Exploring SI-BONE, Inc. (SIBN) Investor Profile: Who’s Buying and Why?

You're looking at SI-BONE, Inc. (SIBN) and wondering if the institutional money knows something you defintely should, right? The short answer is yes, and it's all about a clear path to scale and profitability. This medical device company, focused on sacroiliac joint dysfunction, is projecting worldwide revenue for the 2025 fiscal year to hit the high end of their guidance, between $198 million and $200 million, representing a robust 18% to 20% year-over-year growth. That kind of precision growth is why major players like BlackRock, Inc. and Vanguard Group Inc. are anchor investors, collectively holding over 52.6 million shares and driving institutional ownership to roughly 91.29% of the stock. Honestly, when firms like that are betting big, you need to understand the mechanics-the shift from a Q3 2025 adjusted EBITDA of $2.3 million to an expected full-year positive adjusted EBITDA is the inflection point that changes the valuation model entirely. So, are these funds buying because of a high-growth medical niche, or because the company is finally translating that growth into true bottom-line performance? Let's map out exactly who is buying and why they see the stock, trading around $18.22 per share as of November 2025, as a long-term play.

Who Invests in SI-BONE, Inc. (SIBN) and Why?

The investor profile for SI-BONE, Inc. (SIBN) is overwhelmingly institutional, meaning large funds and financial firms hold the reins. This isn't a stock driven by individual retail investors; it's a growth play for sophisticated capital, and the motivation is clear: double-digit revenue expansion and a shift to profitability in 2025.

Key Investor Types: The Institutional Majority

When you look at the shareholder breakdown, it's a lopsided picture. As of late 2025, institutional investors-think mutual funds, pension funds, and asset managers-own a massive chunk, approximately 96.62% of the company's stock.. This leaves a small float for retail investors and a modest 2.98% held by insiders, which is typical for a growth-focused medical device company..

The sheer size of the institutional holdings means the stock's movement is largely dictated by the strategies of these major players. Here's a snapshot of the top institutional powerhouses:

• BlackRock, Inc.: A giant in asset management, often taking long-term positions.
• Vanguard Group Inc.: Known for its index and passively managed funds, indicating SIBN is a core holding in specific growth or small-cap indices.
• Orbimed Advisors Llc: A healthcare-focused investment firm, suggesting a deep-dive, sector-specific conviction.
• American Century Companies Inc and Brown Advisory Inc: Large active managers who see strong growth potential.

The insiders, like executives and board members, hold a small percentage, but their trading activity is also closely watched. To be fair, most of their sales in 2025 have been non-discretionary, often just covering tax obligations from vested stock units..

Investment Motivations: Growth and the Profit Pivot

Investors are buying SI-BONE, Inc. because the company is executing a clear path toward financial self-sufficiency and market dominance. The core attraction isn't dividends-it doesn't pay any, as it reinvests every dollar back into the business-but pure growth and a critical profitability milestone..

Here's the quick math on why institutional capital is flowing in:

• Revenue Momentum: The company raised its full-year 2025 worldwide revenue guidance to a range of $198 million to $200 million.. This projects an exceptional year-over-year growth rate of approximately 18% to 20%..
• Profitability Turnaround: Management expects to achieve positive adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) for the full year 2025.. This is a huge psychological turning point for a high-growth company.
• Elite Margins: The full year 2025 gross margin is estimated at around 79.5%, which is an incredibly high figure for a medical device company and shows the pricing power of its proprietary technology.

Plus, the Centers for Medicare & Medicaid Services (CMS) confirmed a New Technology Add-On Payment (NTAP) effective October 1, 2025, providing an additional payment up to $4,136 for procedures using the iFuse TORQ TNT product.. That's a direct, defintely quantifiable tailwind for revenue. You can dig deeper into the company's long-term vision here: Mission Statement, Vision, & Core Values of SI-BONE, Inc. (SIBN).

Investment Strategies: The Growth-at-a-Reasonable-Price Play

The dominant strategy here is Growth Investing, or more accurately, Growth-at-a-Reasonable-Price (GARP). Investors are betting on the company's ability to sustain its high revenue growth rate and expand its adjusted EBITDA margin-which hit approximately 5% in Q3 2025-into a strong net income over the next few years..

While the large mutual funds are long-term holders, hedge funds introduce a different dynamic. Firms like Qube Research & Technologies Ltd increased their stake by a significant 48.3% in the third quarter of 2025, suggesting a momentum or event-driven strategy, capitalizing on the raised guidance and positive EBITDA news..

The overall institutional accumulation is high, with the company's stock demonstrating a strong Fund Sentiment Score, which tracks the total increase in disclosed owners and portfolio allocations. This signals that smart money is actively building positions. What this estimate hides, of course, is the risk of a single product focus, but the market is clearly focused on the current execution.

