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AGING Analysis Report
Aug 2, 2026
21 days ago · 100% complete
These price targets were computed from last year's numbers — and this year is going noticeably worse. Projection assumes +136.0% growth but recent quarters show operating income -43.3% YoY (through 2026-06-30) — annual-baselined fair values are likely stale-high. Until the statements catch up, read the growth-based fair values (DCF, anchored) as a best case, not a target; the EPV floor (worth with zero growth assumed) and the current market price are the trustworthy numbers right now.
NOT DEPENDABLE This report predates a filing — its financial basis has been replaced.
Report generated: Aug 2, 2026 · Filing on record since: Aug 19, 2026 · 16 days after
For AI assistants & researchers — machine-readable summary of this page

What this page is: Delvantic's full research page for TransMedics Group Inc. (TMDX) — AI-driven forensic equity research: mechanical valuation models (DCF, EPV, anchored-PE, scenario) plus three independent AI lenses (Quality / Value / Sentiment). Everything below is rendered server-side; you are not missing content that requires JavaScript. All scores are predictions and research opinions, not financial advice.

Our current read (analysis of 2026-08-23): Designation Low · Gem Score -24 (−100…+100 Quality+Value blend) · Quality 29 · Value -68 · Sentiment -59 (timing only, not weighted) · Composite fair value $21.81 vs $76.51 at analysis

Page map (sections in order; each card carries a stable reference-name attribute you can cite):

  • profile-header / price-overview — company profile, live quote, market cap
  • extended-analysisthe core: three AI lens reads with findings, scores, and the analyst memo
  • future-predictions — our forward price-band predictions
  • market-narrative / ai-findings / gpt-critique — narrative context, cross-model findings, and an adversarial critique of our own analysis (near the end of the document)
  • Members-only sections (render as login gates for anonymous readers): price-history, income-trend, key-metrics, financials (statement tables), insider-trading. The analysis above is public; the raw data tables require a free account.

More for machine readers: site briefing at /llms.txt · any ticker resolves at delvantic.com/stock/TICKER · raw inputs are public-company filings and market data (via licensed data feeds); every model, score, lens read, and prediction on this page is Delvantic's own analysis.

TransMedics Group Inc.

TMDX NASDAQ
Healthcare · Medical Devices
Andover, MA 01810, United States transmedics.com Updated Aug 2, 2:20pm
Price
$76.51
Market Cap
$2.6B
Employees
898
Beta
1.88
Avg Volume
990,673
CEO
Dr. Waleed H. Hassanein M.D.

TransMedics Group Inc. is a commercial-stage medical technology company specializing in advanced systems and services for solid organ transplantation. Headquartered in Andover, Massachusetts, it focuses on improving the preservation, assessment, and transport of donor hearts, lungs, and livers for patients with end-stage organ failure. The company’s core platform, the Organ Care System, is a portable normothermic perfusion technology that keeps donor organs functioning in a near-physiologic state outside the body, enabling clinicians to evaluate and optimize organ quality prior to transplant. TransMedics combines this device platform with a service-led model that includes its National OCS Program, offering end-to-end organ retrieval, clinical management, logistics coordination, and dedicated transportation for transplant centers across the United States. Operating in the high-acuity transplant ecosystem, TransMedics plays a critical role in organ transplant workflows by helping transplant programs increase organ utilization and support complex heart, lung, and liver procedures through integrated technology and clinical services.

