Key Highlights

• Total Revenue reached $98.3 million in Q3 2026, an 18% year-over-year increase, with U.S. revenue of $85.8 million growing 16%.

• U.S. procedures exceeded 13,400, representing approximately 22% year-over-year growth, reflecting rising utilization of Aquablation therapy.

• PROCEPT delivered 62 U.S. HYDROS systems during the quarter, including 20 replacement systems, at an average selling price of approximately $495,000 for new systems.

• The company reaffirmed its 2026 financial guidance and anticipates presenting data from the WATER IV randomized trial comparing Aquablation to radical prostatectomy in the first half of 2027.

PROCEPT BioRobotics Corporation (NASDAQ:PRCT), a surgical robotics company focused on urological solutions, reported third quarter 2026 financial results on 4 November 2026. The quarter featured continued expansion of the company's installed base and growing utilization of its Aquablation therapy platform.

Revenue Growth Driven by Procedures and Handpieces

Total revenue for Q3 2026 reached $98.3 million, an 18% increase compared to the prior-year period. U.S. revenue accounted for $85.8 million of the total, representing 16% growth, while international revenue contributed $12.5 million, up 32% year-over-year.

Within U.S. revenue, handpiece and consumable sales reached $53.9 million, a 21% increase that reflects the growing installed base and rising procedure volumes. U.S. system revenue was $24.7 million, flat compared to the prior-year quarter, as the company manages the transition from its legacy AquaBeam platform to the newer HYDROS system.

A key metric for PROCEPT is procedure volume, which serves as a proxy for Recurring Revenue potential. U.S. procedures exceeded 13,400 in the quarter, an approximately 22% year-over-year increase. The handpiece attach rate, measured as U.S. handpieces sold as a percentage of U.S. procedures, was approximately 106%, indicating that some procedures require more than one handpiece. Handpiece average selling prices increased 12% year-over-year to approximately $3,570.

HYDROS System Deployment and Transition

PROCEPT delivered 62 U.S. HYDROS systems during the quarter, which included 20 replacement systems as part of the accelerated transition from AquaBeam to HYDROS. New HYDROS systems sold at an average U.S. price of approximately $495,000. The replacement cycle is a deliberate strategy to upgrade the installed base to the company's latest-generation robotic platform, which is designed to enhance procedural capabilities and drive future handpiece consumption.

CEO Larry Wood described the quarter as one of continued execution, with the company focused on expanding its installed base while driving utilization at existing HYDROS accounts. The balance between new system placements and the replacement cycle is central to the company's near-term revenue trajectory.

Margins and Operating Expenses

Gross Margin for Q3 2026 was 66%, a modest improvement from 65% in the prior-year period. The margin expansion reflects the favorable Economics of handpiece and consumable revenue, which typically carries higher margins than system sales.

Operating expenses totaled $92.5 million, up from $77.2 million a year earlier. The increase reflects continued Investment in personnel, product development, clinical studies, and sales and Marketing programs as PROCEPT scales its commercial operations and advances its clinical pipeline.

WATER IV Trial and the Prostate Cancer Opportunity

Beyond its current commercial focus on benign prostatic hyperplasia, PROCEPT is pursuing the prostate cancer market through its WATER IV clinical trial. This randomized study compares Aquablation therapy to radical prostatectomy in prostate cancer patients, and data is expected to be presented in the first half of 2027. The prostate cancer indication could represent a significant expansion of PROCEPT's addressable market if the trial results support regulatory approval.

Wood characterized the opportunity as representing a clear path to achieving durable growth and profitability, noting the company's excitement about the upcoming data presentation.

What Lies Ahead

PROCEPT reaffirmed its 2026 financial guidance, signaling confidence in its ability to deliver on full-year targets through the remaining quarter. The company's growth algorithm rests on expanding its installed base of HYDROS systems, driving procedure adoption among urologists, and demonstrating the clinical and economic value of Aquablation therapy. The WATER IV data, expected in the first half of 2027, represents the next potential catalyst for the company's long-term trajectory.