PROCEPT BioRobotics Corp is a surgical robotics company dedicated to advancing patient care through innovative urology solutions. The company designs, manufactures, and sells the AquaBeam Robotic System and the HYDROS Robotic System, which are image guided robotic platforms for minimally invasive treatment of benign prostatic hyperplasia. Each system employs a single use disposable handpiece to deliver the proprietary Aquablation therapy, a heat free waterjet procedure that…
PROCEPT BioRobotics Corp is a surgical robotics company dedicated to advancing patient care through innovative urology solutions. The company designs, manufactures, and sells the AquaBeam Robotic System and the HYDROS Robotic System, which are image guided robotic platforms for minimally invasive treatment of benign prostatic hyperplasia. Each system employs a single use disposable handpiece to deliver the proprietary Aquablation therapy, a heat free waterjet procedure that combines real time imaging, personalized treatment planning, and automated resection. Aquablation therapy removes obstructive prostate tissue without thermal injury, aiming to provide durable symptom relief while minimizing risks of incontinence, erectile dysfunction, and ejaculatory dysfunction. The technology was developed to address limitations of existing surgical options and is supported by a growing body of clinical evidence from nine studies and over 150 peer reviewed publications. According to company estimates, the total addressable market for its therapy in the United States approaches $30 billion, driven by the large prevalence of BPH and the high cost of disposable handpieces.
PROCEPT BioRobotics generates revenue primarily from the sale of its robotic systems and the associated disposable handpieces. In addition, the company offers sales type leasing arrangements that allow customers to access the systems without an upfront purchase. Revenue is also derived from service and support contracts related to the installed base of AquaBeam and HYDROS systems. In 2025 the company reported total revenue of $308.1 million, compared with $224.5 million in 2024. As of December 31 2025 the installed base totaled 912 AquaBeam and HYDROS systems worldwide, with 718 units located in the United States. The company also generates income from training and education services provided to healthcare professionals to increase system utilization.
PROCEPT BioRobotics holds a niche position in the urology market as the sole provider of an image guided robotic therapy for benign prostatic hyperplasia. Its main competitors include manufacturers of traditional resective tools such as transurethral resection of the prostate devices, laser based systems offered by Boston Scientific Corporation, and providers of minimally invasive implants like UroLift from Teleflex Incorporated and Rezum also from Boston Scientific. The company’s competitive advantages stem from the proven clinical benefits of Aquablation therapy, which delivers consistent and durable symptom relief, a favorable safety profile, and resection outcomes that are independent of prostate size, shape and surgeon experience, supported by a robust body of peer reviewed publications and strong endorsement from key urological societies. Furthermore, the procedure has secured broad reimbursement coverage, with Medicare administrative contractors providing access in all 50 states and private payors extending coverage to an estimated 95% of men in the United States. The firm’s technology has been incorporated into clinical guidelines of major urology associations including the American Urological Association and the European Association of Urology, reinforcing its legitimacy as a treatment option.
The company’s primary customers are hospitals and ambulatory surgery centers that purchase its robotic systems and disposable handpieces. It also works with distribution partners in select international markets and engages leasing companies to facilitate equipment financing. Ultimately, the procedures are performed by urologists who treat patients suffering from lower urinary tract symptoms due to benign prostatic hyperplasia. In the United States PROCEPT targets approximately 2,700 hospitals that perform resective BPH procedures, aiming to convert a share of the estimated 300,000 annual surgeries to its Aquablation therapy. Outside the United States, the company collaborates with distribution partners in regions such as Europe and Asia to expand access to its robotic systems and support local reimbursement efforts.
