Earnings Call Transcript - MDXG Q3 2025

Operator, Operator

Good afternoon, and thank you for your patience. Welcome to the MiMedx Third Quarter 2025 Operating and Financial Results Conference Call. This conference is being recorded. I would now like to hand it over to your host, Mr. Matt Notarianni, Head of Investor Relations for MiMedx. Thank you. You may now begin.

Matthew Notarianni, Head of Investor Relations

Thank you, operator, and good afternoon, everyone. Welcome to the MiMedx Third Quarter 2025 Operating and Financial Results Conference Call. With me on today's call are Chief Executive Officer, Joe Capper; and Chief Financial Officer, Doug Rice. As part of today's webcast, we are simultaneously displaying slides that you can follow. You can access the slides from the Investor Relations website at mimedx.com. Joe will kick us off with some opening remarks and a summary of our operating highlights as well as a discussion of our financial goals, and Doug will provide a review of our financial results for the quarter. And then Joe will conclude before we make ourselves available for your questions. Before we begin, I would like to remind you that our comments today will include forward-looking statements, including statements regarding future sales, operating results and cash balance growth, future margins and expenses, our product portfolios and expected market sizes for our products. These expectations are subject to risks and uncertainties, and actual results may differ materially from those anticipated due to many factors, including competition, access to customers, the reimbursement environment, unforeseen circumstances and delays. Additional factors that could impact outcomes and our results include those described in the Risk Factors section of our annual report on Form 10-K and our quarterly report on Form 10-Q. Also, our comments today include non-GAAP financial measures, and we provide a reconciliation to the most comparable GAAP measures in our press release, which is available on our website at mimedx.com. With that, I'm now pleased to turn the call over to Joe Capper. Joe?