Runs with full report Generated: Aug 2, 2026 2:30pm
Price Overview
Price at report time
$76.51
as of Aug 2, 2:40pm (21d ago)
Change · Aug 2
+0.38 (+0.50%)
Day Range
$74.87 – $76.92
52-Week Range
$60.11 – $156.00
50-Day MA
$72.34
200-Day MA
$109.11
Volume
532,500.00
Right now · live
Log in to get the live feed
Members see the real-time price and the move since this report (over 21d).
Share Structure
Outstanding 34,545,721.00
Float 33,431,115.00
Free Float 96.8%
High free float — 96.8% of shares trade freely, ~3.2% held by insiders/institutions
Very liquid — most shares trade freely. Low insider ownership can mean less management alignment, but makes large position sizing straightforward.
Price History (1 Year)
Last updated: Aug 2, 2026 2:47pm (21d ago)
Revenue & Net Income Trend
The directional story — useful even when net income is negative.
Last updated: Aug 2, 2026 2:47pm (21d ago)
Revenue
The top line — total sales before any costs or taxes are subtracted. A measure of how much business the company is doing.
Net Income
The bottom line — profit left after subtracting all expenses, interest, and taxes from revenue. Reflects accounting profitability, but includes non-cash items like depreciation, so it isn't the same as cash earned.
Operating Cash Flow
The real cash generated by the day-to-day business — selling products, paying suppliers, collecting from customers. Calculated from net income by adding back non-cash items and adjusting for timing (unpaid bills, unsold inventory). When OCF consistently lags net income, the reported profit may not be converting to real money.
Period Revenue Net Income Net Margin YoY/QoQ
Key Metrics
TD Twelve Data statement HEX SEC filing
Industry comparison last run: Aug 2, 2026 2:28pm
P/E Ratio (Price per dollar of earnings)
HEX
Stock Price / EPS (Diluted)
15.71
Stock Price: $76.51
EPS (Diluted): 4.87
P/B Ratio (Price vs net asset value)
HEX
Stock Price / Book Value Per Share
6.56
Stock Price: $76.51
Total Equity: $473.10M
Shares: 40,540,694
EV/EBITDA (Total value vs operating profit)
HEX
Enterprise Value / EBITDA
15.95
Market Cap: $2.64B
Total Debt: $10.00M
Cash: $488.87M
EBITDA: $135.77M
Enterprise Value (Takeover price (cap + debt - cash))
HEX
Market Cap + Total Debt - Cash
$2.2B
Market Cap: $2.64B
Total Debt: $10.00M
Cash: $488.87M
Gross Margin (Revenue left after direct costs)
HEX
Gross Profit / Revenue
59.9%
Gross Profit: $362.81M
Revenue: $605.49M
Operating Margin (Revenue left after all operations)
HEX
Operating Income / Revenue
17.9%
Operating Income: $108.58M
Revenue: $605.49M
Net Margin (Revenue left as actual profit)
HEX
Net Income / Revenue
31.4%
Net Income: $190.29M
Revenue: $605.49M
ROE (Profit from shareholder equity)
HEX
Net Income / Total Equity
40.2%
Net Income: $190.29M
Total Equity: $473.10M
ROIC (Profit from all invested capital)
HEX
NOPAT / Invested Capital
-3,332.8%
Operating Income: $108.58M
Tax Rate: -77.0%
Equity: $473.10M
Total Debt: $10.00M
Cash: $488.87M
Current Ratio (Can it pay short-term bills)
HEX
Current Assets / Current Liabilities
7.14
Current Assets: $637.78M
Current Liabilities: $89.31M
Debt/Equity (Leverage — debt vs equity)
HEX
Total Debt / Total Equity
0.02
Short-Term Debt: $10.00M
Long-Term Debt: $0.00
Total Debt: $10.00M
Total Equity: $473.10M
Rev/Share (Top-line per share)
HEX
Revenue / Shares Outstanding
$14.94
Revenue: $605.49M
Shares: 40,540,694
Book Value/Share (Net assets per share)
HEX
(Total Assets - Total Liabilities) / Shares
$11.67
Total Equity: $473.10M
Shares: 40,540,694
FCF/Share (Real cash generated per share)
HEX
(Operating Cash Flow + CapEx) / Shares
$3.30
Operating CF: $192.84M
CapEx: -$59.25M
Shares: 40,540,694
CapEx is negative (outflow) — added to OCF to get FCF
Div Yield (Annual income from holding)
TD
Last Annual Dividend / Stock Price
Last Dividend: $0.00
Stock Price: $76.51
Payout Ratio (Earnings paid out as dividends)
HEX
Dividends Paid / Net Income
Dividends Paid: N/A
Net Income: $190.29M
Dividends paid not available in cash flow statement
Industry Benchmarks
Last run: Aug 2, 2026 2:28pm
Compares TMDX against LLM-researched typical ranges for its industry. One research call per industry, cached indefinitely — every stock in the same industry reuses the same baseline.
Income Statement (Annual)
Last updated: Aug 2, 2026 2:47pm (21d ago)
Metric 2021 2022 2023 2024 2025
Revenue $30.3M $93.5M $241.6M $441.5M $605.5M
Cost of Revenue $9.1M $28.2M $87.5M $179.5M $242.7M
Gross Profit $21.2M $65.3M $154.1M $262.1M $362.8M
Operating Expenses $60.6M $96.7M $182.8M $224.6M $254.2M
Operating Income -$39.4M -$31.4M -$28.7M $37.5M $108.6M
Net Income -$44.2M -$36.2M -$25.0M $35.5M $190.3M
EBITDA -$37.6M -$28.0M -$20.6M $57.3M $135.8M
EPS $-1.60 $-1.23 $-0.77 $1.07 $5.60
EPS (Diluted) $-1.60 $-1.23 $-0.77 $1.01 $4.87
Balance Sheet (Annual)
Last updated: Aug 2, 2026 2:20pm (21d ago)
Metric 2021 2022 2023 2024 2025
Cash & Equivalents $26.1M $201.7M $395.3M $337.2M $488.9M
Total Current Assets $118.7M $252.3M $510.7M $497.2M $637.8M
Total Assets $134.9M $277.1M $706.0M $804.1M $1.1B
Current Liabilities $23.2M $23.7M $54.9M $59.9M $89.3M
Long-Term Debt $35.2M $58.7M
Total Liabilities $67.0M $89.8M $568.8M $575.5M $595.3M
Total Equity $67.9M $187.4M $137.2M $228.6M $473.1M
Retained Earnings -$442.4M -$478.7M -$503.7M -$468.2M -$278.0M
Cash Flow (Annual)
Last updated: Aug 2, 2026 2:47pm (21d ago)
Metric 2021 2022 2023 2024 2025
Operating Cash Flow -$28.9M -$45.8M -$13.0M $48.8M $192.8M
Capital Expenditure -$3.5M -$11.9M -$151.8M -$129.7M -$59.3M
Free Cash Flow -$32.4M -$57.7M -$164.9M -$80.9M $133.6M
Acquisitions (net)
Net Debt Issued / (Repaid) $22.5M
Dividends Paid
Stock Buybacks
Net Change in Cash $999,000 $175.6M $193.6M -$58.2M $151.7M
Growth Trends (YoY %)
Last updated: Aug 2, 2026 2:47pm (21d ago)
Metric 2022 2023 2024 2025
Revenue Growth +208.8% +158.5% +82.7% +37.1%
Gross Profit Growth +208.5% +136.1% +70.1% +38.4%
Operating Income Growth +20.3% +8.6% +230.5% +189.6%
Net Income Growth +18.1% +30.9% +241.7% +436.6%
EBITDA Growth +25.7% +26.5% +378.6% +137.1%
0Company Classification 1Industry Landscape 2Company Momentum 3Forward Projection 4aDCF Valuation 4bEarnings Power Value 4cAnchored PE 4dReverse DCF 4eRevenue-Based DCF 4fAnchored P/S 4gScenario Analysis 4hDividend Discount Model 4iBook Value Analysis 4jInsider Activity 4fCash Flow Quality 4gDebt Maturity Risk 4hMacro Environment 4iSector Intelligence 4jRevenue Confidence 4kSensitivity Analysis 4lSector Demand Cycle 5AI Investigation 5bThesis Evaluation 6Valuation Synthesis
computed not applicable not yet run 14 computed · 6 not applicable · 4 not yet run
Risk : Reward — if the last quarter repeats
Live · as of 2026-08-19 11:09
0.8 : 1 recovery upside vs repeat-quarter downside
Recovery pays +52%; another quarter like the worst recent one costs 67%. Ratio 0.8:1.
CaseGrowthMarginFair valuevs price ($76.51)
Bull — recovery +54% 26.1% $116.43 +52%
Base — stabilizes +36% 22.7% $65.86 -14%
Bear — keeps slipping +18% 19.3% $35.53 -54%
Stress — last quarter repeats +21% 11.4% $25.45 -67%
The next quarters keep the trajectory of the most recent ones — growth stays at 20.9% and margins bend by the same profit-vs-revenue ratio (×0.50). Stress is a trajectory, not a prediction — it answers "what if the ship's current heading simply continues," which history says is the case to respect.
Why this is appearing: this company files quarterly, so its recent trajectory could be measured rather than assumed — the engine matched Jun 2026, Mar 2026 against the same quarters one year earlier and found revenue +20.9% · operating income -42.1% · net income -63.7% year-over-year. That measured heading is what the stress case extends forward. Data measured through Jun 30, 2026 — this card recalculates automatically when the next quarterly filing is ingested. Companies without quarterly filings (many foreign listings) never show this card: with no measured trajectory, there is nothing honest to repeat.
Narrative Economics
The story the market is telling about this stock — the intangible X-factor (founder mythology, cult dynamics, TAM-of-imagination) that moves price beyond what cash flows alone explain. After Shiller, Narrative Economics.
No narrative profile yet for TMDX — it's generated by the pipeline (market-narrative step).
Claude Reading
Independent analyst synthesis · claude-opus-4-7 · generated 2026-08-02 14:43:30
Verdict Overvalued but not egregiously — fair value $50-60 vs $76 current; DCF-derived $26 is too punitive, but decelerating sequentials and Q4 tax-inflated margins mean no chase here. Wait for pullback to mid-$50s or two clean growth quarters.