Sector:HealthcareSector rationaleThe company designs, manufactures, and sells the AquaBeam and HYDROS robotic systems and disposable handpieces specifically for the medical treatment of benign prostatic hyperplasia. Its primary customers are hospitals and ambulatory surgery centers, and its revenue is derived from medical devices and associated clinical services, placing it squarely in the Healthcare sector.Industries:Medical DevicesHealthcarePrimaryPROCEPT BioRobotics designs and manufactures the AquaBeam and HYDROS Robotic Systems, which are image-guided robotic platforms used for the surgical treatment of benign prostatic hyperplasia. These are therapeutic and surgical medical devices sold to hospitals and ambulatory surgery centers.Medical SuppliesHealthcareSecondaryThe company generates significant revenue from the sale of single-use disposable handpieces required to deliver Aquablation therapy, which are medical consumables.Classified using BQ-MICSCIK: 0001588978
Investment Thesis
▲ Bull case
PRCT has demonstrated early success in its commercial realignment, with Q1 procedure volume reaching approximately 12,200 units and showing 30% year-over-year growth despite transition disruptions, indicating strong underlying demand that is poised to accelerate as the integrated regional structure and dedicated launch teams become fully operational, particularly as the company noted that the full benefits of these changes are expected to materialize in the second half of 2026, setting the stage for sustained procedure growth beyond current expectations.
The company is benefiting from a favorable regulatory and clinical tailwind, including the European Association of Urology’s strong recommendation for Aquablation therapy as an alternative to TURP for prostates 30-80 milliliters, which validates the clinical efficacy of its technology and supports broader adoption, especially given the emphasis on preserving ejaculatory function—a key differentiator that addresses unmet patient needs and could drive faster uptake in both U.S. and international markets.
PRCT’s international expansion is gaining traction, with 7 new Hydros systems sold in the United Kingdom during Q1 at an average selling price over USD 400,000, signaling early success in a market with solid reimbursement infrastructure and growing adoption at high-volume NHS hospitals, which suggests the international opportunity is materializing faster than anticipated and could become a more meaningful contributor to revenue sooner than current guidance implies.
The WATER IV trial enrollment is ahead of schedule, with full enrollment expected by end of May 2026 and results slated for presentation at AUA in spring 2027, and given the strong surgical interest and patient willingness to participate highlighted by management, a positive outcome could unlock a significant adjacency in prostate cancer treatment, leveraging the existing installed base of Hydros systems and creating a high-margin, low-customer-acquisition-cost growth vector that is not yet reflected in current financial guidance.
Despite guiding for a more conservative system ASP range of $450,000–$460,000 for the remainder of 2026, PRCT achieved a Q1 U.S. Hydros system ASP of approximately $485,000—an all-time high and 14% above Q4 2025—driven by pricing discipline and favorable customer mix, suggesting that the company’s value proposition supports sustained pricing power, and if this environment persists, full-year ASP could exceed current models, directly boosting revenue and gross margin expansion beyond guidance.
PRCT has demonstrated early success in its commercial realignment, with Q1 procedure volume reaching approximately 12,200 units and showing 30% year-over-year growth despite transition disruptions, indicating strong underlying demand that is poised to accelerate as the integrated regional structure and dedicated launch teams become fully operational, particularly as the company noted that the full benefits of these changes are expected to materialize in the second half of 2026, setting the stage for sustained procedure growth beyond current expectations.
The company is benefiting from a favorable regulatory and clinical tailwind, including the European Association of Urology’s strong recommendation for Aquablation therapy as an alternative to TURP for prostates 30-80 milliliters, which validates the clinical efficacy of its technology and supports broader adoption, especially given the emphasis on preserving ejaculatory function—a key differentiator that addresses unmet patient needs and could drive faster uptake in both U.S. and international markets.
PRCT’s international expansion is gaining traction, with 7 new Hydros systems sold in the United Kingdom during Q1 at an average selling price over USD 400,000, signaling early success in a market with solid reimbursement infrastructure and growing adoption at high-volume NHS hospitals, which suggests the international opportunity is materializing faster than anticipated and could become a more meaningful contributor to revenue sooner than current guidance implies.
The WATER IV trial enrollment is ahead of schedule, with full enrollment expected by end of May 2026 and results slated for presentation at AUA in spring 2027, and given the strong surgical interest and patient willingness to participate highlighted by management, a positive outcome could unlock a significant adjacency in prostate cancer treatment, leveraging the existing installed base of Hydros systems and creating a high-margin, low-customer-acquisition-cost growth vector that is not yet reflected in current financial guidance.
Despite guiding for a more conservative system ASP range of $450,000–$460,000 for the remainder of 2026, PRCT achieved a Q1 U.S. Hydros system ASP of approximately $485,000—an all-time high and 14% above Q4 2025—driven by pricing discipline and favorable customer mix, suggesting that the company’s value proposition supports sustained pricing power, and if this environment persists, full-year ASP could exceed current models, directly boosting revenue and gross margin expansion beyond guidance.