Joseph Capper, CEO

Thanks, Matt. Good afternoon, everyone. Thank you all for joining us for today's call. I'm very pleased to report that our third quarter performance was outstanding across the enterprise, generating strong top line growth in both our Wound and Surgical franchises. We set new company highs for quarterly revenue, adjusted EBITDA and adjusted EBITDA margin, which added $23 million of cash in the quarter. I am extremely proud of the team's focus, which drove these superior results. We continue to prove we can adjust to challenges and advance on opportunities whenever they arise. As such, we are once again raising our full year 2025 revenue growth guidance and our expectations for adjusted EBITDA margin. Our goal for the remainder of the year is to maximize near-term opportunities to ensure a strong finish and usher in the pending Medicare reimbursement reforms from a position of strength. The final rules are likely to be implemented at the start of 2026, and we are well prepared for a range of potential scenarios, especially given the dramatic financial improvements we made to the business over the last few years. I will touch on some of the highlights of the quarter and then provide an update on our strategic focus, which I'm confident will help you understand why we are so bullish about the future for MiMedx. For the third quarter, year-over-year net sales growth was an exceptional 35%, finishing at a record $114 million. Our adjusted gross profit margin was 88% in the quarter. Adjusted EBITDA was $35 million or 31% of net sales. We continue to build cash, ending Q3 with $124 million in net cash, a sequential increase of $23 million for the quarter, and we expect to end the year with a net cash balance of more than $150 million. Our Surgical business was an important contributor, growing 26% this quarter, driven by the continued growth across the portfolio. We now have over half of the target patients enrolled in our EPIEFFECT randomized controlled trial, and we have recently completed an interim analysis with favorable results. We launched a few strategic collaborations with companies offering complementary solutions in the wound care market, and we continue to evaluate additional products to expand our portfolio for both our wound and surgical businesses. In terms of our strategic focus, we continue to make excellent progress in the three areas we have consistently highlighted as the most important for our long-term growth. Our top strategic priority is to continue to innovate and diversify our product portfolio. As you have witnessed, one of the ways we have been able to maintain strong momentum in the business has been with the introduction of products designed to address the numerous unmet needs in both the wound care and surgical markets. In this year alone, we continued with the full market release of EPIEFFECT, licensed and introduced HELIOGEN, CELERA and EMERGE, and we have just begun the rollout of EPIXPRESS. A randomized controlled trial for EPIEFFECT continues to progress on schedule. As mentioned, we have over half of the target number of patients enrolled and randomized, which provided sufficient data for interim analysis and manuscript submission. These favorable results will be presented tomorrow at the Tissue Repair Evidence Summit. This is excellent news as we will then have completed all the necessary steps to request reimbursement coverage for EPIEFFECT as required by the pending LCDs. On our last call, I mentioned that we had received a TRG letter for EPIXPRESS, which confirmed its status as an FDA Section 361 product. EPIXPRESS is a fenestrated allograft designed to be used in post-acute cases where the flow or extraction of fluid is of critical importance to the healing process. The full market release of EPIXPRESS is now underway and the early feedback is extremely positive. CELERA and EMERGE allografts we licensed to remain competitive in the private office marketplace until Medicare reform is enacted, both performed well in the quarter, contributing to our growth in wound care. We also continued executing on the previously announced co-marketing pilot with Vaporox. As a reminder, the Vaporox system named VHT or vaporous hyperoxia therapy is a 510(k) cleared device that delivers ultrasonic mist and concentrated oxygen for the treatment of nine types of hard-to-heal chronic wounds, including diabetic foot ulcers, venous leg ulcers and pressure ulcers. We are receiving excellent early feedback about this solution. Our second priority is to develop and deploy programs intended to expand our footprint in the surgical market. To achieve our continued success in this area, exemplified by our 26% surgical revenue growth in Q3, we have committed significant resources toward the introduction of products like our Xenograft Particulate HELIOGEN, additional commercial resources and development of robust real-world evidence demonstrating the potential clinical benefits for patients, the healthcare economic payoff and the immense business opportunity for MiMedx. By way of example, we've mentioned the use of our technology in anastomosis procedures a few times in the past. One of the most common complications from those procedures are leaks, which occur in upwards of 9% of patients who undergo colorectal surgery and are associated with statistically significant increases in morbidity, mortality, length of stay and rehospitalization. The cost associated with these complications is estimated to be approximately $28 million for 1,000 patients, making anastomotic leaks a nearly $14 billion challenge for the healthcare system. As we have demonstrated in peer-reviewed publications, the application of AMNIOFIX as a protective barrier to the surgical closure site has proven to help reduce anastomotic leaks by nearly 50% and readmissions by approximately 40%, which would provide massive savings. Given there are over 500,000 colorectal surgeries per year in the U.S., our total addressable market is in excess of $500 million for AMNIOFIX just in colorectal procedures. We will continue to make these critical investments and expect to generate evidence across a variety of procedures. Our third initiative is to introduce programs designed to enhance customer intimacy. As we have mentioned, we believe the way we interact with our customers and our company's comprehensive value offering will help drive engagement and retention, especially as we transition to a reimbursement environment where profit potential is no longer a primary driver in product selection. We continue to invest in ways to enhance these relationships, including increased and improved customer interaction at various levels within the company. We also