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©2020 Cardiovascular Systems, Inc. All Rights Reserved. Cardiovascular Systems, Inc. June 10, 2020

Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

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Page 1: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

©2020 Cardiovascular Systems, Inc. All Rights Reserved.

Cardiovascular Systems, Inc.June 10, 2020

Page 2: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Safe HarborFORWARD LOOKING STATEMENTS

This presentation contains forward-looking statements and information within the meaning of Section 27A of the Securities Act of 1933, as amended, or the “Securities Act”, and

Section 21E of the Securities Exchange Act of 1934, as amended, or the “Exchange Act”, which are subject to the safe harbor created by those sections. These forward-looking

statements include, but are not limited to, statements in this presentation regarding CSI’s strategy and goals; growth; future financial measurements and investments;

shareholder value; product development plans, milestones and introductions; geographic expansion; clinical trials and evidence; professional education efforts; market

estimates and opportunities; and developments, goals and expectations relating to the COVID-19 pandemic and the recovery therefrom. Forward-looking statements are only

predictions and are not guarantees of performance. These statements are based on CSI management’s beliefs and assumptions, which in turn are based on their interpretation

of currently available information.

These statements involve known and unknown risks, uncertainties and other factors that may cause CSI’s results or CSI’s industry’s actual results, levels of activity,

performance or achievements to be materially different from the information expressed or implied by these forward-looking statements. CSI may not actually achieve the plans,

intentions or expectations disclosed in these forward-looking statements and you should not place undue reliance on our forward-looking statements. These forward-looking

statements involve known and unknown risks and uncertainties that could cause CSI’s actual results, performance or achievements to differ materially from those expressed or

implied by the forward-looking statements, including, without limitation, the risks set forth in our filings with the Securities and Exchange Commission.

CSI’s actual future results may be materially different from what CSI expects. You should not place undue reliance on these forward-looking statements. You should assume

that the information contained in this presentation is accurate only as of the date of this presentation. Except as required by law, CSI assumes no obligation to update these

forward-looking statements publicly, or to update the reasons actual results could differ materially from those anticipated in these forward-looking statements, even if new

information becomes available in the future. CSI qualifies all of the information presented in this presentation, and particularly the forward-looking statements, by these

cautionary statements.

FINANCIAL INFORMATION

This presentation includes calculations or figures that have been prepared internally and have not been reviewed or audited by CSI’s independent registered accounting firm.

Use of different methods for preparing, calculating or presenting information may lead to differences, which may be material.

NON-GAAP FINANCIAL MEASURES

This presentation uses Adjusted EBITDA, a non-GAAP financial measure, to supplement financial information presented in accordance with GAAP. There are limitations to the

use of non-GAAP financial measures presented in this presentation. For example, non-GAAP financial measures may not be comparable to similarly titled measures of other

companies. Other companies may calculate non-GAAP financial measures differently than the CSI, limiting the usefulness of those measures for comparative purposes. For

further information on the use of non-GAAP measures, please see slide 30.

2

Page 3: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Offering Summary

3

Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII)

Base Offering Size: $125 million (100% Primary)

Overallotment Option: 15% (100% Primary)

Use of Proceeds:

CSI intends to use the net proceeds from this offering for working capital and general corporate purposes,

which may include expansion of marketing programs, international expansion, new product development,

clinical studies and publications, acquisitions, investments, or general working capital needs

Lock-up Period: 90 days for the Company, directors and executive officers

Bookrunners: Barclays, SVB Leerink

Expected Pricing: June 9, 2020

Page 4: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Our Mission

Saving Limbs, Saving Lives Every Day

2 Million+Patients with Critical

Limb Ischemia (CLI)1

160,000Annual Amputations

in the U.S.2

370,000Deaths Annually From

Coronary Artery

Disease in the U.S.3

525,000High Risk or Complex

High Risk Procedures

Annually in the U.S.4

Focused on Complex Peripheral and Coronary Artery Disease

4

1. Yost ML, CLI U.S. Supplement, Beaufort, SC. 2016 as presented at NCVH 2017

2. Allie DE, Hebert CJ, Ingraldi A, Patlola RR, Walker CM. 24-Carat Gold, 14-Carat Gold, or Platinum Standards in the Treatment of Critical Limb Ischemia: Bypass Surgery or Endovascular Intervention? J Endovsc Ther. 2009;16(Suppl I):I134–I146.

