BDSX — Q2 2026 Financial Report Analysis

Biodesix sells blood tests that help doctors decide what to do about a spot found on a lung scan. In the second quarter of 2026 (April to June), revenue rose 34% to $26.9 million. The growth came from its Nodify Lung tests: 38% more tests were delivered, about 20,900 in total, and each test brought in a little more money. Costs rose much more slowly than revenue, so the operating loss nearly halved, to $5.4 million. The company is still losing money and borrowing at about 12.65%. It also issued new shares to raise cash, so existing shareholders now own a smaller slice of the company.

At a glance

• Diagnostic test revenue up 42% to $25.3 million. Test volume grew 38%, and the rest came from higher pay per test, which management puts down to more insurers covering the tests and better billing and collection.
• Operating costs other than lab costs up only 7%, against 34% revenue growth. That gap is why the operating loss fell from $9.7 million to $5.4 million. The sales force hired over the past year is now selling more per person.
• Cash rose to $30.0 million, but mostly from selling shares. The company raised $23.1 million net by selling stock in the first half of the year, and the share count rose 28% in six months, from 8.25 million to 10.55 million.

The numbers

Gross margin here means the share of revenue left after the direct cost of running the tests and services (lab supplies, staff, royalties). Operating margin means what's left after all operating costs, including sales, research and administration, before interest. Both are negative-to-positive measures of how close the business is to paying for itself. Figures are from the 10-Q's statements of operations. The prior-year test count is implied from the stated 38% growth.

Takeaway: For the first time, Biodesix is adding revenue much faster than it adds costs: $6.8 million more revenue against $2.5 million more operating expense. That is the pattern a lab company needs before it can stop losing money. But it hasn't got there yet. It still burns cash and pays roughly $2 million a quarter in interest on a $50 million loan, and it has been selling shares to fund itself. The question for the next few quarters is whether test growth can close the gap before more shares need to be sold.

What drove the quarter

Nodify Lung is almost the whole story. Diagnostic Tests revenue rose $7.5 million, and the 10-Q says $7.3 million of that came from the Nodify Lung Nodule Risk Assessment tests (Nodify CDT and XL2). These tests help a doctor judge whether a lung nodule (a small spot on a CT scan) is likely to be cancer. The filing attributes the gain to "increases in tests delivered and improvements in average revenue per test as our sales efforts continue to focus on Nodify CDT and XL2 tests."

Pay per test edged up as well as volume. Revenue grew 42% while volume grew 38%, so average revenue per test rose about 3%, to roughly $1,210 (our estimate: diagnostic revenue divided by tests). For a lab, this is the number that matters: many tests get paid only partly or not at all, so collecting more per test goes almost straight to profit. Management credits wider payer coverage (more insurers agreeing to pay) and better revenue-cycle management (the work of billing and chasing payment). Medicare was 35% of total revenue in the quarter, up from 33% a year earlier, so the company depends heavily on one payer's pricing.

Development Services shrank this quarter. This is the smaller unit that does contract work for drug and diagnostics companies. Its revenue fell 29% to $1.5 million, which the 10-Q blames on "timing of sample receipts and the early closure of certain clinical trials." Over the first half it is still up 27%, at $4.8 million, because Q1 was strong. This revenue moves around from quarter to quarter, so one weak quarter tells you little.

Costs grew slowly. Lab and service costs rose 20% as test volume grew, slower than revenue, which lifted gross margin to 82.1%. Sales, marketing and admin costs rose 8% to $24.3 million, mostly from pay for the larger sales team. R&D fell 4% to $3.1 million because spending on clinical trials dropped from $0.5 million to $0.2 million. Total operating expenses rose $2.5 million while revenue rose $6.8 million.