PRCT’s Q1 procedure growth of 30% year-over-year, while positive, fell short of the implied acceleration needed to meet its full-year guidance of 39–48% U.S. procedure growth, with management acknowledging flat quarter-over-quarter procedure volume and attributing it to normal seasonality and commercial realignment disruption, raising concerns that the expected second-half ramp may not materialize if the launch team model and integrated sales structure fail to deliver faster-than-anticipated procedure pull-through from newly placed systems.
The company’s handpiece-to-procedure ratio was approximately 95% in Q1, below the targeted 1:1 ratio, and while management dismissed this as normalization, the persistent gap suggests either incomplete inventory rationalization or weaker-than-expected consumable demand per procedure, which could indicate that system placements are not translating into/utilization as expected, undermining the recurring revenue model critical to long-term profitability.
Despite highlighting pricing discipline, PRCT’s Q1 U.S. system ASP of $485,000 was achieved in a seasonally weak quarter with minimal large IDN activity, and management explicitly guided to a lower ASP range of $450,000–$460,000 for the remainder of the year, indicating that the Q1 strength may be transient and susceptible to reversal as customer mix shifts toward larger accounts with greater pricing leverage, posing a risk to revenue and margin expansion if sustainable pricing power is overestimated.
Operating expenses rose to $86.6 million in Q1 from $71.6 million in the prior year, driven by continued investment in commercial expansion, innovation, and the WATER IV trial, and while management frames this as necessary for long-term growth, the resulting adjusted EBITDA loss widened to $18.1 million from $15.8 million, highlighting that the path to profitability remains contingent on operating leverage that has yet to materialize, with any delay in procedure growth or ASP normalization increasing the risk of prolonged cash burn.
The company’s international revenue, while growing 25% year-over-year to $11.1 million in Q1, remains a small fraction of total revenue at approximately 13%, and management acknowledged that international expansion is heterogeneous and time-intensive, with the U.K. being the primary focus in Europe, suggesting that meaningful contribution from international markets may take longer than anticipated and could fail to offset domestic growth risks if U.S. commercial execution stalls.
PRCT’s Q1 procedure growth of 30% year-over-year, while positive, fell short of the implied acceleration needed to meet its full-year guidance of 39–48% U.S. procedure growth, with management acknowledging flat quarter-over-quarter procedure volume and attributing it to normal seasonality and commercial realignment disruption, raising concerns that the expected second-half ramp may not materialize if the launch team model and integrated sales structure fail to deliver faster-than-anticipated procedure pull-through from newly placed systems.
The company’s handpiece-to-procedure ratio was approximately 95% in Q1, below the targeted 1:1 ratio, and while management dismissed this as normalization, the persistent gap suggests either incomplete inventory rationalization or weaker-than-expected consumable demand per procedure, which could indicate that system placements are not translating into/utilization as expected, undermining the recurring revenue model critical to long-term profitability.
Despite highlighting pricing discipline, PRCT’s Q1 U.S. system ASP of $485,000 was achieved in a seasonally weak quarter with minimal large IDN activity, and management explicitly guided to a lower ASP range of $450,000–$460,000 for the remainder of the year, indicating that the Q1 strength may be transient and susceptible to reversal as customer mix shifts toward larger accounts with greater pricing leverage, posing a risk to revenue and margin expansion if sustainable pricing power is overestimated.
Operating expenses rose to $86.6 million in Q1 from $71.6 million in the prior year, driven by continued investment in commercial expansion, innovation, and the WATER IV trial, and while management frames this as necessary for long-term growth, the resulting adjusted EBITDA loss widened to $18.1 million from $15.8 million, highlighting that the path to profitability remains contingent on operating leverage that has yet to materialize, with any delay in procedure growth or ASP normalization increasing the risk of prolonged cash burn.
The company’s international revenue, while growing 25% year-over-year to $11.1 million in Q1, remains a small fraction of total revenue at approximately 13%, and management acknowledged that international expansion is heterogeneous and time-intensive, with the U.K. being the primary focus in Europe, suggesting that meaningful contribution from international markets may take longer than anticipated and could fail to offset domestic growth risks if U.S. commercial execution stalls.