Assay
Financial-condition grades for SEC filers
Company Report · as of Oct 9, 2026
|
| Establishment Labs Holdings Inc.ESTA · healthcare | |
|---|---|
| Grade |  Bsecond fifth of 371 graded peers; percentile 35.7, sampling error 2.5 points; lower is stronger |
| Rank | 133 of 371 |
| Profitability | Cpercentile 46.0 |
| Solvency | Cpercentile 50.3 |
| Growth and financing | Bpercentile 34.5 |
| Reliability | 0.87 AUCfailure model, filers with $120M to $591M assets; 95% interval 0.83 to 0.90; 206 events, 2020 to 2025 |
| Peer failure rate | 1.03% a yearItem 1.03 bankruptcies, same asset band, 2012 to 2025 |
| Size band | $120M to $591M assetstotal assets $357.2M[1] |
| Standard universe | insiderevenue above $1M and assets above $10M[1-2] |
| Warnings | none active · fortress balance sheetnot computable: distress |
| Inputs computable | 8 of 14 |
| Graded from | filings received through Feb 27, 2026224 days before the rescan; every figure keyed to the SEC receipt date |
| Last close | $60.542026-10-08; market equity $1.8B; iex feed |
| Price used in grade | None |
| Share price, twelve months to the rescansplit-adjusted close; a lollipop at every rescan carries the letter held then; baseline ticks are SEC receipt dates of the inputs; ranges and dragging scroll the full history | ||||||||||||||||||||||||||||||||||||||||||||
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Percentile at every rescan on file, Jan 21, 2012 to Oct 9, 2026; stronger toward the top. Hover for the date. Open this report as it stood on | ||||||||||||||||||||||||||||||||||||||||||||
Each date opens the report as it stood on that rescan. |
Business, in the company's words. Opening of Item 1 of the 10-K received Feb 27, 2026; the document on sec.gov.
We are a global medical technology company focused on improving patient safety and aesthetic outcomes, initially in the breast aesthetics and reconstruction market. We initially incorporated in Costa Rica in 2004 and subsequently reorganized in 2013 under a parent holding company in the British Virgin Islands. Our line of silicone gel-filled breast implants, branded as Motiva Implants, is the centerpiece of our medical technology platform. Our 5-year results from our Motiva U.S.
Warnings [top]
7 checks ran; none of them enters the letter. The checks are listed on the warnings screen.
The Fourteen Inputs [top]
Lower percentile is stronger. Source numbers open the SEC filing; a range that spans filings opens the sources table.
| Input | Percentile, 0 to 100 | Value | Source | Peer median | Percentile | Peers | Period end |
|---|---|---|---|---|---|---|---|
| Profitability, sleeve percentile 46.0 | |||||||
| Gross profitability | 41.0% | [1,5] | 32.2% | 30.7 | 372 | 2025-12-31 | |
| Return on invested capital | not computable | 9.3% | |||||
| a prior annual debt, equity, and cash observation is required | |||||||
| Accruals ratio | (0.05%) | [1,6-8] | (6.6%) | 81.2 | 811 | 2025-12-31 | |
| Gross margin stability, five years | 1.6 pts | [2,5,9-16] | 2.8 pts | 26.0 | 243 | 2025-12-31 | |
| Solvency, sleeve percentile 50.3 | |||||||
| Twelve-month failure probability | not computable | 0.07% | |||||
| latest liabilities, cash plus short-term investments, book equity, and shares are required | |||||||
| Altman Z double-prime | (2.10) | [1,17-22] | (0.31) | 45.2 | 756 | 2025-12-31 | |
| Net debt to EBITDA | not computable | 1.82x | |||||
| EBITDA must exceed $100,000 | |||||||
| Interest coverage | not computable | (4.51x) | |||||
| latest aligned inputs end 2023-12-31; latest annual assets end 2025-12-31 | |||||||
| Current ratio | 3.04x | [17-18] | 2.96x | 55.5 | 839 | 2025-12-31 | |
| Growth and financing, sleeve percentile 34.5 | |||||||
| Revenue growth, three-year compound | 9.3% | [2,10,12,14] | 10.0% | 51.9 | 415 | 2025-12-31 | |
| Free cash flow growth, three-year compound | not computable | 10.9% | |||||
| current FCF must be positive and base FCF must exceed $100,000 | |||||||
| Reinvestment rate | not computable | 37.1% | |||||
| NOPAT must exceed $100,000 | |||||||
| Asset growth, three years | 19.2% | [1,8,23-24] | 2.1% | 21.8 | 704 | 2025-12-31 | |
| Net share issuance, one year | 1.6% | [25-26] | 2.5% | 29.9 | 634 | 2026-02-26 | |
Gross profitability. Revenue less cost of goods sold, over total assets.