3. American Heart Association - Heart Disease and Stroke Statistics- 2018 Update

4. CSI estimates

Page 5: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

CSI Today Building on our orbital atherectomy foundation

5

Coronary Peripheral

z

Page 6: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Company ProfileDeveloping innovative solutions for treating peripheral & coronary arterial disease

6

800+Employees and a highly

experienced leadership team

#1U.S. market leader in calcified

peripheral and coronary atherectomy

5,700+Real-world patients studied through

clinical studies as of FY19

80,000+ Patients treated annually

200+ Patents

1,700+U.S. customers; hospital and

office based labs

200 U.S. direct sales representatives

125 U.S. clinical specialists

Page 7: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Experienced and Talented TeamAverage Experience in Medical Technology: 20 Years

Organizational Values: Accountability, Community, Courage, Excellence, Integrity and Velocity

Sandra M. Sedo, MBA,

JD

Chief Compliance Officer

Alexander Rosenstein,

JD

General Counsel &

Corporate Secretary

Scott R. Ward, MS, MBA

Chairman,

President and CEO

Rhonda J. Robb, MBA

Chief Operating Officer

Stephen J. Rempe

VP, Human Resources

Ryan D. Egeland, MD

PhD

Chief Medical Officer

John M. Hastings, MBA

VP, Manufacturing

& Operations

David S.

Whitescarver, JD

VP, Corporate Development

& Intellectual Property

Jeffrey S. Points, MBA,

CPA

Chief Financial Officer

7

Page 8: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Strong Financial Platform for Profitable Growth

$178

$205$217

$248

FY16 FY17 FY18 FY19

12%CAGR

(FY16-FY19)

80% 81% 82% 81%80%

FY16 FY17 FY18 FY19 Q3FY20

80%

($39)

$13

$16

$14

FY16 FY17 FY18 FY19

+$53M

$61

$108$117

$123

$107

FY16 FY17 FY18 FY19 Q3FY20

+$47M

Revenues Gross Margin Adjusted EBITDA* Cash Balance**

8

$ in millions

*Adjusted EBITDA is a non-GAAP metric. For a reconciliation to the nearest GAAP measure, net income (loss), please see slide 30.

**Cash, cash equivalents and marketable securities

Page 9: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Revenue Mix / Impact of COVID on Q3 FY20 Growth

9

WW Peripheral Revenue

US Peripheral$42.1

US Coronary$16.0

International$3.1

Q3 FY20 Revenue: $61.2 million

WW Coronary Revenue WW Total Revenue

10%12%

10%8%

(6%)

Q3 FY19 Q4 FY19 Q1 FY20 Q2 FY20 Q3 FY20

25% 24%27%

30%

2%

Q3 FY19 Q4 FY19 Q1 FY20 Q2 FY20 Q3 FY20

14%15% 15% 14%

(3%)

Q3 FY19 Q4 FY19 Q1 FY20 Q2 FY20 Q3 FY20

• Q3 revenue impacted $10-11 million by COVID

• Q3 on plan prior to March 8: +10.7% atherectomy growth

Steady improvement in weekly

orders during April and May

• March 9-31 daily orders decreased 25% vs. prior year

• April orders decreased 53% vs. prior year

(Y-o-Y %)

Page 10: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Key Goals During Coronavirus Pandemic

• No material disruption to manufacturing or supply chain

• Sourced and distributed PPE to field sales employees

• Supporting cases in person or virtually where possible

Assure continued ability to serve customers and support patients

• Safeguarded facilities and office-based employees are telecommuting

• Deployed screen, test, trace and isolate protocols

• No layoffs or furloughs

Protect health of employees while retaining the strength and capacity of business

• Amended RCF, increased borrowing capacity to $50M

• Reduced forecasted fiscal Q4 operating expenses by 15% vs. LY

• Anticipate an acute, but short term impact in fiscal Q4

• Steady improvement observed in April and May

Ensure business continuity

10

Page 11: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Driving Future GrowthBroaden Our Value Streams

Financial Goal: Accelerate Profitable Revenue Growth

Financial strength and the talent to execute

Grow and Protect

the Core Business

Innovation Drives

Incremental Growth

Global Expansion Accelerates

Growth of Core Business

Sustain Market Leadership

Attractive and Consistent Growth

in Core Business

Expand Product Portfolio and

Addressable Markets

Drive higher revenue per orbital

atherectomy procedure

Steady Cadence of Commercial

Launches

Capturing Market Share and

Driving Market Development

11

Page 12: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Expansion of the Complex Coronary Product OfferingDrives Incremental Revenue Opportunity Per Case