continue to experience excellent adoption of MiMedx Connect, our proprietary customer portal. In the third quarter, we saw sequential sales growth of nearly 60% for orders managed within MiMedx Connect. We also recently added bill pay functionality within Connect for online payments and invoicing, and we're actively developing additional features to this system designed to improve workflow and strengthen the bond between MiMedx and our customers. We believe our commitment to this approach will lead to enhanced customer relationships, improved Net Promoter Scores, higher margins and ultimately an increase in the average lifetime value of a customer. On last quarter's call, we discussed the reforms CMS plans to implement to address the runaway fraud, waste and abuse plaguing the skin substitute market. As a reminder, CMS announced the following initiatives. First, at the end of June, CMS introduced the wasteful and inappropriate service reduction or Wiser model, which is focused on leveraging artificial intelligence and machine learning in concert with human clinical review to curb broad waste abuse in healthcare. This voluntary model, which aims to encourage safe and evidence-supported best practices for treating Medicare beneficiaries will run from January 1, 2026, through December 31, 2031, in five states and will examine several product categories, including skin substitutes. Next, in July, CMS posted the proposed physician fee schedule or PFS, and the Outpatient Prospective Payment System, or OPPS, for calendar year 2026. These proposed rules move away from the ASP methodology in the private office and the bundle in wound care centers in favor of a fixed payment for skin substitutes of $125.38 per square centimeter in all outpatient sites of care, private offices and wound care centers alike. We submitted our comments to the proposed rules in September, recommending CMS consider setting a higher application fee for providers covered by the PFS, reimbursing skin substitutes as pass-through items, setting the fixed price using other reasonable inputs we highlighted, resulting in a relatively modest increase in the price per square centimeter, applying an inflationary index moving forward and phasing in the price change over time. We believe these suggestions taken together would compensate providers appropriately for the important work they do, eliminate perverse incentives to overutilize skin substitutes and ensure product developers continue to invest in cutting-edge technologies and solutions, all while saving U.S. taxpayers, the Medicare trust fund and beneficiaries billions of dollars. Final rules are expected to be published in November to take effect at the start of the new year. Lastly, the much-discussed LCDs are scheduled to go into effect on January 1. It remains to be seen if they will be modified and/or delayed once again. But as I said earlier, we are well positioned for any scenario. As we stated in the past, we are extremely confident of the company's position post Medicare reimbursement reform. When product performance is once again the primary factor driving product selection, our best-in-class technology will carry the day. Let me offer three facts in support of this statement. First, in 2023, we grew our business by 20% with constant pricing. It was all volume-related growth driven in part by the introduction of a few new products and commercial execution. This was just about the time we started to see a rapid uptick of new high-priced skin substitutes entering the market, which subsequently caused our growth to slow. Second, in the surgical market, where profit potential does not so overwhelmingly drive product selection, we have been outperforming in the market as evidenced by our 26% growth in the third quarter. And third, we've recently introduced a few wound products that are more competitively priced. While these products are priced below the mean of other available products on the market, they have been enough to stem the attrition of customers in search of these opportunities. These three points illustrate that profit potential is not such an outsized motivator in product selection and performance and outcomes are of greater importance, MiMedx grows faster than the market. We also expect to see a number of competitors decrease in the wound care market when the reimbursement reform goes into effect as certain business models will become significantly less attractive. We, therefore, see this as an excellent opportunity to pick up market share. Before I turn the call over to Doug for a detailed financial review of the quarter, I'd like to share some of my thoughts on guidance. First, we had a great third quarter, and we expect to finish the year in a similar fashion. As such, we are increasing our full year 2025 revenue growth rate outlook from the low teens to the mid- to high teens. We also now expect our full year adjusted EBITDA margin to be at least in the mid-20s as a percentage of net sales. Second, we were no doubt trying to determine how to model the business for 2026 post the implementation of the proposed reforms. We are somewhat in the same boat. However, it would not be prudent to project the base case from the proposed numbers and current volumes given the other factors which will no doubt benefit our business. Until we have clarity on the CMS final rules for the PFS and OPPS, which have yet to be published, we do not want to overspeculate. At a higher level, we do expect some choppiness in the early part of the year as the industry navigates the changes. Still, we welcome these reforms and expect the change will bring much-needed stability and predictability to the market. We firmly believe that the change is an opportunity for MiMedx to pick up share due to our numerous competitive advantages. We have a fully vertically integrated business from product development to manufacturing to commercialization, including donor recovery. We have an excellent, robust and defensible intellectual property portfolio. We have arguably the most comprehensive and effective commercial organization in this space. And over the past 2.5 years, we have dramatically improved our financial position to include an anticipated net cash balance of more than $150 million by year-end. I've been running med tech companies for decades, and I can tell you that these types of events have a way of shaking out the marginal players. Our fundamentals are solid, and we are going to leverage our competitive advantages to ensure continued success in this new area. That is why I am incredibly bullish regarding the prospects for MiMedx. Now let me turn the call over to Doug for a more detailed review of our financial results. Doug?

