Sec Form 4 Filing - Browne Sean E @ Xtant Medical Holdings, Inc. - 2025-11-15

FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person Browne Sean E 2. Issuer Name and Ticker or Trading Symbol Xtant Medical Holdings, Inc. [ XTNT] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X __ Director _____ 10% Owner X __ Officer (give title below) _____ Other (specify below) President and CEO (Last) (First) (Middle) C/O XTANT MEDICAL HOLDINGS, INC., 664 CRUISER LANE 3. Date of Earliest Transaction (MM/DD/YY) 11/15/2025 (Street) BELGRADE, MT59714 4. If Amendment, Date Original Filed (MM/DD/YY) 6. Individual or Joint/Group Filing (Check Applicable Line) __ X __ Form filed by One Reporting Person _____ Form filed by More than One Reporting Person (City) (State) (Zip)

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1.Title of Security (Instr. 3) 2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4) Code V Amount (A) or (D) Price Common Stock 11/15/2025 A 394,937 ( 1 ) A $ 0 2,575,274 ( 2 ) D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) 6. Date Exercisable and Expiration Date (MM/DD/YY) 7. Title and Amount of Underlying Securities (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4) Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares Performance Stock Units (PSUs) ( 3 ) 11/15/2025 A 789,874 ( 4 ) ( 3 ) 11/15/2028 Common Stock 789,874 ( 4 ) $ 0 789,874 ( 4 ) D

Reporting Owners Reporting Owner Name / Address Relationships Director 10% Owner Officer Other Browne Sean E C/O XTANT MEDICAL HOLDINGS, INC. 664 CRUISER LANE BELGRADE, MT59714 X President and CEO Signatures /s/ Amy Culbert, attorney-in-fact 11/18/2025 Signature of Reporting Person Date

Explanation of Responses:

( 1 )These shares will vest with respect to 98,734 shares on each of November 15, 2026, November 15, 2027, and November 15, 2028, and with respect to 98,735 shares on November 5, 2029 pursuant to a deferred stock unit (DSU) award granted under the Xtant Medical Holdings, Inc. Amended and Restated 2023 Equity Incentive Plan, conditioned upon the Reporting Person remaining an employee of Xtant through the applicable vesting date. The settlement of the vested shares underlying the DSU award has been deferred and will occur at a later date pursuant to the terms of the DSU award agreement. Each DSU represents a contingent right to receive one share of the Issuer's common stock. ( 2 )Includes an aggregate of 1,213,677 shares issuable upon vesting and settlement of restricted stock unit (RSU) awards or DSU awards granted under the Xtant Medical Holdings, Inc. Amended and Restated 2023 Equity Incentive Plan, in each case conditioned upon the Reporting Person remaining an employee of Xtant through the respective vesting dates. ( 3 )Each PSU represents a contingent right to receive one share of the Issuer's common stock. The PSUs will vest and become earned in one-third increments based on the achievement of specified stock price performance goals during a three-year performance period and subject to additional service-based vesting conditions. ( 4 )Represents the maximum number of shares that may be issued pursuant to the PSUs, which is 200% of the target number of shares (394,937).

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4(b)(v).

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