business there and continue to feel optimistic about our growth trajectories.

Great. Thanks again. Yeah. Thank you.

Thank you. Our next question comes from Mike Matson with Needham & Company. You may proceed. Yeah, thanks.

Just with regard to AirSeal, I know that Intuitive and da Vinci's pretty dominant and most of the robots out there are one of theirs, but there are a lot of emerging companies out there. Medtronic, J&J have robots now, and there's a bunch of Chinese companies, et cetera. Are there any plans to make AirSeal compatible with any of these other robots? Particularly in the ASC setting, I know there's a few companies targeting ASCs with different types of robots that may be a little more suitable for that setting Great question, Mike.

I was at the Surgical Robotics Society meeting last week in Florida, and I was at the meeting also last year in Strasbourg. This is a really dynamic meeting. The CONMED insufflation booth was loud and proud in the middle of a number of outstanding robotic companies. It was excited to be there, and I would tell you, every robotic surgery system needs an insufflator. CONMED's focus is continuing to be the best, and our clinically superior insufflation system is proving to be that.

Okay. We can be used in any robot, and I want to confirm, we've had AirSeal installed around the world on multiple robotic platforms, and I commented earlier, that includes the U.S. and the ASC environment.

Okay, got it. I just wanted to make sure that there wasn't any FDA clearances or anything like that required to make it compatible with those other systems.

No, there is not any. Most robotic systems actually have to have an independent insufflator used with them.

Okay. All right. I saw the tariff rebate, it's great that you got that, there's also been some changes to the tariff rates lately. What's the outlook for the latest tariff rates? Is it basically similar to what you were expecting before?

It is. Hey, it's John here. Thanks for the question. The expectation continues to be the same on tariffs for the year as far as we had cooked in $0.35 of full year 2026 EPS headwind related to tariff. The refund that we received, of course, was separate and was related to the previous year. The $0.35 remains intact, the update that we had to the guidance was related to the refund that we received related to tariffs paid in 2025.

Okay, thank you. Thank you.

Our next question comes from Robbie Marcus with J.P. Morgan. You may proceed. Oh, great.

I'll also offer my welcome and congratulations on the role.

Thank you. I was wondering, I don't think anyone asked yet, the lowering of the organic sales growth rate at the high end of the guide.

Just maybe walk us through the rationale and what prompted that.

Yeah, Robbie. If you think about it, at the end of quarter one, we had a second half guide of growth to be in the I'm pulling up my numbers here for the second half. To be between, I want to say almost 9%, Robbie. After a second quarter that we grew 6%, and we knew that we had a second half that was going to have to accelerate, but I thought it was prudent to lower the second half top end, what was $1.35 billion to $1.344 billion. We actually lowered the top end by $6 million. We have a second half guidance that says we've got to grow in the 6% plus range. We've just grown 6%. We believe we have a strong approach towards the 6% in the second half, and I remain confident in our ability for the total year to grow 5%.

Great. The other one I wanted to ask on was free cash flow. It's down about $20 million year-over-year. There are a couple of cash costs you're excluding in the adjustments. How are you thinking about free cash flow for the year, and what's the right conversion rate for the business moving forward? Thanks a lot. Yeah, thanks.

On free cash flow, it's primarily working capital that's driving the down year-on-year and versus the previously guided number. That's the primary driver. We also have interest expense and some movement on the tax rate. It's early days for me. I don't have what the typical conversion is on free cash flow, but what I've seen certainly in the two weeks that I've been here is we've got a strong cash flow organization. There is likely some opportunity as we look at working capital inventory at the company, and that's certainly an area of focus. Overall, the strong cash flow of the company is helpful in supporting the de-leveraging efforts that we've had underway.

Yeah, Robbie, we've also, this past year, we've also talked about our focus on taking care of our customers and ensuring we didn't allow inventory to hold us back from doing that. I also commented that now our operations team is focused on optimization and improving some of those areas. You should expect inventory going forward to improve.

Thanks a lot. Thank you.

Our next question comes from Matthew O'Brien with Piper Sandler. You may proceed. Great. Hi, this is Anna on for Matt.

Thanks for taking our questions here. Just two from us. Firstly, on ortho, the headline number was nice, but seems like domestically things were a bit short of what you were expecting. Just if you could elaborate a bit more on some of the puts and takes there. Then maybe within that, any additional comments you could provide on a shift in mix, maybe between ASCs and the inpatient setting.

Got you. Good question. Again, let's level set ourselves. Ortho sales increased 6.8% globally, international was 10.8%, and domestic was essentially flat or U.S. I also want to give you some context. Our U.S. orthopedic business has grown mid-single digits five of the last eight quarters and three of the last four. This is one out of the three of the four that we didn't grow in. In the second quarter, our U.S. business had some strategic activities where we were looking to strengthen our commercial organization to position for growth. We took some actions. It caused our growth to pause. We are on offense, and we expect it to continue to grow. Your thoughts on ASC growth and volume versus the acute care hospital setting, you're right on there.

More and more sports medicine procedures and more and more total joint orthopaedic procedures are moving to the ASC setting. We continue to see that.

Great. Thank you. Then I guess just to double down on the volume commentary that you provided earlier, appreciate you said nothing's changed to date that you're seeing, what are your expectations for surgical volumes for the rest of the year? Just sort of how that's implemented into the guide. Thanks. Our expectations is surgical volumes will continue to be as they were.

Again, we see the news and the publications that come out, some would challenge surgical volumes are going to go lower. Some challenge surgical volumes are going up. We continue to see healthy trends from our customers.

Thank you. I would now like to turn the call back over to Pat Beyer for any closing remarks.

Thank you very much. I want to reiterate, CONMED had a strong second quarter. Our financial results were strong, and we accomplished a lot operationally and organizationally to continue to advance our cause to improve patient outcomes and to deliver long-term shareholder value. I want to thank you all for joining us on this call today.

Thanks, everybody. Thank you. That concludes our conference call for today.

Thank you for your participation.