Douglas Rice, CFO

Thank you, Joe, and good afternoon to everyone on today's call. I'm pleased to review our results with you all today. As a quick reminder, as Matt mentioned at the top, many of the financial measures covered in today's call are on a non-GAAP basis, so please refer to our earnings release for further information regarding our non-GAAP reconciliations and disclosures. Moving on to the results. Our third quarter 2025 net sales of $114 million represented 35% growth compared to the prior year period. By product category, third quarter wound sales of $77 million increased 40% versus the prior year period, while surgical sales of $37 million were up 26%, reflecting strong results across both of our franchises. We saw significant contributions across our business in the third quarter. In Wound, our third quarter performance was driven by new product sales of CELERA and EMERGE. In our Surgical franchise, AMNIOFIX and AMNIOEFFECT once again delivered strong double-digit year-over-year increases in sales, and our particulate products also demonstrated strong growth on a year-over-year and sequential basis. Our third quarter 2025 GAAP gross profit was about $95 million, a 38% increase compared to the prior year period. Our GAAP gross margin was 84% in the third quarter 2025 compared to 82% last year. Excluding the incremental acquisition-related amortization expense in the quarter, our non-GAAP adjusted gross margin was 88%, up about 540 basis points compared to the third quarter of 2024. This increase was primarily a result of product mix as well as the timing of positive production variances. In light of the strong year-to-date results, we now expect our full year non-GAAP gross margin to be around 85%. Turning to our operating expenses. GAAP sales and marketing expenses were $54 million or 47% of net sales in the third quarter compared to $42 million or 50% of net sales in the prior year period. The dollar increase was due to a combination of increased sales costs, including higher commissions associated with both higher sales as well as the changes we made to our sales commission plans in the middle of 2024. As a result of our year-to-date results, we now expect full year 2025 sales and marketing expenses to be between 49% and 50% of net sales, which would be a modest improvement on a percentage of sales basis compared to 2024, albeit up in absolute dollars. GAAP general and administrative expenses, or G&A, were $15 million or 13% of net sales in the third quarter compared to $12 million or 14% of net sales in the prior year period. The dollar increase was driven by incremental spend from legal and regulatory disputes in the current period, including our ongoing litigation with certain competitors and former employees. As with other operating expense lines, we expect GAAP G&A to grow in absolute dollars for the full year 2025 and to be about 14% to 15% of net sales. Our third quarter R&D expenses of $4 million or 3% of net sales was up $800,000 compared to the prior year period. Our R&D expenses are primarily comprised of the costs associated with our EPIEFFECT RCT as well as additional spend related to the development of future products in our pipeline. As Joe mentioned, we have prepared an interim analysis of the EPIEFFECT RCT and have submitted it for publication and presentation later this year in support of any potential Medicare coverage requirements. As we think about the full year, we expect R&D expenses to be about 3% of net sales. GAAP income tax expense for Q3 2025 was around $6 million, reflecting an effective GAAP tax rate of 27%. We continue to expect our long-term non-GAAP effective tax rate to be 25%. Our third quarter GAAP net income was $17 million or $0.11 per share on a diluted basis compared to GAAP net income of $8 million or $0.05 per share in the prior year period. Adjusted net income for the third quarter was $23 million or $0.15 per share compared to $10 million or $0.07 per share in the prior year period. Third quarter adjusted EBITDA was $35 million or 31% of net sales compared to $18 million or 22% of net sales in the prior year period. Sequentially, our third quarter adjusted EBITDA grew by nearly $11 million as we focus on expense management that enables our sales increases to drop to the bottom line. Turning to our liquidity. We continue to bolster our balance sheet and position the company to make growth investments. In the third quarter, the business generated $29 million in free cash flow, a record for the company, and our net cash position rose to $124 million. The steady improvement in our balance sheet provides us with the ability to evaluate a range of organic and inorganic investments, and we believe we have a healthy amount of combined firepower between cash on hand and borrowing capacity to help continue to grow and diversify our business. I will now turn the call back to Joe.

Joseph Capper, CEO

Thanks, Doug. As you just heard, we had an outstanding quarter and expect a strong finish to the year. We set record highs for revenue and adjusted EBITDA with strong growth in both the Wound Care and Surgical businesses. We continue to generate excellent cash flow. We launched EPIXPRESS. We advanced a few pilot programs to co-market complementary solutions in the wound care market, and we increased our 2025 guidance meaningfully to reflect our strong momentum. As far as the upcoming wound care reimbursement reform is concerned, it is a matter of when, not if this is going to happen. The current trends are not sustainable. We hope these much-needed reforms incorporate our recommendations. We believe they would be beneficial to all stakeholders. And as I said, we are confident in our ability to excel when the industry resets to the proposed guidelines. In closing, I would like to once again thank the MiMedx team for a tremendous quarterly performance and for your unwavering commitment to our mission and the many individuals we have the good fortune to serve. Let's now shift to Q&A and open the call to questions. Operator, we are ready for our first question. Please proceed.