Accruals ratio. Net income less operating cash flow, over average assets; lower is stronger.
Gross margin stability, five years. Standard deviation of gross margin; lower is stronger.
Twelve-month failure probability. CHS model; lower is stronger.
Net debt to EBITDA. Lower is stronger.
Net share issuance, one year. Split-adjusted; lower is stronger.
Sleeves are equal-weighted; within a sleeve each computable input carries equal weight. Composite -0.142; sampling error 2.5 percentile points on 371 peers.
Among 371 Peers [top]
Composite score of every graded peer, smoothed. Vertical rules are the letter band edges at the 20th, 40th, 60th and 80th percentiles. Small dots are the six largest peers by market equity.
| Rank | Company | Percentile | Letter | Warnings |
|---|---|---|---|---|
| 128 | BrightSpring Health Services, Inc. (BTSG) BrightSpring Health Services, Inc. (BTSG) Bsecond fifth; percentile 34.5 Nasdaq · Services-Home Health Care Services last close $63.69 No active warnings; 8 of 14 inputs | 34.5 | B | |
| 129 | BrightSpring Health Services, Inc. (BTSGU) BrightSpring Health Services, Inc. (BTSGU) Bsecond fifth; percentile 34.5 Nasdaq · Services-Home Health Care Services last close $185.87 No active warnings; 8 of 14 inputs | 34.5 | B | |
| 130 | Glaukos Corp. (GKOS) Glaukos Corp. (GKOS) Bsecond fifth; percentile 34.9 NYSE · Surgical & Medical Instruments & Apparatus market equity $9.5B; last close $161.17 Warnings: fortress balance sheet; 8 of 14 inputs | 34.9 | B | fortress balance sheet |
| 131 | Fitlife Brands, Inc. (FTLF) Fitlife Brands, Inc. (FTLF) Bsecond fifth; percentile 35.1 Nasdaq · Medicinal Chemicals & Botanical Products market equity $81.7M; last close $8.56 No active warnings; 8 of 14 inputs | 35.1 | B | |
| 132 | Insmed Inc. (INSM) Insmed Inc. (INSM) Bsecond fifth; percentile 35.4 Nasdaq · Pharmaceutical Preparations market equity $21.9B; last close $100.57 No active warnings; 10 of 14 inputs | 35.4 | B | |
| 133 | Establishment Labs Holdings Inc. (ESTA) Establishment Labs Holdings Inc. (ESTA) Bsecond fifth; percentile 35.7 Nasdaq · Orthopedic, Prosthetic & Surgical Appliances & Supplies market equity $1.8B; last close $60.54 Warnings: fortress balance sheet; 8 of 14 inputs | 35.7 | B | fortress balance sheet |
| 134 | Ionis Pharmaceuticals Inc. (IONS) Ionis Pharmaceuticals Inc. (IONS) Bsecond fifth; percentile 35.9 Nasdaq · Pharmaceutical Preparations market equity $7.2B; last close $43.29 No active warnings; 10 of 14 inputs | 35.9 | B | |
| 135 | Biocryst Pharmaceuticals Inc. (BCRX) Biocryst Pharmaceuticals Inc. (BCRX) Bsecond fifth; percentile 36.2 Nasdaq · Biological Products, (No Diagnostic Substances) market equity $2.1B; last close $8.29 Warnings: fortress balance sheet; 10 of 14 inputs | 36.2 | B | fortress balance sheet |
| 136 | Tenet Healthcare Corp. (THC) Tenet Healthcare Corp. (THC) Bsecond fifth; percentile 36.5 NYSE · Services-General Medical & Surgical Hospitals, NEC market equity $21.0B; last close $260.68 No active warnings; 10 of 14 inputs | 36.5 | B | |
| 137 | Sanuwave Health, Inc. (SNWV) Sanuwave Health, Inc. (SNWV) Bsecond fifth; percentile 36.8 Nasdaq · Surgical & Medical Instruments & Apparatus market equity $50.3M; last close $5.78 No active warnings; 10 of 14 inputs | 36.8 | B | |
| 138 | LifeMD, Inc. (LFMD) LifeMD, Inc. (LFMD) Bsecond fifth; percentile 37.2 Nasdaq · Services-Offices & Clinics of Doctors of Medicine last close $2.65 Warnings: late filer; 8 of 14 inputs | 37.2 | B | late filer |
| Peer policy | Letter | Percentile | Peers |
|---|---|---|---|
| all graded filers, equal sleeves | B | 35.1 | 2204 |
| sector peers, equal sleeves (the grade) | B | 35.7 | 371 |
| same exchange, equal sleeves | B | 34.2 | 1219 |
| sector peers, equal inputs | B | 33.2 | 371 |
Each letter is one fifth of the 371 graded peers, about 74 companies. A boundary letter (A/B, B/C, C/D, D/E) marks a percentile within one sampling error of a band edge.