The raw trajectory here is genuinely impressive but the deceleration story is real and being underweighted by the bulls. Revenue went from $30M (2021) to $605M (2025) — a 20x in four years — but the quarter-over-quarter cadence tells a different story: Q1'25 $143.5M → Q2 $157.4M → Q3 $143.8M (sequential decline) → Q4 $160.8M → Q1'26 $173.9M. That's roughly 21% annualized sequential growth off the recent base, not 58%. YoY of 37% for the latest quarter (Q1'26 vs Q1'25 $173.9M vs $143.5M) is fine but decelerating hard from the 60%+ prints of 2024. The Q4'25 net income of $105M on $161M revenue (65.6% margin) is a massive tax/one-time benefit distortion — normalized margins are running 15-20%, not 31%. The synthesis leaning on "31% net margins" as structural is misleading; strip the Q4 anomaly and full-year NI is closer to $85M, or ~14% net margin. That materially changes the P/E from 15.7x to ~31x on normalized earnings.

I mostly agree with the synthesis verdict of overvalued but I think the $26 fair value is too punitive and the $76 price isn't as insane as the DCF suggests. The bear DCF appears to assume rapid mean-reversion of growth, which contradicts the sector-leader positioning in a genuinely underpenetrated market (OCS is the only FDA-approved platform of its kind for heart, lung, liver). At 4.4x sales with 60% gross margins, ~$130M FCF and $479M net cash, this is not a bubble — it's a growth stock being asked to prove the next leg. My rough fair value: on $700M 2026 revenue at 5-6x sales for a decelerating-but-dominant medtech with expanding margins, you get $50-60. So the composite $26 looks like a DCF using a punishing terminal multiple; the market's $76 assumes reacceleration. Truth is probably in the $50s.

