In 2025, Pulmonx faced significant operational challenges in its U.S. sales organization, resulting in limited revenue growth and a notable decline in Q4. The company is focused on rebuilding its sales force and refining its strategies to drive strong revenue growth in 2026.
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How do Pulmonx's operational challenges affect its revenue in the U.S. for 2025?
Pulmonx Corporation experienced significant operational difficulties in its U.S. business in 2025, primarily due to internal executional and organizational issues:
Sales Force Disruptions:
The U.S. sales team was overstretched by handling too many competing initiatives simultaneously, like managing new call points and services such as LungTraX Detect, which diluted their focus on core revenue-generating activities.
At the start of 2025, there were material changes to U.S. Territory Manager roles and responsibilities that proved disruptive, alongside a suboptimal incentive structure that failed to motivate the sales force effectively.
These factors collectively led to significant sales force turnover—about half the sales organization during the year—disrupting customer continuity and account management.12
Sales Team Turnover and Hiring:
The turnover spanned the whole year, but Pulmonx has now filled nearly all open U.S. sales positions. The new hires are currently ramping up their productivity, which typically takes about 6 to 9 months per territory.342
Refined Sales Strategy:
The company is streamlining the U.S. sales force's priorities, focusing on a "near to far" outreach strategy to strengthen relationships within hospital systems that already offer Zephyr Valves. Efforts are targeted on engaging pulmonary service line directors rather than top-level administrators, and concentrating direct-to-patient marketing in geographies with established treatment centers instead of broad-based campaigns.
This approach aims to rebuild clinical buy-in, operational support, and patient flow efficiency, establishing a better foundation for growth.561
This uneven performance within the year aligns with the timeline of sales force turnover and gradual hiring, where the latter part of the year reflects the initial positive effect of newly staffed territories that are still not fully productive.
Pulmonx expects to resume U.S. sales growth in the back half of 2026, with the ramp-up of the newly hired sales force combined with the more focused commercial strategy now in place.594
Management projects a transition from year-over-year declines in the first half of 2026 to double-digit growth in the second half, due in part to sales productivity improvements as reps reach full ramp.10114
The incentive plan for the U.S. sales force has been realigned to be more conventional and well-understood, avoiding the pitfalls of 2025, to better motivate reps going forward.2
The senior rep/junior rep territory pairing is expected to accelerate ramp-up by providing mentoring and continuity, further supporting growth prospects in 2026.4
Overall, Pulmonx guides for full-year 2026 revenue in the range of $90 million to $92 million globally, with gradual improvement in U.S. sales as a key driver behind returning to double-digit growth toward the later part of the year.9
| Aspect | Impact/Detail | Citation |
|---|---|---|
| 2025 U.S. revenue growth | +1% full year; Q4 decline of 11% due to operational challenges and sales force turnover | 78 |
| Operational challenges | Overstretched sales initiatives, disruptive territory role changes, suboptimal incentive plan, high sales team turnover (~50%) | 12 |
| Sales force rebuilding progress | Nearly all U.S. sales positions filled; productivity ramp expected over 6-9 months; senior-junior rep pairs facilitate ramp | 5342 |
| Strategic refocus | Concentrated efforts on existing treating hospitals, physician education, administrative support, and well-chosen patient outreach | 561 |
| 2026 Revenue outlook U.S. | Return to growth expected in back half of 2026; guidance implies gradual ramp from quarter-to-quarter decline to double-digit growth | 51094 |
| Compensation restructuring | 2026 incentives realigned to proven plans and quotas to improve motivation and alignment | 2 |
Pulmonx’s operational challenges in 2025—especially sales force disruptions due to organizational and incentive misalignments—were significant headwinds that limited U.S. revenue growth to a mere 1% for the year, with notable declines in the latter quarters. These challenges led to a protracted transition period as the company rebuilt its U.S. sales team, refined commercial strategies, and realigned incentives.
The newly filled sales territories and focused sales efforts are expected to drive a recovery and growth resumption in the U.S. starting mid-2026, with management targeting double-digit revenue growth by the end of the year. The operational changes and strategic focus are designed to create a more stable and productive sales organization, and thus improve U.S. revenue performance in 2026 and beyond.
This outlook, however, requires time for ramping and execution of the refined sales strategy and clinical engagement programs; 2025's operational issues significantly delayed this progress but are now being addressed decisively.
This financial and operational analysis highlights that Pulmonx’s challenges were primarily internal and are not attributed to market capacity or external headwinds, positioning the company for a controlled and managed recovery focused on long-term sustainable growth in the U.S. market.
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