What the Price Implies [top]
Market measures at the 2026-10-08 close. None enters the grade. Percentile among graded peers with the same measure.
| Measure | Value | Peer median | Percentile | Reading |
|---|---|---|---|---|
| Twelve-month price change, skipping the latest month | 69.1% | 8.0% | 83 | hotter than 83 of 100 peers |
| Distance from 52-week high | (36.6%) | (31.4%) | 40 | closer to its high than 40 of 100 peers |
| EBIT to enterprise value | (2.2%) | (1.5%) | 47 | pricier than 53 of 100 peers |
| Free cash flow yield | (3.2%) | (1.0%) | 44 | pricier than 56 of 100 peers |
| Book value to price | 0.01 | 0.28 | 13 | pricier than 87 of 100 peers |
| Sales to price | 0.12 | 0.31 | 28 | pricier than 72 of 100 peers |
| Composite equity issuance, five years | 23.6% | 20.3% | 52 | more equity-funded than 52 of 100 peers |
| Relative strength against the sector, log excess return | 0.31 | (0.14) | 83 | ahead of 83 of 100 peers |
Inputs: market equity $1.8B; EBIT -$39.0M; free cash flow -$56.9M; book equity $21.6M; sales $211.1M; debt $0; cash $71.2M[27].
Diagnostics [top]
Diagnostics do not feed the grade.
| Piotroski F-score: 4 of 9, period end 2025-12-31 | ||
|---|---|---|
| Return on assets above zero | (14.7%) | ✗ fail[6,8] |
| Operating cash flow above zero | -$50.9M | ✗ fail[7] |
| Return on assets improved | 16.8 pts | ✓ pass[6,8,23,28] |
| Operating cash flow exceeds net income | $174,000 | ✓ pass[6-7] |
| Long-term leverage fell | (1.0 pts) | ✓ pass[1,8,23,29-30] |
| Current ratio improved | (51.7 pts) | ✗ fail[17-18,31-32] |
| No new shares issued | 1.6% | ✗ fail[25-26] |
| Gross margin improved | 3.3 pts | ✓ pass[2,5,9-10] |
| Asset turnover improved | (0.9 pts) | ✗ fail[2,8,10,23] |
Downloads [top]
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Sources [top]
Every citation on this page. Filing opens the SEC index page for that submission; viewer opens the SEC interactive data for the same filing; series opens the SEC XBRL API record for that tag and company.