Coronary Diamondback 360®

with GlideAssist®Sapphire® Expansion

ScoreFlex NC

Sapphire® Balloons

Teleport® Microcatheter

Launched FY19Launched FY19

Sapphire SC II PRO 1.0-4.0mm

Sapphire NC Plus 2.0-4.0mm

Launched FY19

FY20 Launches

• Sapphire SC II PRO 1.0mm OTW

• Sapphire NC Plus 4.5-5.0mm

Expected Launch FY21

Adding Essentials of

the Complex PCI Toolkit

Increasing the Clinical Utility

of the Sapphire Portfolio in

the Near-Term

Continuing to Innovate around

the Complex Patient Long-TermViperWire Advance® with Flex Tip

Launched Q1 FY20

Represents $800-$1,000 of

incremental revenue

opportunity

12

Page 13: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Expansion of the Peripheral ToolkitIncreasing Revenue Opportunity Per Case Launching in FY21

Radial PAD Products: $800-$1,000/OAS Procedure

Extended Length:

Exchange Catheters

PTA Balloons

Radial Access Sheaths

Guidewires

Exchange Catheters

PTA Balloons

Access Sheaths

Guidewires

WIRION Embolic Protection

System

PAD Products: $1,600-$1,800/OAS Procedure

13

Page 14: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

WIRION® Embolic Protection SystemSupporting Our Commitment to Complex Patients

14

• Easier to use and more versatile than competing EPDs with

clearance for use with any peripheral atherectomy device and any

0.014” guidewire

• Demonstrated safety and non-inferiority to pre-specificed

performance goals in capturing debris with low adverse event rates

in WISE LE study

• Platform enables future innovation for potential BTK and Radial

applications

Share-Taking Differentiated Technology

Commercialization expected in FY21 following completion of the manufacturing transfer from Gardia Medical

Broadens value streams in $50M market, 50,000 devices used in the U.S.

Complements CSI’s future directional atherectomy platform

Provides assurance to physicians not using atherectomy today due to

concern of distal emboli

Synergistic with CSI Strategy and Mission

Protecting Patients During PVIs

Embolic debris can be associated with all types of peripheral vascular

intervention procedures

EPDs are typically used when treating vessels located above the knee with

long lesions, high plaque burden, and poor run off

Can provide additional assurance when treating complex peripheral

interventions and lesions

Page 15: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Supporting Complete Leg RevascularizationExchangeable Series with GlideAssist® – Reduces Rehospitalization

Patient and economic benefits with more efficient procedures aligned to market

dynamics

Future Portfolio: New 1.0mm crown for small vessel / below-the-ankle lesions

and a larger crown intended for larger vessels like the common femoral and

iliac arteries

GlideAssist to facilitate tracking, repositioning and removal of OAD through

challenging anatomy

Exchangeable cartridges with different catheter lengths and crown options to

optimally treat patients with multi-level disease (seen ~50% of the time)

within the same procedure

Ease-of-Use Enhancements to Handle: Backloadable system facilitating easier

wire exchanges and improved tactile feel

15

Page 16: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Percutaneous Ventricular Assist Device (pVAD) SystemMulti-Generational Platform Highly Synergistic with Our Strategy and Competency

16

• Millennium Research Group (2017 December) Medtech360 Market Analysis – Cardiac Assist Devices– US – 2018

Entering a High Growth pVAD Market*Generation 1 Overview

IDE clinical studies planned to highlight

procedural safety and perfusion

metrics/endpoints

* Includes Complex PCI and Cardiogenic Shock

$0

$300

$600

$900

$1,200

$1,500

$1,800

FY19 FY23 FY27

$ M

illio

ns

16% CAGR

Recent Accomplishments / Status

Multiple animal studies completed successfully

Pre-submission meetings completed and underway with the FDA

First-in-human in FY21

• Leverages CSI core

competency in motor control

and spinning cables

• Easy setup and use

• Flow: 3-5 LPM

• Crossing Profile: 10-14 Fr

• Catheter Profile: 6-8 Fr

• Improved deliverability

• Physician control in the

sterile field

• Simplified touch

screen display

• Compact console design

(<15 lbs.)

