What happened
Carlsmed, Inc. (NASDAQ: CARL) named Richard Heppenstall chief financial officer and reaffirmed full-year 2026 revenue guidance of $74 million to $78 million. The change took effect on September 28, 2026. Heppenstall replaces Leo Greenstein, who had been CFO since 2023 and is leaving to pursue other professional interests.
The filing says Greenstein’s departure took effect on September 25, 2026. It also says the departure was not tied to any disagreement about accounting, disclosure or internal controls. On September 29, 2026, Carlsmed and Greenstein signed a separation and release agreement and an advisory agreement. He will receive $500,000 in cash payments, a prorated annual incentive award for calendar year 2026, COBRA premiums for up to 12 months and $60,000 in advisory fees through December 31, 2026.
The filing also says he will receive accelerated vesting on certain equity awards.
Explain the financial terms
Guidance is management's forecast, not a completed result.
Why it matters
At the midpoint, the revenue range points to 50% growth over 2025. So the revenue view is unchanged even as the company changes finance leadership. OptimistFi’s case is that CARL works if aprevo becomes a repeat-use patient-specific spine platform and scales before cash burn or competitors erase the premium.
The new CFO arrives as Carlsmed says the new aprevo Lumbar spinal fusion procedure CMS reimbursement takes effect on October 1. The company also points to planned launches of the aprevo Lumbar Bi-lateral procedure and corra cervical procedure. Heppenstall’s employment agreement sets a $500,000 base salary and a target annual cash incentive of 60% of base salary.
It also grants inducement stock options and RSUs with $1.4 million grant-date fair values each. The relocation agreement can reimburse up to $150,000 for reasonable out-of-pocket relocation, housing setup and transition-related expenses. The guidance is still a forecast, and the filing is a management change, not a result.
Explain the financial terms
Guidance is management's forecast, not a completed result.
What's next
The next dated catalyst is October 1, when the new aprevo Lumbar spinal fusion procedure CMS reimbursement goes into effect. Carlsmed also flags planned launches of the aprevo Lumbar Bi-lateral procedure and corra cervical procedure. If those steps happen on schedule, the reaffirmed revenue range looks better supported. If they slip, the filing’s signal weakens.