Operator, Operator

Our first question comes from Frank Takkinen with Lake Street Capital Markets.

Frank Takkinen, Analyst

Congrats on a really nice quarter. I was hoping to start with the guide for the rest of the year. How should we be thinking about kind of contribution from wound versus surgical? Obviously, we still have the wound policy in place through year-end, and that might change at the beginning or likely will change at the beginning. But should we continue to expect that, that grows really heavily? And then should we continue to expect that surgical business too as well? Just trying to kind of get a little bit more of the variables behind the Q4 guide.

Douglas Rice, CFO

Thanks, Frank. This is Doug. Good question. We're really pleased with the record revenue for the quarter, driven by 40% growth in our wound franchise and 26% in Surgical. Looking ahead, we expect strong momentum in the surgical suite to continue into Q4, and the wound business is also set to grow at a healthy pace. It's important to remember that Q3 last year was the lowest point due to the sales turnover we experienced in Q2, so the comparisons will get a bit tougher in Q4. I'll stop there.

Joseph Capper, CEO

The only caveat to Q4 as Doug mentioned, it's going to be a tougher comp in Q3. And as the rules on the rules and adjustments start to take place, there's probably some folks that will make those adjustments a little bit earlier. So back of December will be a little bit more difficult to predict. But we've got great momentum. Obviously, the first month is in good shape.

Frank Takkinen, Analyst

Got it. That's helpful. And then maybe just thinking a little bit about kind of post January 1. I know you mentioned you're doing a number of things to prepare for that. Maybe you call out some of those things that you're doing today to prepare for different reform options and maybe if you can extend to what you feel like would be the best outcome for your company? Is it kind of how your comments were structured and proposed? Or is there anything else you think would be kind of the best outcome for MiMedx?

Joseph Capper, CEO

I believe our previous comments reflect what would be the best outcome for both the industry and MiMedx. We have long been advocating for a more balanced playing field to eliminate price variability. It seems that change is on the horizon, which we clearly welcome. Based on our experience competing under fair conditions, we are confident in our ability to outperform the market. While I won't go into specifics about our scenario planning, it's likely that a less favorable profitability environment will drive some competitors out. This opens up numerous opportunities for market share growth. We have ample evidence of our past success, particularly in our surgical market where we are seeing growth in more balanced conditions. Lastly, we have a strong balance sheet, allowing us to explore opportunities to gain market share as they arise.

Frank Takkinen, Analyst

Got it. And then maybe if I can squeeze one more quick one in. Cash ending at $142 million. I know you guided to greater than $150 million of cash. That obviously leaves the door open above $150 million. But how should we maybe think about cash generation if you just put up $20 million this quarter and that $150 million is out there?

Joseph Capper, CEO

Yes, we may have caused some confusion because we sometimes discuss gross cash and net cash. We currently have about $18 million drawn on our line. So when we mention $150 million by year-end, that refers to net cash. From a gross perspective, you're probably looking at the high 160s. The question is why we haven't paid down that line. The reason is that we've been evaluating numerous opportunities and thought it made sense to address them all simultaneously.

Operator, Operator

Our next question is from the line of Chase Knickerbocker with Craig-Hallum.

Chase Knickerbocker, Analyst

On the quarter. Maybe just first, Joe, I was hoping you'd be willing to share in your wound business on a overall square centimeters basis, what volume growth was either sequentially or year-over-year. I respect your comments on the uncertainty as it relates to '26, but just trying to get some sort of kind of guidepost for us as we think about Q4 and then 2026 as it relates to volumes.