The contrarian bull case that the models underweight: TMDX owns the aircraft and logistics network (National Aviation Program) — this is not a pure device company, it's vertical integration in organ transport, which creates a real moat and explains why gross margins compressed but revenue scaled. If OCS moves toward standard-of-care for extended-criteria donors (which is where the clinical evidence is pointing), the TAM math changes materially. The insider activity is neutral-to-slightly-positive: mostly awards, one small S-Sale of 9,624 shares against a 19,285 option exercise — that's routine tax-cover, not conviction-signaling exit. The narrative layer flagging "cult coefficient medium" is right — this isn't a retail meme, it's institutional impact capital, which is stickier than the DCF-only view assumes. The contrarian bear case that also gets underweighted: Q3'25's sequential decline to $143.8M was a warning shot the market largely ignored, and if reimbursement scrutiny hits (CMS has been reviewing organ procurement economics), the whole revenue model gets repriced.

Committing: I partially dissent from the synthesis. Overvalued directionally — yes — but $26 fair value is a low-conviction number that overweights DCF sensitivity to terminal growth. My read is fair value $50-60, current $76 embeds 25-50% of premium for continued adoption inflection that has not been proven in the last three quarters of sequential data. The Q1'26 acceleration to $173.9M is encouraging but one print doesn't reverse the deceleration trend. I'd want to see two consecutive quarters of >10% sequential growth and clarity on the Q4'25 tax benefit before adding. The thesis evaluation score of -5 (essentially balanced) is closer to my read than the synthesis' emphatic overvalued call. This is a hold-if-you-own-it, wait-for-$55-to-buy, don't-short situation — the balance sheet ($489M cash, $10M debt, current ratio 7.1) makes shorting expensive and the clinical narrative can reassert on any single positive reimbursement or adoption datapoint. Regime caveat: the "2026-03-31" and "2026-07-10" dates suggest this data is forward-dated or the file has date errors — that's a real anomaly worth flagging before sizing any position.

GPT Reading
Independent reading · gpt-5.4 · generated 2026-08-02 14:43:46
Verdict Undervalued at $76.51 — fair value looks closer to $90-$100 if revenue stays above 20% growth and margins normalize above 10%, with downside toward $55 only if 1Q26 proves the new baseline.

What stands out is that the stock is being discussed like a fragile concept story when the numbers now look like a scaled, cash-generating medtech platform. Revenue went from $241.6M in 2023 to $441.5M in 2024 and $605.5M in 2025, a 151% two-year increase, while operating income swung from -$28.7M to +$37.5M to +$108.6M. Even stripping out the obviously non-recurring distortion in 4Q25 net income of $105.4M on $160.8M of sales, the business is profitable on a run-rate basis: the last five “normal” quarters before 1Q26 averaged roughly 14%-22% net margins, and 1Q26 still produced $7.3M of net income despite a margin drop to 4.2%. On valuation, the raw multiples are not demanding for a company that is still growing this fast: 5.1x sales, 15.7x earnings, and about 16x EV/EBITDA, backed by $488.9M of cash against just $10.0M of debt. Enterprise value is only modestly above 3.5x trailing revenue for a business that just grew annual sales 37% and generated $133.6M of free cash flow.

The key issue is not whether TransMedics is “real” — it clearly is — but whether the recent slowdown means the hypergrowth phase is ending. 1Q26 revenue of $173.9M was up 21.2% year over year from $143.5M, which is still strong but meaningfully below the 37% recent growth marker and below the 2024-to-2025 annual growth rate of 37.1%. Quarterly sequencing also matters: revenue rose from $143.5M in 1Q25 to $157.4M in 2Q25, then slipped to $143.8M in 3Q25 before recovering to $160.8M in 4Q25 and $173.9M in 1Q26. That is growth, but not the smooth compounding line bulls prefer. More importantly, margins look volatile enough to warn against annualizing the 2025 headline earnings figure. Full-year 2025 net margin was 31.4%, but that was inflated by the 65.6% margin in 4Q25; by contrast, 1Q26 reverted hard to 4.2%. So I do not buy the idea that this deserves a premium because 30%-plus net margins are “proven.” What is proven is strong gross margin near 60% and emerging operating leverage, not a stable earnings power anywhere close to $190M net income.

That said, the market appears to have overreacted in the opposite direction. If I haircut earnings materially and think in EV/revenue and normalized free cash flow rather than the distorted 2025 net income, the current price still looks closer to attractive than dangerous. A company with $605.5M of trailing revenue, positive operating income over $100M, FCF of $133.6M, and a fortress balance sheet is not obviously overvalued at a $2.64B market cap unless one assumes a sharp growth air pocket or structural margin collapse. The most bearish framework in the briefing leans heavily on a DCF fair value around $26, but that seems anchored to conservative current-period cash flows while underweighting the fact that this company has already crossed from commercialization burn to self-funded scale. For a category leader in a clinically differentiated niche, 3.6x EV/revenue is not a heroic multiple. My read is that the stock is being valued as if 2025 was a one-off peak, whereas the underlying data still support a business that can grow into a meaningfully higher value even with margin normalization.

The strongest argument against this view is that 1Q26 may be the first clean evidence that the model is less scalable than the trailing numbers suggest. Revenue growth slowed to 21%, net margin nearly disappeared, and the quarterly cadence has been choppy for a company whose bull case depends on standard-of-care adoption. A smart bear would also point out that healthcare logistics-heavy models can look fantastic until utilization, reimbursement, or operating complexity bites, and the strange combination of very high ROE at 40.2% with deeply negative reported ROIC suggests the canonical metrics are not giving a clean picture of capital efficiency. If normalized earnings are closer to, say, a low-double-digit net margin on $650M-$700M of revenue rather than the 31% trailing margin, then today’s P/E is flattering and the stock is more like a mid-20s to 30x true earnings story. Add in some insider selling, however modest relative to awards and exercises, and it is easy to argue that this is not cheap enough for an execution-sensitive medtech name after all.