Here's a look at the key 2025 financial metrics driving this investment thesis:

The next concrete step for you is to monitor the Q4 2025 earnings release for confirmation that the company hit the high end of this revenue guidance and sustained that positive adjusted EBITDA. Finance: Confirm Q4 2025 earnings date and model Q4 revenue against the $198M-$200M target.

Institutional Ownership and Major Shareholders of SI-BONE, Inc. (SIBN)

You're looking at SI-BONE, Inc. (SIBN) and the first thing you need to know is that this stock is overwhelmingly controlled by big money. Institutional ownership-the percentage of shares held by mutual funds, pension funds, and other large entities-is exceptionally high, sitting at approximately 94.40% as of November 2025. That's a huge vote of confidence in the company's long-term strategy, but it also means institutional trading dictates much of the stock's price movement. The total institutional value (Long) is substantial, coming in around $892.95 million USD. This is not a stock where retail investors set the tone; the institutions are the primary drivers.

Top Institutional Investors and Their Stakes

The investor profile for SI-BONE, Inc. is anchored by some of the largest asset managers in the world, which is defintely a stabilizing factor. These firms aren't just buying; they're taking significant, multi-million-share positions, signaling a belief in the company's leadership in minimally invasive sacroiliac (SI) joint surgery. For a deeper dive into the company's foundation, you can check out SI-BONE, Inc. (SIBN): History, Ownership, Mission, How It Works & Makes Money.

Here are the top institutional holders, with their share counts based on the most recent 2025 filings:

BlackRock, Inc. and Vanguard Group Inc. are typically passive index fund managers, so their large stakes are often driven by SI-BONE, Inc.'s inclusion in major indices. But the presence of active managers like Brown Advisory Inc and Orbimed Advisors Llc suggests a more calculated, fundamental-driven investment thesis.

Recent Shifts in Institutional Ownership

Looking at the most recent quarter (Q3 2025), the picture is one of high-volume churn, which is normal as funds rebalance. We saw 85 institutional investors add shares, but also 57 decrease their positions. This tells you there's a divergence of opinion on the near-term valuation, but overall institutional accumulation remains strong.

Key movements include:

• FIRST LIGHT ASSET MANAGEMENT, LLC added 475,426 shares, an increase of 41.8% in Q1 2025.
• Vanguard Group Inc. increased its position by 41,449 shares as of the Q3 2025 reporting date.
• Conversely, Orbimed Advisors Llc significantly reduced its stake by 863,874 shares in the second quarter of 2025.

The net result of these moves is a slight decrease in total institutional shares (Long) by -2.76% in the most recent quarter, totaling a reduction of about -1.47 million shares. Still, the high overall ownership percentage shows this is more of a minor trimming than a mass exodus.

Impact on Stock Price and Corporate Strategy

High institutional ownership-at over 90%-is a double-edged sword. It provides stability and validation, but it also means the stock can be volatile when a few large funds decide to rebalance or exit. When one of the top five holders sells, the stock price feels it immediately.

The reason these investors are buying and holding is clear: SI-BONE, Inc.'s strong fundamental performance in 2025. The company recently reported Q3 2025 worldwide revenue of $48.7 million, representing a 20.6% year-over-year increase. Plus, they achieved a positive adjusted EBITDA of $2.3 million in the same quarter, narrowing the net loss to $4.6 million (or -$0.11 per share). This shift toward profitability and strong revenue growth is what drives institutional accumulation and validates the investment thesis for a growth-focused medical device company.

The institutional backing also gives management a longer leash for strategic decisions. They can focus on long-term growth initiatives, like expanding their active U.S. physician base-which grew 27% to 1,530 in Q3 2025-instead of worrying about short-term activist pressure. The raised full-year 2025 revenue guidance of $198 million-$200 million is a direct result of this successful strategy, and it's the number institutions are watching most closely. Your next step should be to model how that new revenue guidance impacts their path to sustained profitability.

Key Investors and Their Impact on SI-BONE, Inc. (SIBN)

If you're looking at SI-BONE, Inc. (SIBN), the first thing to understand is that institutional money overwhelmingly drives this stock. The investor profile isn't a mixed bag of retail traders; it's nearly all professional funds, which means the stock moves on big-picture strategic bets, not day-to-day noise. Institutional investors own a massive 98.11% of the company's stock, totaling over 52.6 million shares as of the latest filings.

This high level of institutional ownership is defintely a double-edged sword: it provides a strong foundation of capital, but it also means a major fund deciding to rebalance can cause a sharp price swing. You need to watch the big players because they are the market here. The company's full-year 2025 worldwide revenue guidance is in the range of $198 million to $200 million, and these investors are betting on continued, profitable growth against that backdrop.

• BlackRock, Inc.: A passive giant, holding 3,455,119 shares valued at approximately $60.19 million as of Q3 2025.
• Vanguard Group Inc: Another index fund powerhouse, controlling 2,489,989 shares worth about $43.38 million.
• Orbimed Advisors Llc: A key healthcare specialist fund, with 2,578,979 shares valued at around $44.93 million.