Joseph Capper, CEO

We haven't shared specific details on that because there are many variables involved, including the performance of new products, which may require varying amounts of materials. This means that your volume measurements can fluctuate significantly based on numerous factors. We generally avoid delving into specifics, especially by segment. As I mentioned earlier, we are confident about the upcoming changes and believe we are well-positioned to gain market share, depending on the final pricing. Additionally, the impact of new regulations, such as pricing adjustments and discounting opportunities, further complicates the situation. There are many mechanics to consider regarding how these rules will be implemented, which could influence marketing strategies. It's still early, and we expect to receive the final regulations in a few weeks. While we all wish we had answers today, we are close to that point. I want to emphasize that I believe no other company is better positioned than we are to compete once these rules are established.

Chase Knickerbocker, Analyst

Understood. Maybe just on that, have you had a chance to get any feedback on the Hill or from any sort of constituents on some of those suggestions that you made, I think, particularly around kind of the potential pass-through mechanism or like a CPI adjustment, for example, instead of a recalculation annually. I mean, have you gotten any feedback from that?

Joseph Capper, CEO

Nothing that we could publicly comment on. We work through third-party advisers who communicate directly with as much as possible. Obviously, we're in a shutdown, but as much as possible directly with CMS and the MACs and we try to put together as much information on it as we can. But there's nothing that we can share publicly that we can stand behind 100% at this point today.

Chase Knickerbocker, Analyst

And then just last, maybe on the LCDs. The submission regarding when the clinical data is expected to be submitted is coming up very quickly. Have you heard from the MACs about getting your data in for the LCDs, which could likely be moving forward? Also, I know you mentioned the presentation tomorrow. Can you provide any additional details about that data or your confidence that it will be sufficient to support inclusion on the LCD related to EPIEFFECT?

Joseph Capper, CEO

So I'm going to frustrate you for the third time, case, I apologize. There's really not a whole lot more I can offer in terms of LCD, go/no-go, whether they're going to be implemented, whether they're going to be modified. And all that's kind of rumor in the industry. Everybody's got their opinion. The second part of your question of whether or not we feel that we've got sufficient evidence relative to EPIEFFECT to justify reimbursement. The answer to that is yes. The analysis was very strong. And then there are steps we have to go through either has to be a presentation and there has to be a manuscript submission and then you can apply for reimbursement. And we have those steps completed as of tomorrow. So we feel comfortable that our submission is in good shape. Whether or not they stick to that protocol is yet to be seen or I would say, requirement is yet to be seen. That will tie back to whether or not the LCDs are once again postponed and/or modified. But we're in pretty good shape with that product.

Operator, Operator

Our next question is from the line of Carl Byrnes with Northland Capital.

Carl Byrnes, Analyst

Congratulations on the quarter. Considering the foreseeable shakeup, obviously rising from reimbursement changes, which are longer and your cash buildup, I mean are you seeing any compelling low-hanging fruit with respect to M&A prospects or business development opportunities that would fit nicely?

Joseph Capper, CEO

Yes, the answer is yes. We have identified some compelling assets. We have focused more on the surgical aspect of our business by exploring opportunities to license or acquire technologies, products, or companies. This does not mean we are neglecting the wound care segment; rather, valuing assets with exposure to impending changes is more challenging at the moment. However, I believe we have significant opportunities to utilize our balance sheet to expedite our strategic growth plan. As previously mentioned, we are not acquiring just for the sake of acquiring. We will consider options that align with our strategic plan, enhance our current product portfolio in wound care, or provide strategic advantages in the surgical sector, as these are the types of assets we are pursuing.

Operator, Operator

Our next question is coming from the line of Ross Osborn with Cantor Fitzgerald.

Ross Osborn, Analyst

Congrats on a strong quarter. So starting off, would you walk through where you're seeing adoption of HELIOGEN and where you stand on evidence generation there?

Joseph Capper, CEO

We haven't put out a number on that, but...

Douglas Rice, CFO

It's increasing quarter-to-quarter sequentially.