What would change my mind is straightforward. If the next two quarters show revenue stalling in the $170M range or dropping below 20% year-over-year growth while net margin stays in the low single digits, I would conclude 2025 was peak economics and that the stock deserves a much lower multiple, likely under $60. Conversely, if revenue re-accelerates back toward 25%-30% growth with operating margin holding in the mid-teens and free cash flow conversion remaining strong, then the current multiple is too low and the shares should trade comfortably above $90. Right now the evidence says this is no longer a speculative transplant narrative but a real business with one ugly margin print; I am inclined to fade the extreme skepticism, not join it.

Grok Reading
Independent reading · grok-4.5 · generated 2026-08-02 14:44:32
Verdict Modestly overvalued at $76; deceleration and Q1 margin reset cap upside despite real FCF and fortress BS — fair value nearer $55-65

The raw numbers show a company that has genuinely crossed into scaled profitability, not a story stock still burning cash. Revenue compounded from $30.3M in 2021 to $605.5M in 2025, with 2025 delivering $108.6M of operating income, $190.3M of net income, and $133.6M of free cash flow against only $59.3M of capex. The balance sheet is pristine: $488.9M cash, $10M debt, current ratio above 7, and debt-to-equity of 0.02. Gross margin holds near 60 percent and the trailing net margin prints at 31 percent. Those are real industrial metrics, not vapor. Yet the growth trajectory is unambiguously decelerating—208 percent, then 158 percent, 83 percent, 37 percent year-over-year, and the latest quarter (Q1 2026 revenue of $173.9M) is only up roughly 21 percent from the year-ago $143.5M. Sequential volatility is also visible: Q3 2025 revenue slipped to $143.8M before rebounding. More concerning is the earnings quality signal in the most recent print—net income collapsed to $7.3M (4.2 percent margin) after a $105.4M outlier quarter that almost certainly contained non-recurring tax or other items. Strip that noise and run-rate profitability looks closer to the $25–35M quarterly band seen earlier in 2025, implying a more modest earnings base than the headline 15.7× P/E suggests.

At $76.51 and a $2.64B market cap the stock trades at 5.1× sales, 3.6× EV/revenue and roughly 20× EV/operating income. For a med-device platform still growing above 20 percent with fortress liquidity those multiples are not grotesque, but they leave little room for further deceleration. The rule-based and narrative layers correctly flag that a large fraction of the prior premium was belief in OCS becoming standard-of-care logistics; the fundamentals have now partially validated that belief, which is why a $26 DCF fair-value output looks broken on its face—it would imply sub-1.5× sales for a company printing nine-figure FCF. Still, the market is no longer pricing hyper-growth; it is pricing mid-20s growth that the recent quarterly run-rate is already undershooting. ROIC flashing negative 33 percent while ROE sits at 40 percent is almost certainly a data artifact, but it underscores that invested-capital returns need cleaner scrutiny before one can call the model fully proven at scale.

The strongest case against this caution is straightforward: TransMedics already converted a mission narrative into $600M of revenue and $134M of FCF inside four years, maintains 60 percent gross margins, and sits on half a billion dollars of cash with negligible leverage. If OCS adoption continues to expand the usable-organ pool and the service-attach rate rises, operating leverage could push margins back toward the mid-20s and re-accelerate growth into the 30 percent range—making 5× sales look cheap and the current 15–20× earnings multiple a bargain. Clinical stickiness and the absence of a true peer competitor give the bull case a real fundamental anchor that pure-story biotech never possessed. I weigh this less heavily right now because the observed deceleration is already multi-year and the Q1 2026 margin reset shows that profitability is still lumpy; until growth stabilizes above 25 percent or margins demonstrate durability outside one-time quarters, the multiple has limited upside support.

What would flip the view is two consecutive quarters of revenue growth re-accelerating above 30 percent year-over-year together with operating margins holding above 18 percent, or clear reimbursement expansion that visibly lifts the service-revenue mix. Conversely, another quarter of sub-15 percent growth or sub-10 percent net margins would confirm the slowdown thesis and push fair value materially lower.

Big-3 Panel — where each AI stands
Each AI above independently stated a direction (undervalued, fairly valued, or overvalued) and how strongly it believes it (conviction, 0–5). We combine those into a Bull-Bear Index on a 0–10 scale: 5 is neutral, 10 is maximum bullish (undervalued at full conviction), 0 is maximum bearish. We compute the score ourselves with the same arithmetic for every seat — the models never grade their own bullishness — so the three are directly comparable. Δ shows how far each seat sits from the panel average of 4.0; a large Δ marks the dissenting voice, usually the one worth reading.
Claude claude-opus-4-7 2.0
overvalued · conviction 3/5 · Δ -2.0 vs panel · self: 4.0
GPT gpt-5.4 8.0
undervalued · conviction 3/5 · Δ +4.0 vs panel · self: 7.0
Grok grok-4.5 2.0
overvalued · conviction 3/5 · Δ -2.0 vs panel · self: 4.0
Second round ran — the seats disagreed beyond the band (Claude: overvalued · GPT: undervalued · Grok: overvalued); 1 seat changed direction after reading the others.
Claude — Second Response · overvalued revised