| # | Concept | XBRL tag | Value | Period end | Received | Form | Links |
|---|---|---|---|---|---|---|---|
| 1 | assets | us-gaap:Assets | $357.2M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 2 | revenue | us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax | $211.1M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 3 | cash | us-gaap:CashAndCashEquivalentsAtCarryingValue | $90.3M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 4 | total debt | us-gaap:LongTermDebt | $0 | 2024-12-31 | 2025-02-28 | 10-K | filing · viewer · series |
| 5 | gross profit | us-gaap:GrossProfit | $146.3M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 6 | net income | us-gaap:NetIncomeLoss | -$51.1M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 7 | operating cash flow | us-gaap:NetCashProvidedByUsedInOperatingActivities | -$50.9M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 8 | assets | us-gaap:Assets | $346.8M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 9 | gross profit | us-gaap:GrossProfit | $109.5M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 10 | revenue | us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax | $166.0M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 11 | gross profit | us-gaap:GrossProfit | $107.0M | 2023-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 12 | revenue | us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax | $165.2M | 2023-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 13 | gross profit | us-gaap:GrossProfit | $106.6M | 2022-12-31 | 2025-02-28 | 10-K | filing · viewer · series |
| 14 | revenue | us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax | $161.7M | 2022-12-31 | 2025-02-28 | 10-K | filing · viewer · series |
| 15 | gross profit | us-gaap:GrossProfit | $85.4M | 2021-12-31 | 2024-03-04 | 10-K | filing · viewer · series |
| 16 | revenue | us-gaap:RevenueFromContractWithCustomerExcludingAssessedTax | $126.7M | 2021-12-31 | 2024-03-04 | 10-K | filing · viewer · series |
| 17 | current assets | us-gaap:AssetsCurrent | $249.9M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 18 | current liabilities | us-gaap:LiabilitiesCurrent | $82.1M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 19 | retained earnings | us-gaap:RetainedEarningsAccumulatedDeficit | -$495.8M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 20 | operating income | us-gaap:OperatingIncomeLoss | -$39.0M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 21 | book equity | us-gaap:StockholdersEquity | $23.5M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 22 | liabilities | us-gaap:Liabilities | $333.6M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 23 | assets | us-gaap:Assets | $268.6M | 2023-12-31 | 2025-02-28 | 10-K | filing · viewer · series |
| 24 | assets | us-gaap:Assets | $211.1M | 2022-12-31 | 2024-03-04 | 10-K | filing · viewer · series |
| 25 | shares outstanding | dei:EntityCommonStockSharesOutstanding | 29,320,846 | 2026-02-26 | 2026-02-27 | 10-K | filing · viewer · series |
| 26 | shares outstanding | dei:EntityCommonStockSharesOutstanding | 28,845,813 | 2025-02-27 | 2025-02-28 | 10-K | filing · viewer · series |
| 27 | shares outstanding | dei:EntityCommonStockSharesOutstanding | 29,801,891 | 2026-08-06 | 2026-08-07 | 10-Q | filing · viewer · series |
| 28 | net income | us-gaap:NetIncomeLoss | -$84.6M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 29 | long term debt | us-gaap:LongTermDebtNoncurrent | $247.5M | 2025-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 30 | long term debt | us-gaap:LongTermDebtNoncurrent | $219.6M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 31 | current assets | us-gaap:AssetsCurrent | $243.0M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 32 | current liabilities | us-gaap:LiabilitiesCurrent | $68.3M | 2024-12-31 | 2026-02-27 | 10-K | filing · viewer · series |
| 33 | cash | us-gaap:CashAndCashEquivalentsAtCarryingValue | $71.2M | 2026-06-30 | 2026-08-07 | 10-Q | filing · viewer · series |
| 34 | operating cash flow | us-gaap:NetCashProvidedByUsedInOperatingActivities | -$20.9M | 2026-06-30 | 2026-08-07 | 10-Q | filing · viewer · series |
| 35 | operating cash flow | us-gaap:NetCashProvidedByUsedInOperatingActivities | -$4.3M | 2026-03-31 | 2026-05-08 | 10-Q | filing · viewer · series |
| 36 | operating cash flow | us-gaap:NetCashProvidedByUsedInOperatingActivities | -$50.7M | 2025-09-30 | 2025-11-07 | 10-Q | filing · viewer · series |
| 37 | operating cash flow | us-gaap:NetCashProvidedByUsedInOperatingActivities | -$39.5M | 2025-06-30 | 2026-08-07 | 10-Q | filing · viewer · series |
Limitations [top]
Grade boundary. Percentile 35.7 is 4.3 points from the nearest band edge; sampling error is 2.5 points.
Peer group. Sector assignment from four-digit SIC codes, hand-tuned and published. The grade under three alternative peer policies is tabled above.
Size. Within a sector the letter tracks size. Among graded filers in the smallest asset band, 72% grade E and 0% grade A; in the largest, 13% grade E and 21% grade A. Universe as of Oct 9, 2026.
Failure model. filings 2012-01-01 to 2019-12-31 fit, filings 2020-01-01 to 2025-12-31 test; status post hoc pending confirmation. pre-registered on 2026 filings once their 12-month outcome windows close; supported if the paired per-quintile gain over the pooled model has a lower bound above 0.05.
Input validity. Revenue or total assets at or below $100,000 sets the degenerate-inputs flag. An input whose denominator is at or below $100,000 is left not computable rather than ranked.
Returns. No input on this page has a post-2015 confidence interval on returns that excludes zero. The grade ranks reported financial condition and is not a return forecast.
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