What the headline numbers hide

• Loss per share improved faster than the loss, because there are more shares. Net loss narrowed 37%, but loss per share narrowed 54%. Average shares outstanding rose 40%, from 7.33 million to 10.30 million. The company sold shares through an "at-the-market" (ATM) program, which sells new stock gradually into the market. At last year's share count the loss would have been about $0.99 a share, a 37% improvement. So about 18 of the 54 points come from spreading the loss over more shares, not from the business doing better. The share counts also reflect a 1-for-20 reverse stock split in September 2025: every 20 old shares became 1, applied retroactively to both years.
• The cash increase was mostly funded by investors. Cash rose from $25.6 million at March 31 to $30.0 million at June 30. The company says $6.5 million of that came from ATM share sales, so cash from all other sources fell by about $2.1 million in the quarter. That is much less than Q1's outflow of about $10 million, which included yearly payments the company makes each first quarter. For the first half, operating cash outflow was $11.7 million, compared with a $15.1 million net loss. The gap is mostly non-cash charges (depreciation and share-based pay), partly offset by $3.7 million of working-capital timing, meaning cash that came in later or went out earlier.
• Adjusted EBITDA excludes some real costs. The company's preferred figure, an adjusted EBITDA loss of $3.2 million, leaves out $2.0 million of interest, $1.4 million of depreciation and amortization, and $0.8 million of share-based pay. The interest is paid in cash, so this measure makes the company look closer to breaking even than its cash flow shows.
• The debt is costly but not due soon. The company owes $50.0 million to Perceptive Advisors at about 12.65%, with interest only and no principal due until November 21, 2028. That date was extended from 2027 in February, and in exchange Biodesix gave the lender warrants (rights to buy stock at a set price) on 100,000 shares at $12.93. The loan requires at least $2.5 million in cash at all times and a minimum level of revenue each quarter. The company says it was in compliance at June 30.
• Receivables are under control. Accounts receivable (money billed but not yet collected) were $9.1 million, about the same as at December 31, even though revenue grew more than 30%. So the higher pay per test is turning into cash, not piling up as unpaid bills. Medicare's share of receivables did rise, from 18% to 32%.
• Q1's one-off doesn't affect Q2. Q1 gross margin included a $0.4 million refund of sales and use taxes. Q2 has nothing similar, so the 82.1% gross margin is a clean figure.

Balance sheet: no longer below zero

Shareholders' equity (what would be left for shareholders if every asset were sold and every debt repaid) went from −$2.5 million at December 31 to +$9.1 million at June 30. All of that came from ATM share sales. The first-half loss of $15.1 million alone would have pushed it further below zero. As of June 30, $18.8 million of capacity remained under the $50 million ATM program, so more share sales remain possible.

Outlook

Management kept its full-year 2026 revenue guidance at $108–114 million, which it had raised in May from $106–112 million. It expects gross margin of about 80% and "continued improvement on path to profitability" in adjusted EBITDA. The company has not given a date for breaking even.

First-half revenue was $52.4 million, so the guidance implies $55.6–61.6 million in the second half. Even the low end is above two quarters at Q2's pace ($53.7 million), so the company needs revenue to keep growing from quarter to quarter. The midpoint implies about $29 million a quarter, roughly 9% above Q2. That looks achievable: test volume rose from 17,800 in Q1 to 20,900 in Q2, and Development Services should recover if its backlog of contracts turns into revenue as the company expects.

Our read: the business is improving. Revenue grew 34% while operating costs other than lab costs grew 7%, and pay per test is rising rather than falling as volume grows. At Q2's pace, adjusted EBITDA could turn positive within a few quarters. The weak spot is funding. Over the past two quarters, cash excluding share sales fell by about $12 million in total, and interest is a large fixed cost. Breaking even on adjusted EBITDA would still leave the company short of covering its interest. Three things to watch next quarter: (1) whether test volume keeps growing from quarter to quarter, (2) whether average revenue per test holds as Medicare's share rises, and (3) how many more shares the company sells. If it stops selling shares, that would be the strongest sign the business can pay for itself.

Source: Biodesix Form 10-Q for the quarter ended June 30, 2026 (filed August 5, 2026) and the Q2 2026 earnings release furnished on Form 8-K the same day. This is our first published analysis of Biodesix.