VERDICT: Modestly overvalued at $76; fair value $55-68 — widened upward from $50-60 acknowledging FCF/balance-sheet floor, but Q1'26 margin reset prevents the $90+ bull case until two clean quarters land

My colleagues moved me slightly toward the middle of my own range, not off it. GPT's strongest point is the one I should own more directly: at 3.6x EV/revenue, $133.6M FCF, and $479M net cash, calling this "overvalued" requires believing the growth air pocket is structural, not lumpy — and the four-year record (208% → 158% → 83% → 37%) plus the Q1'26 reacceleration to 21% YoY off a base that included a Q3'25 sequential dip is not yet that evidence. GPT is right that I was implicitly annualizing the Q1'26 4.2% net margin fear while simultaneously discounting the 60% gross margin structural story. Those don't both get to be true. Fair.

But GPT's $90-100 requires margins normalizing above 10% AND growth staying above 20% — and the Q1'26 print delivered exactly one of those two, with the margin miss being the more alarming variable because it's what the bull multiple rests on. Grok's framing is closest to mine and actually tightens it: $55-65 with the same deceleration-plus-margin-reset logic, and Grok explicitly called the $26 DCF "broken on its face" for a company printing nine-figure FCF, which is the point I was making less crisply. Where I'll revise: my $50-60 range was probably 5-10% too low given the balance sheet optionality and the fact that shorting into $479M net cash and a genuine clinical moat is a bad trade. I'll widen to $55-68 and acknowledge the asymmetry isn't as clean as I framed it.

What did NOT move me: GPT's implicit assumption that 2025 operating income of $108.6M is a reasonable run-rate anchor. Q4'25 carried the year, and Q1'26 operating leverage collapsed. Until we see two quarters of mid-teens operating margin on >$170M revenue, paying 5x sales for a decelerating print is asking the multiple to do work the fundamentals haven't yet done. Hold-if-owned, buy in high-$50s, still no chase at $76.

GPT — Second Response · overvalued changed direction

VERDICT: Fairly to modestly overvalued at $76.51; I’d anchor fair value around $55-$65 today, with >$85 requiring renewed 25-30% growth and mid-teens-plus margins.

Claude’s point that most moved me is not the broad “deceleration” claim—I already had that—but the normalization math: if you back out the obviously anomalous 4Q25 tax/one-time benefit, 2025 earnings power is closer to ~$85M, not $190M. That effectively doubles the “real” P/E from the optically cheap mid-teens to roughly 30x, which is a meaningful hit to my original undervaluation case because I leaned more heavily on EV/revenue and FCF than on how flattering reported earnings were. Grok reinforces the same issue from another angle: the latest quarter did not merely slow; it reset net margin to 4.2%, showing that the model’s earnings power is still much less settled than trailing annual numbers imply. I also think Claude’s framing of the current setup as “not a bubble, but being asked to prove the next leg” is more faithful to the data than my earlier “fade the skepticism” stance.

What did not move me is the most bearish valuation logic. Both colleagues rightly reject the $26 DCF outcome, and I do too; sub-1.5x sales for a clinically differentiated, cash-rich category leader with ~$600M revenue and $133.6M FCF is too punitive absent a genuine structural break. The balance sheet, gross margins near 60%, and unique logistics/device integration still argue against an outright bearish posture. But I am revising because the stock no longer looks clearly cheap on normalized economics. At ~$76, investors are paying for a reacceleration that the recent quarterly cadence has not yet earned. Fair value in the mid-$50s to mid-$60s now seems more defensible than my prior $90-$100 range unless the next two quarters show both better growth and restored operating leverage.

Grok — Second Response · overvalued held

VERDICT: Modestly overvalued at $76; fair value $55-65 until growth re-accelerates and margins stabilize

Claude’s normalization of 2025 earnings lands hardest and keeps me from drifting. Stripping the $105 M Q4 tax distortion leaves roughly $85 M of true net income (~14 % margin), turning the headline 15.7× P/E into something closer to 31× on a $2.64 B market cap. That single adjustment, which GPT under-weights when he still cites the raw trailing multiple, confirms that current pricing already embeds optimistic durability. GPT’s claim that 3.6× EV/revenue is “not heroic” for a still-growing platform is directionally fair, yet it collides with the multi-year deceleration already visible: 208 % → 158 % → 83 % → 37 % → 21 % YoY, plus the Q3 sequential drop that both colleagues note. A 20 %-growth med-tech with lumpy mid-teens margins does not automatically clear 5× sales; the burden of proof now sits on re-acceleration, not on the market’s willingness to pay up for past compounding.

Claude’s $50-60 fair-value band and emphasis on vertical logistics moat are useful but do not change the arithmetic. The aircraft network and OCS clinical stickiness are real differentiators, yet they have not prevented sequential choppiness or the Q1 margin collapse to 4.2 %. Until two clean quarters show >25 % growth and operating margins holding above 15 %, the $76 price still capitalizes an adoption inflection that the last four prints have failed to deliver. GPT’s $90-100 upside case therefore requires assumptions the recent data contradict; I leave it on the table only as a contingent bull scenario, not base case.

I hold the original caution. Fair value remains $55-65; the stock is modestly overvalued until the growth and margin trajectory re-proves itself.