The Influence of Strategic and Specialist Funds

The investor landscape for SI-BONE, Inc. is a mix of passive index funds and highly strategic, health-focused capital. The largest single shareholder, Skyline Venture Partners V LP, holds a significant 11,059,955 shares, representing a 25.49% stake valued at approximately $192.66 million. This is venture capital money, and their influence is less about trading and more about long-term strategic direction-they helped fund the company's growth and are invested in its mission. You can see their conviction reflected in the Mission Statement, Vision, & Core Values of SI-BONE, Inc. (SIBN).

Healthcare-focused funds like Orbimed Advisors Llc are also crucial. They don't just buy a stock; they buy into the clinical data and the market adoption of products like iFuse TORQ TNT. Their presence is a vote of confidence in the company's innovation pipeline and its ability to secure favorable reimbursement, such as the New Technology Add-on Payment (NTAP) of over $4,100 for procedures involving iFuse TORQ TNT, effective October 1, 2025.

Recent Investor Activity and Insider Signals

In the third quarter of 2025, we saw a clear signal of accumulation from certain funds. American Century Companies Inc, for example, significantly increased its position, acquiring an additional 521,683 shares as of the September 30, 2025 filing date. This kind of move shows conviction in the company's trajectory, especially after SI-BONE, Inc. reported Q3 2025 worldwide revenue of $48.7 million and positive adjusted EBITDA of $2.3 million.

On the flip side, you also need to look at insider selling, but with a critical eye. In November 2025, CEO Laura Francis sold 11,341 shares in one transaction, and President, Commercial Ops Anthony J. Recupero sold 3,833 shares. Here's the quick math: these sales, totaling roughly $264,500 at the time, were primarily to cover tax withholding obligations related to vested restricted stock units. That's not a discretionary trade signaling a lack of faith; it's a required tax payment. Still, it's a net reduction in insider holdings, so you can't ignore it.

What this estimate hides is the continued net institutional accumulation, which is a much stronger signal than routine tax-related insider sales. Funds are still buying. For instance, Wellington Management Group LLP boosted its holdings by 74.7% in the recent quarter. So, while the CEO is covering taxes, the big money is adding to their position, betting on the company's momentum toward profitability.

Market Impact and Investor Sentiment

You're looking at SI-BONE, Inc. (SIBN) and trying to figure out if the big money is still committed, and the answer is a clear yes. Institutional investors hold a dominant position, and their sentiment remains broadly positive, driven by the company's strong financial performance in 2025. This high level of institutional ownership, sitting at approximately 98.11% of the stock, acts as a significant vote of confidence in the company's long-term growth trajectory.

The institutional conviction is rooted in the company's ability to execute, specifically hitting and raising its fiscal year guidance. For example, SI-BONE, Inc. raised its full-year 2025 worldwide revenue guidance to a range of $198 million to $200 million, implying year-over-year growth of up to 20%. This kind of consistent, profitable growth-plus a full-year gross margin estimate of around 79.5%-is exactly what major funds are buying.

• BlackRock, Inc. holds 3,469,501 shares, or 8.04%.
• The Vanguard Group, Inc. holds 2,489,989 shares.
• Wellington Management Group LLP recently increased its position by 74.7%.

Deconstructing Recent Ownership Changes

While the institutional picture is overwhelmingly positive, you may have seen news about recent insider sales. Honestly, these sales are not a red flag. In mid-November 2025, CEO Laura Francis sold 16,752 shares for a total of approximately $293,385, and other executives also sold shares. Crucially, these were non-discretionary 'sell to cover' transactions.

Here's the quick math on that: when restricted stock units (RSUs) vest, they become taxable income. Executives sell just enough shares to cover the tax withholding obligations, which is a standard, pre-arranged process under a Rule 10b5-1 trading plan. It doesn't signal a lack of belief in the company; it's just paying the tax man. The stock's strong performance-trading near its 52-week high of $20.05 in November 2025-is defintely the real story here.

Stock Performance and Analyst Confidence

The market has responded very positively to the underlying business momentum, not to ownership shifts. The stock has posted a strong 53% return over the past year, with the price around $18.60 as of November 2025.

The positive reaction was amplified by the Q3 2025 earnings report, where SI-BONE, Inc. reported worldwide revenue of $48.7 million, beating analyst consensus and achieving a positive adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) of $2.3 million. This operational strength is what analysts are focusing on, not the tax-related insider sales.

The consensus from Wall Street analysts is a 'Strong Buy/Moderate Buy,' which is a powerful indicator. They see significant upside remaining.

What this estimate hides is the potential impact of new technology add-on payments (NTAP) for the iFuse TORQ TNT procedure, which became effective on October 1, 2025, providing an additional payment of over $4,100 per procedure. This regulatory tailwind is a key driver for the bullish outlook.

For a deeper dive into the metrics driving this optimism, you should read our comprehensive breakdown: Breaking Down SI-BONE, Inc. (SIBN) Financial Health: Key Insights for Investors.