Joseph Capper, CEO

It's increasing month-to-month and quarter-to-quarter. However, it takes time to get the product on contract and navigate through the bidding or value analysis committees. Also, proving efficacy at the surgical level is essential. The feedback has been positive, and we are building evidence around it in various cases. While we haven't disclosed a specific growth number, it is becoming a significant contributor to our surgical business. It's important to emphasize that our surgical business is continuing to grow well. When we decided to close down the KOA business about two years ago, our goal was to pivot and focus more on the surgical side, which we have successfully done. We've added personnel to that group and launched several new products, including HELIOGEN, and have dedicated considerable time to evidence generation. That segment currently makes up about one-third of our business and is experiencing growth rates of 15% to over 20% consistently throughout the year. If it were a standalone surgical company with such a growth rate, it would likely have a significantly higher valuation than MiMedx does today. We're very excited about continuing to invest in this area.

Ross Osborn, Analyst

Great. And then turning to AXIOFILL, what's the path forward there following the September court ruling?

Joseph Capper, CEO

We need to resubmit our arguments and likely have another hearing with the judge, so we're essentially starting over. In the meantime, AXIOFILL continues to perform well in the market. When we added HELIOGEN to our portfolio, part of the reasoning was to have a backup plan if AXIOFILL were to be discontinued. We haven't made significant changes to that product, and it has stabilized and even grown in some instances. Looking at our particulate business, which includes AXIOFILL and HELIOGEN, it is a very strong business that continues to expand. We'll navigate through this situation, and we have mitigation plans in place in case AXIOFILL unexpectedly becomes unavailable. We believe our case is robust, and our arguments are very strong. I wouldn't interpret the delay in any negative way; it simply seemed a bit extended from a scheduling perspective, which might have prompted the judge to reset the process.

Operator, Operator

The next question is from the line of Anthony Petrone with Mizuho Group.

Anthony Petrone, Analyst

Congrats on a great quarter, very, very bullish results all around. Maybe on the 40% wound growth in the quarter, and obviously, you mentioned the final CMS LCD outcome here coming in November. Do you think there was pull forward of demand in the physician channel specifically just ahead of that ruling? Did you notice any of that taking place? And then just when you think of underlying volumes on the surgical side, we've heard from others in the medical device space that there's some pull forward of just surgeries generally on the notion that potentially ACA policies may not renew just with the government shutdown happening here. Did you notice any pull-through on the surgical side from any Medicaid or ACA dynamics? And I'll have one quick follow-up.

Joseph Capper, CEO

We didn't notice pull-through on either side of the business. We certainly didn't notice pull forward, I should say, on the surgical side of the business. Frankly, I wouldn't expect it in the types of procedures where our product is being utilized. These are not elective surgeries. So I doubt we would be impacted by that. You might see it more in the orthopedic space or something like that, but you're not going to see it really where our products being used for the most part.

Anthony Petrone, Analyst

Okay. Great. And then just a follow-up again on looking at the final rule here, and I know there's just a debate out there on potentially how skin substitute products could settle on a per centimeter square basis, but also on the allotment for how many applications could be decided on in the LCD. So is there any way to just set expectations on what the range of scenarios could be on a per centimeter squared basis, but as well as a total application basis?

Joseph Capper, CEO

Yes. I think it's a good point you bring up, not limitations because there are things that we still need clarity on, which is one of the reasons why I'm staying away from speculating. And I'm going to frustrate you as much as I frustrated Chase. I just can't give you that range right now. I certainly am not going to speculate on what the final price is going to be because there's all kinds of rumors running around in the marketplace, and they are just that. We're really close to this thing being public. If I were a betting person, I'd say we're going to see it sooner in November rather than later in November. So we're going to know real soon, Anthony. And then we'll be able to kind of plug these inputs into the way we've been modeling potential scenarios, and we'll have more clarity. But again, I have to stress that regardless of the rules, the industry will be more stable. It will be more predictable. If it resets somewhat, that's okay because this company will outperform the market as it has done in the past when the playing field is even. When everybody is playing by the same rules, especially relative to price and profitability, we will outperform the market. So we welcome it.

Operator, Operator

At this time, this concludes our question-and-answer session. I'll hand the floor back to Joe Capper for closing comments.

Joseph Capper, CEO

Thanks, operator, and we appreciate you guys being on the call today and the interest in the company. That concludes today's call, and we will speak to you after our next quarter. Thanks, everybody.

Operator, Operator

Thank you. Today's conference has concluded. You may now disconnect your lines at this time, and have a wonderful day.