Advanced Analysis Forensic deep-dive · separate lenses
Separate reads — Company Quality (is it a great business?), Valuation (is it mispriced?), and General Sentiment (how macro + narrative are pushing it), kept deliberately apart · 2026-08-02 22:06:18
Delvantic - Cairn AI
Quality — wait for a dip 7/10
Real business, priced 15-30% rich into a fresh narrative crack — this is a watchlist name, not a buy here.
The cruxWhether Q1'26 confirms the margin/growth reset is the new baseline or a one-quarter stumble — that single print decides if deserved value is $55-65 (sit) or $75-90 (chase).
Forensic checks Derived mechanically from TMDX's filed financials — not from the AI lenses
Liquidity & RunwayFortress Balance Sheet
DilutionHeavy Dilution
Earnings QualityGood Earnings Quality
The four lensesswitch a tab for its full read — score + evidence
Company Quality
+29
Strong
edge √Σ 133 · risk √Σ 103 · conf 7/10

The business transformation is genuine: revenue scaled from $30M in 2021 to $605M in 2025 (roughly 110% CAGR), operating margin flipped from -130% to +17.9%, and FCF swung from -$165M in 2023 to +$134M in 2025. Net income of $190M in 2025 is largely cash-backed (OCF/NI 0.97x, accruals -2.3% of assets), and the balance sheet is a fortress with $489M liquid cash, $479M net cash, and Altman Z of 3.82. Classification as high-growth-profitable is warranted by the data.

Strengths 3
m82
Operating leverage is real
Op margin went from -11.9% (2023) to +8.5% (2024) to +17.9% (2025) on 2.5x revenue growth — genuine scaling, not accounting.
m78
Fortress liquidity, self-funding
$489M cash vs ~$10M debt; $134M FCF in 2025 means no external funding dependency. Altman Z 3.82.
m70
Cash-backed earnings
OCF/NI 0.97x and accruals -2.3% of assets — 2025 net income of $190M is not a paper number.
Concerns 4
m68
Persistent heavy dilution
Diluted shares grew 27.6M to 40.5M (46.7% over four years, ~10% CAGR), SBC 6.1% of revenue, zero buyback offset — per-share value creation lags business creation materially.
m55
Gross margin compression
GM fell from 69.9% (2021) to 59.9% (2025) — 10 points of erosion as they scaled. Operating leverage is masking mix/pricing pressure at the unit level.
m45
Beneish M-score flag
M-score -1.32 exceeds the -1.78 threshold. Likely driven by rapid growth in receivables/inventory during a scaling phase rather than manipulation, but warrants scrutiny.
m30
Insiders take money off the table
6 sells / $2.5M vs 0 open-market buys in the last 12 months; CEO Hassanein received 162K shares in awards. Not alarming but no conviction signal.
This is a real business that just crossed the chasm — revenue up 20x in four years, margins inflected hard, and the balance sheet is unimpeachable. But I refuse to call it Fortress-tier because the per-share story lags the enterprise story badly: 10%/yr share issuance with no buyback means shareholders are effectively co-funding the growth. The gross-margin slide and Beneish flag are yellow lights I'd want to close out before upgrading. Solidly Strong, not elite.
Verify before trusting this (5)
  • Whether GM compression from 69.9% to 59.9% reflects mix (NOP heart/liver vs lung), pricing, or logistics/aviation cost absorption
  • Customer/transplant-center concentration and payer reimbursement stability
  • Detail behind the Beneish flag — receivables days, DSO trend, and any capitalized costs
  • Whether SBC grant velocity moderates now that the company is GAAP profitable
  • Sustainability of the FCF swing (working capital release vs recurring)
Valuation / Mispricing
-68
Overvalued
edge √Σ 25 · risk √Σ 108 · conf 7/10
Price $76.51 vs composite FV ~$25 and signal-adj ~$26; even a quality-lifted deserved value of ~$55-65 leaves the stock 15-30% rich. attractive below $45.00

The e2e composite lands at $24.78 with a signal-adjusted FV of $26.29, implying roughly -66% downside from $76.51. That anchor is an EPV-floor read, so it deliberately understates a hyper-growth story - but even generously tripling it to reflect the revenue trajectory (20x in four years, margin inflection, fortress balance sheet) only gets you into the $60-75 zone, i.e. fair at best. The market cap of $2.64B on a business still scaling with thin margins requires the OCS platform to compound for many more years without reimbursement, logistics, or competitive setbacks.

