Exagen Q3 Revenue Rises 7% to $18.4M, Net Loss Narrows

Exagen Inc. (Nasdaq: XGN) reported on November 10, 2026 that third-quarter revenue rose 7% year over year to $18.4 million, up from $17.2 million, while net loss narrowed to $6.3 million from $7.1 million. The Carlsbad, California-based autoimmune diagnostics company said trailing-twelve-month average selling price for its AVISE CTD test reached $451 per test, its 14th consecutive quarter of growth. Adjusted EBITDA was a loss of $1.9 million.

Context — Why Exagen's Narrowing Loss Matters Now

The quarter extends a year-to-date pattern the company framed as a record year. For the nine months ended September 30, 2026, revenue reached $55.7 million against $49.9 million a year earlier, an 11% gain. Over the same stretch, net loss fell 12% to $13.5 million from $15.3 million, and adjusted EBITDA loss improved by more than 30% to $4.2 million from $6.1 million.

The improvement is not uniform across every line. Operating loss widened to $4.4 million in the quarter from $3.1 million, and to $9.5 million year-to-date from $9.1 million. Total operating expenses climbed to $15.2 million in the quarter from $13.2 million, driven by selling, general and administrative costs of $12.8 million and a $587,000 in-process research and development charge tied to a July 16, 2026 asset acquisition.

That acquisition covered rights to technology, software, source code, know-how and patents comprising an AI-enabled rheumatology practice workflow-optimization software platform. The company did not disclose the purchase price beyond the $587,000 IPR&D charge recognized.

What separates the net loss from the operating loss is largely non-cash. The change in fair value of the warrant liability swung to a $909,000 charge in the quarter from a $2.7 million charge a year earlier, and interest expense eased to $1.2 million from $1.3 million. Those items pulled net loss below the operating loss line.

Exagen sits in the specialty diagnostics segment of healthcare, where payers scrutinize reimbursement for novel tests. The company's ability to lift ASP for 14 straight quarters speaks to pricing power the broader diagnostics group has struggled to hold.

Data — What the Numbers Show

Gross margin edged up to 58.8% in the third quarter from 58.4%, and to 59.7% year-to-date from 59.3%. Cost of revenue rose to $7.6 million from $7.2 million, producing gross profit of $10.8 million against $10.1 million.

Metric	Q3 2026	Q3 2025
Revenue	$18.4M	$17.2M
Gross margin	58.8%	58.4%
Operating loss	-$4.4M	-$3.1M
Net loss	-$6.3M	-$7.1M
Adjusted EBITDA	-$1.9M	-$1.9M
AVISE CTD ASP	$451	$441

The balance sheet tightened. Cash and cash equivalents ended the quarter at $28.1 million, down from $35.7 million at September 30, 2025, and from $32.2 million at December 31, 2025. Total current assets were $45.3 million against $13.1 million in current liabilities, a current ratio near 3.5.

Borrowings totaled $22.8 million across current and non-current portions, net of discounts and issuance costs. Stockholders' equity fell to $13.8 million from $17.4 million at year-end, and the accumulated deficit deepened to $327.8 million from $314.3 million.

Net loss per share improved to $0.25 from $0.31, aided by a higher weighted-average share count of 24.8 million versus 22.9 million. Shares issued and outstanding rose to 25.4 million from 22.9 million at December 31, 2025, reflecting equity issuance during the year.

Analysis — What It Means for Diagnostics Investors

The mixed quarter leaves XGN exposed to the same tension facing small-cap diagnostics: revenue growth and ASP gains against a cash burn that consumes roughly $1.9 million per quarter on an adjusted EBITDA basis. At the reported cash level and current burn, the runway is finite, though the company did not disclose a runway estimate.

The bull case rests on ASP compounding and the coming myositis launch, which management said remains on track for early 2027. The company said it presented nine abstracts at the 2026 American College of Rheumatology Convergence Conference, including two podium presentations on proprietary T-cell marker disease associations and an analysis of phenotypic patterns across more than 375,000 AVISE CTD tests. That volume underpins the data moat argument.

The bear case is cost discipline. SG&A rose to $12.8 million from $11.4 million, and R&D edged up to $1.8 million from $1.7 million. Operating use has not yet arrived at the operating line, even as net loss narrowed. Adjusted EBITDA was essentially flat year over year at a $1.9 million loss, so the improvement is concentrated in the nine-month comparison rather than the quarter.

Positioning reflects that split. Investors holding XGN are underwriting the 2027 pipeline and ASP trajectory; skeptics point to the cash decline and the flat quarterly adjusted EBITDA as evidence the model still needs scale. The equity raise embedded in the higher share count is the clearest signal of how the company is funding the gap.

Outlook — What to Watch Next

Exagen reiterated full-year 2026 revenue guidance of $72 million to $75 million. With $55.7 million booked through nine months, hitting the low end requires roughly $16.3 million in the fourth quarter and the high end about $19.3 million.

The company will host an educational webcast on December 15, 2026, at 12:00 p.m. ET to discuss the unmet clinical need in myositis, its myositis solution, and additional pipeline development efforts. Management said registration details would follow.

A conference call and webcast is scheduled for 8:00 a.m. ET on the report date, with CEO John Aballi and CFO Jeff Black, and a replay will be available for 12 months on the investor relations site.

Watch the fourth-quarter revenue print against the $72 million to $75 million range, the cash balance for signs of further drawdown, and any update on myositis timing ahead of the early-2027 target.

Frequently Asked Questions

What does Exagen's Q3 2026 result mean for retail investors?

It shows a company growing revenue and cutting its net loss while still burning cash. Revenue rose 7% to $18.4 million and net loss fell to $6.3 million, but adjusted EBITDA stayed negative at $1.9 million and cash dropped to $28.1 million from $35.7 million a year earlier. The investment case hinges on whether ASP growth and the 2027 myositis launch convert into positive cash flow.

Why did Exagen's net loss shrink if operating loss widened?

The gap comes from non-cash and financing items below the operating line. The change in fair value of the warrant liability was a $909,000 charge this quarter versus $2.7 million a year ago, and interest expense fell to $1.2 million from $1.3 million. Those swings pulled net loss to $6.3 million even as operating loss widened to $4.4 million from $3.1 million.

What happens next for Exagen's myositis test?

Management said the myositis offering remains on track to launch early in 2027 and will detail the clinical need and the solution on a December 15, 2026 webcast. The company also reiterated 2026 revenue guidance of $72 million to $75 million. No launch date beyond early 2027, pricing, or reimbursement terms were disclosed.

Bottom Line

Exagen grew revenue and trimmed its net loss, but flat quarterly adjusted EBITDA and a shrinking cash pile keep the 2027 pipeline central to the story.

Disclaimer: This article is for informational purposes only and does not constitute investment advice. CFD trading carries high risk of capital loss.