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California-based medtech company Carlsmed Inc. has completed its initial public offering (IPO), raising approximately $100.5 million in gross proceeds.
These proceeds are aimed at supporting manufacturing scale-up, commercial expansion, and growth of its aprevo platform for 3D printed personalized spine surgery. Trading commenced on July 23 as Carlsmed priced 6.7 million shares of common stock at $15.00 per share under the ticker symbol “CARL” on the Nasdaq Global Select Market, with the offering closing the following day.
Underwriters were granted a 30-day option to purchase up to an additional 1,005,000 shares at the same price. BofA Securities, Goldman Sachs & Co. LLC, and Piper Sandler led the offering as joint book-running managers, while Truist Securities and BTIG served as joint book-runners.
Shortly after the IPO, Carlsmed secured approval from Centers for Medicare & Medicaid Services (CMS) for New Technology Add-On Payment (NTAP) reimbursement of cervical fusion procedures using its 3D printed aprevo implants.
Beginning October 1, 2025, hospitals will be eligible for up to $21,125 in additional reimbursement per qualifying inpatient procedure. Part of CMS’s 2026 Hospital Inpatient Prospective Payment System (IPPS) final rule, the approval is expected to accelerate adoption of the company’s personalized surgical technology across U.S. hospitals.
“We appreciate CMS’s support in making innovative medical technologies more accessible to Medicare beneficiaries by mitigating some of the financial burden on hospitals,” said Mike Cordonnier, Chairman and CEO of Carlsmed.
A closer look at aprevo technology
According to the California-based company, the aprevo platform combines AI-driven surgical planning with 3D printing to create patient-specific interbody implants. The process begins with a CT scan, which is converted into a 3D model of the patient’s spine.
Carlsmed’s proprietary software uses this model, along with spinopelvic alignment targets and historical outcomes data, to generate a fully customized surgical plan. Once approved by the surgeon, each implant is 3D printed to match the patient’s unique anatomy and shipped sterile for use in the operating room.
During surgery, Carlsmed’s myaprevo app provides detailed 3D visualizations of both the implant and the surgical plan, enabling precise alignment and easier execution. After the procedure, post-operative imaging is analyzed to determine whether the clinical objectives were met. This feedback loop helps refine future planning and supports reproducible outcomes across cases.
Currently, aprevo implants are FDA-cleared for both lumbar and cervical spine fusion procedures. The lumbar solution is already in commercial use, and Carlsmed is preparing for a US launch of its cervical line in 2026. The cervical implants have also been granted Breakthrough Device designation by the FDA, a recognition that underscores their potential to improve outcomes in complex spinal reconstruction.
Having now received the NTAP reimbursement approval and IPO proceeds, Carlsmed’s integrated approach across pre-op planning, intra-op guidance, and post-op analysis aims to reduce revision surgeries and improve long-term outcomes through personalization.
Scaling 3D printed spinal implants
The development and scaling of customizable medical implants has become a key growth area within additive manufacturing, as clinical adoption and production capabilities continue to expand.
Two years ago, Chinese medical firm Wedo Bio-Medical Technology received Chinese market approval for the WedoCage, a 3D printed spinal implant made of hydroxyapatite-coated porous titanium. Produced using BLT-S210 and BLT-S310 metal printers from Bright Laser Technologies (BLT), the WedoCage featured a complex truss and micro-porous structure designed for low elastic modulus and high fatigue resistance.
BLT worked closely with Wedo’s R&D team to optimize print parameters, support strategies, and heat treatment. In clinical trials conducted across more than 10 hospitals since 2019, the implant achieved a 97.10% fusion rate at six months, outperforming PEEK devices with no product-related adverse events reported.
Elsewhere in 2018, Johnson & Johnson Medical GmbH acquired German specialist Emerging Implant Technologies (EIT) to expand the interbody implant offerings of its orthopedic division, DePuy Synthes. EIT’s 3D printed spinal implants, created using SLM, featured porous titanium structures engineered to encourage bone in-growth and improve spinal fusion outcomes.
Prior to the acquisition, EIT’s Cellular Titanium implants had received FDA 510(k) clearance and had been used in over 10,000 procedures across more than 15 countries. The deal reflected a broader trend of consolidation in the medical 3D printing space, as additive manufacturing gained traction in spinal care.
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Featured image shows 3D printed titanium implants for spinal fusion. Image via Carlsmed.