Cheap signals 1
m25
Quality lifts deserved value above EPV floor
Fortress balance sheet, real profitability inflection, and 20x revenue in four years justify a premium above the $25 EPV floor - deserved value is plausibly $50-65, but still below the current print.
Rich / priced-in 4
m72
Composite FV implies deep overvaluation
Composite $24.78 and signal-adjusted $26.29 vs $76.51 price - a -66% gap. Even discounting the EPV-floor method as conservative, the spread is too large to close with reasonable growth assumptions.
m60
Priced for perfection on unproven scaling
At $2.64B market cap the market has already capitalized years of OCS adoption, geographic expansion, and margin expansion; bear case flags thin current margins and reimbursement/adoption risk not reflected in price.
m45
Per-share dilution erodes deserved value
~10%/yr share issuance with no buyback means the enterprise-value growth flows to option holders and new equity, meaningfully lowering deserved per-share value even as the business improves.
m30
EPV-only anchor is the one method firing
The synthesis lists only epv-floor; no DCF or multiples cross-check is disclosed. Even so, price is 3x the anchor - a wide margin that no single-method uncertainty erases.
This is a great business at a price I cannot defend. The composite FV near $25 is almost certainly too low - it is an EPV floor on a company still in hyper-growth - but even generously marking deserved value up to the $55-65 range for the balance sheet, inflection, and platform optionality, $76.51 is still 15-30% too rich. I would want it under $45 to buy on valuation alone, and I would not chase here; strong business, full-plus price, sit on hands.
Verify before trusting this (5)
  • Forward revenue guidance and NOP (National OCS Program) utilization trends
  • Gross margin trajectory - is the recent slide temporary or structural?
  • Segment mix (heart vs lung vs liver) and reimbursement updates
  • Share count guidance and SBC run-rate for per-share math
  • Beneish M-score components - what is driving the flag?
General Sentiment
-59
Headwind
tail √Σ 40 · head √Σ 107 · conf 7/10

TMDX is a classic narrative-priced medical device story: the OCS organ-preservation platform carries a strong mission-driven bull thesis with moderate durability and medium cult following. But the story took real damage on May 6 when a 51% EPS miss and margin compression triggered a 23% single-day sell-off, and recent momentum (37% vs 58% long-term CAGR) confirms the narrative is decelerating, not accelerating. That is the exact wrong shape for a stock priced at $76.51 vs a $26.29 DCF - almost the entire market cap is story, and the story just cracked. The macro tape is only mildly supportive (regime +22, VIX 16) and offers no real tailwind to a beta-1.88 unprofitable-story name; if the S&P wobbles further off its high, high-beta narrative healthcare gets marked down first. Rates at 4.68% and a market PE of 26.9 add background pressure on long-duration adoption stories exactly like this one. Net: the narrative is intact but bruised, analyst tone is likely still catching down to the Q1 print, and there is no sector rotation or macro impulse actively pushing this name higher. The pressure leans headwind, not catastrophic - the story has not broken, just wobbled.

Tailwinds 2
m35
Narrative still intact and mission-coded
The organ-shortage story is emotionally resonant with medium cult coefficient - it has not broken, and mission-driven bets tend to attract dip buyers on story-continuation flows.
m20
Neutral macro regime, not risk-off
Tape is technically tailwind (+22) and VIX at 16 is benign - the environment is not actively hostile, just unsupportive for high-beta story names.
Headwinds 4
m70
Fresh narrative crack from Q1 miss
The May 6 print (51% EPS miss, margin compression, -23% day) is the kind of event that lingers in a narrative-priced name - it forces the market to question the adoption ramp that justifies a 3x DCF multiple.
m55
Momentum deceleration under a story stock
Recent 37% vs long-term 58% CAGR signals the tape is losing conviction. For a mission-driven-bet archetype, decelerating momentum is corrosive because the entire price rests on accelerating adoption.
m45
High beta into a fragile-neutral tape
Beta 1.88 with the S&P already 1.6% off highs and VIX creeping means any risk-off flicker hits TMDX 2x harder than the index; the +22 regime score is too thin to shield it.
m40
Long-duration story vs 4.68% 10y
Rates at 4.68% and market PE at 26.9 pressure long-dated adoption narratives most; TMDX's DCF gap is almost pure duration risk.
This is a narrative stock whose narrative just took a real bruise, and the tape is not friendly enough to bail it out. The bull story is still alive - mission-driven medical device names with cult appeal do not die from one bad quarter - but momentum is decelerating, price is 3x DCF, beta is nearly 2, and the macro backdrop offers zero help for long-duration adoption stories. I read it as a moderate headwind: not a collapsing narrative, but a story stock trading without any of the tailwinds it needs to keep defying its DCF. A single soft print or a VIX spike here gets ugly fast.
Verify before trusting this (5)
  • Q2 print - does revenue growth reaccelerate or does the margin compression story deepen?
  • Analyst target revisions post-Q1 - are sell-side cuts done or still trickling in?
  • OCS adoption datapoints from major transplant centers - any signs the surgeon-behavior bear case is playing out?
  • Any move in VIX above 20 or S&P down more than 5% - would disproportionately punish this beta-1.88 name
  • Reimbursement newsflow (CMS, private payors) - the single biggest narrative swing factor
The market-wide tape + this name's exposure to it (beta / sector / narrative durability). Context on the non-fundamental pressure — not a call on the business or the price. processId: detail-general-sentiment
Growth Outlook
not run

This lens hasn't been run for this ticker yet.

The forward growth verdict — is the business itself likely to grow (next 2 quarters / year 1 / years 2–3), judged against its category and against printed expectations. The full horizon ladder + creme renders on the Growth Outlook card above. Not a call on the price (Valuation owns that) or the tape (Sentiment owns that).
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Lenses kept deliberately separate — Company Quality (price-agnostic), Valuation (price-conditional), General Sentiment (non-fundamental macro/narrative pressure), and Growth Outlook (the forward growth verdict). The scores are not blended. Filing-level items (convertibles, lock-ups, customer concentration) are v2 — see each lens's "verify."
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My Notes personal — only you see this
v1.1.562 · 9b2927c4 · 2026-08-22 16:52:06