Veracyte (NASDAQ:VCYT) management said fourth-quarter results capped “another outstanding year” of execution, highlighted by double-digit revenue growth, expanding profitability and progress toward multiple new product launches planned for 2026.
Fourth-quarter and full-year performance
Chief Executive Officer Marc Stapley said fourth-quarter total revenue was $141 million, representing 19% year-over-year growth. He attributed the performance to strength in the company’s core testing business, which grew 21% on “strong volume and ASP.” Stapley said Decipher volume rose 21% and Afirma volume increased 12%, contributing to 16% total testing volume growth.
Chief Financial Officer Rebecca Chambers said fourth-quarter revenue was $140.6 million, up 19% from the prior-year period, with total volume of about 48,000 tests. Testing revenue was $135.8 million, up 21% year over year, driven by Decipher and Afirma revenue growth of 27% and 16%, respectively. Testing volume was approximately 45,500 tests, up 16% year over year. Chambers said testing average selling price was about $2,984, up 4% year over year, driven primarily by higher prior period collections (PPCs). Normalized ASP, excluding about $5 million of PPCs, was $2,875, up 1%.
Margins, cash flow, and operational changes
Stapley highlighted profitability and cash generation as key accomplishments, noting adjusted EBITDA margin exceeded 27% in 2025, surpassing the company’s 25% target “more than a year ahead of plan.” He also cited the restructuring of Veracyte SAS and completion of the transition of all Afirma volume to the company’s “more scalable, lower-cost” v2 transcriptome platform.
Chambers said non-GAAP gross margin in the fourth quarter was 75.1%, up 580 basis points year over year. Testing gross margin rose 380 basis points to 76.1%, which she attributed to operational efficiencies from the v2 transcriptome platform and higher PPCs. She reported quarterly GAAP net income of $41.1 million and full-year GAAP net income of $66.4 million. Adjusted EBITDA was $42.3 million for the quarter, representing 30.1% of revenue, which the company said benefited from PPCs.
Veracyte generated $52.6 million of cash from operations in the fourth quarter and ended the period with $412.9 million in cash and cash equivalents, Chambers said. She added the company increased its cash balance by more than $120 million over the course of 2025.
Core franchise updates: Afirma and Decipher
Stapley said Afirma delivered approximately 18,250 tests in the fourth quarter, up 12% year over year. He said Veracyte believes Afirma ended the year with about 38% market share and that the full transition to the v2 transcriptome platform reduced the no-result rate, with the fourth-quarter no-result rate 2% lower than the prior quarter. He also said the company plans to release an updated version of Afirma GRID in 2026 with additional signatures to support thyroid nodule research.
For Decipher, Stapley said the company delivered approximately 27,200 tests in the fourth quarter, representing its 15th consecutive quarter of more than 20% year-over-year volume growth. He said ordering physicians increased 18% year over year in the quarter and that more than 100,000 of the >300,000 patients tested since launch were tested in 2025 alone. He said the company estimates Decipher market penetration at about 33%.
Stapley said Veracyte is working to add optional insights to the Decipher report tied to signatures such as PORTOS, PTEN, and PAM50, citing published studies and trial results discussed on the call, and said the company is seeing accelerated growth in advanced disease following the launch of Decipher Metastatic. Management also said it has scanned more than 210,000 slides from over 150,000 patients with outcomes data as part of an effort to combine digital pathology and AI-powered analysis with molecular data.
2026 outlook and launch plans
Chambers said Veracyte is reiterating 2026 total revenue guidance of $570 million to $582 million, representing 10% to 13% growth. The outlook includes expected testing revenue growth of 14% to 16%, with Afirma expected to grow mid- to high-single digits and Decipher expected to grow about 20%.
Management emphasized that guidance excludes PPCs and reflects a headwind of about $10 million of PPCs recognized in 2025. Chambers said adjusted EBITDA margin is expected to be approximately 25% in 2026 and future years, and noted first-quarter adjusted EBITDA margin should be lower due to typical seasonal expense patterns and the absence of fourth-quarter PPC benefits.
Stapley outlined two planned launches in 2026:
- TruMRD, initially for recurrence monitoring in patients recovering from muscle-invasive bladder cancer (MIBC). Stapley said Veracyte remains on track for a first-half launch, pending completion of a MolDX technical assessment for reimbursement. Management said it intends to focus on patients treated in urology and radiation oncology settings, which it estimates represent about 70% of MIBC cases, and later expand into additional cancer indications over time.
- Prosigna, which Veracyte plans to launch in the U.S. as an LDT “over the summer” on its transcriptome lab workflow. Stapley said the company expects the full OPTIMA trial readout to be presented at ASCO in June and described ongoing commercial buildout, including sales leadership hires, expanded medical science liaison coverage, and reimbursement work.
In the Q&A, management said it is not including meaningful new-product revenue in 2026 guidance, describing 2026 as more foundational for Prosigna and TruMRD, with revenue expected to become a larger driver in 2027 and beyond. Chambers also said the implied 2026 outlook includes “less than $1 million” in biopharma revenue, reflecting a policy of excluding uncontracted revenue from guidance.
On capital allocation, Stapley said the company’s philosophy is unchanged, pointing to organic investment and continued evaluation of external opportunities, while maintaining a high bar for deals.
About Veracyte (NASDAQ:VCYT)
Veracyte, Inc is a genomic diagnostics company focused on improving diagnostic accuracy and patient care through advanced molecular testing. Founded in 2008 and headquartered in South San Francisco, California, the company develops and commercializes minimally invasive genomic tests that aid in the diagnosis of thyroid, lung and other diseases. Veracyte’s proprietary platform analyzes gene expression patterns in clinical samples to help physicians make more informed treatment decisions, reducing unnecessary surgeries and improving patient outcomes.
The company’s flagship product, the Afirma Genomic Sequencing Classifier, is designed to assess thyroid nodules with indeterminate cytology, helping clinicians distinguish benign from suspicious nodules.