Page 17: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Excellence in Quality and ManufacturingScalable and Continuous COGS Reductions

Manufacturing

Initiatives

Sourcing and

Supply Chain

Volume driven overhead leverage

Scalable and

continuous reductions

to protect margins

from ASP declines

Labor productivity

LEAN continuous improvement

Material cost reductions

Vertical Integration

17

Page 18: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Consistent Reimbursement

FacilityInpatient/

OutpatientProcedure 2020 Reimbursement % Change from 2019

Hospital Inpatient PAD $11,392 - $20,532* 3.1% - 3.2%

Hospital Inpatient CAD $10,534 - $19,858** 2.8% - 0.4%

Hospital Outpatient PAD/CAD $9,907 - $15,938 2.5% - 3.8%

Non-Hospital Outpatient/OBL PAD (ATK) $11,582 - $14,891 (6.9)% - (7.1)%

Non-Hospital Outpatient/OBL PAD (BTK) $11,626 - $14,476 (6.6)% - (5.0)%

$0

$5,000

$10,000

$15,000

$20,000

PAD OBL

PTA Ath/PTA

Stent Ath/Stent

$0

$5,000

$10,000

$15,000

$20,000

PAD Hospital Outpatient

PTA Ath/PTA

Stent Ath/Stent

$0

$5,000

$10,000

$15,000

$20,000

CAD Inpatient

PCI PCI/BMS PCI/DES

$0

$5,000

$10,000

$15,000

$20,000

CAD Outpatient

PTCA Ath/PTCA

Stent Ath/Stent

MS-DRG 246, 247, 248, 249, 250, 251, 252, 253, 254; CPT® Codes 37225, 37227, 37229, 37231, 92924, 92933; C-APCs 5193,5194;

HCPCS Code C9602

Payment amounts based on National Medicare Averages and will vary by provider.

CMS released IPPS Proposed Rule for FY21 on May 11, 2020

*Peripheral atherectomy procedures increase 2.8%-7.1%

**Coronary atherectomy procedures increase 1.2%-6.1%18

Page 19: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

LIBERTY 360 Clinical StudyEvaluating long-term clinical and economic outcomes in patients with symptomatic PAD

19

Prospective, Observational, Study to Evaluate

Clinical and Economic Outcomes in Patients

Treated for PAD: 1,204 patients at 51 sites

OAS Sub Study: 503 patients

Freedom from Major Amputation on Target Limb

at Three Years:

RC 2-3: 100% RC 4-5: 95.3% RC 6: 88.6%

Mean Index Procedure Cost of $11,621

RC2-3 RC4-5 RC6

Survival Time (Days)

Su

rviv

al P

rob

ab

ility

Page 20: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

ECLIPSE Trial - Enrollment paused due to COVID-19Generating Level One Evidence to Impact Guidelines

2000Patients with Severely

Calcified Lesions

2nd generation DES implantation

and optimization

2nd generation DES implantation

and optimization

1. Post-PCI in-stent MSA by OCT (N=~500 in imaging sub-study)

2. 1-year TVF (all subjects)1o Endpoints

2o Endpoints 1. Procedural Success: Successful stent delivery (all subjects)

2. Strategy Success: Procedural success without crossover

1.25 mm Classic Crown followed by

balloon pre-dilation

Orbital Atherectomy Strategy

Conventional and/or specialty balloons

per operator discretion

Conventional Angioplasty Strategy

Principal Investigators

Study Chairman

Randomize

1:1

Ajay Kirtane, MD; Philippe Généreux, MD;

Gregg W. Stone, MD

~500 subjects in OCT cohort

OAS >1 mm2 superior MSA vs. POBAMSA

All subjects

OAS >5% reduction in TVF vs. POBATVF

Primary Endpoints

20

Page 21: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Global Distribution Network

CSI Direct Sales OrbusNeich Medikit

St. PaulCorporate Headquarters

• ~ 800 employees

• United States direct sales force includes

~200 sales reps and ~125 clinical specialists

TokyoCorporate Headquarters

• ~ 1,000 employees

• Exclusive distributor for OAS in Japan

Hong KongCorporate Headquarters

• ~ 600 employees

• Develops, manufactures and distributes vascular

intervention devices in more than 60 countries

• Exclusive distributor for OAS outside U.S. and Japan

21

Partnerships to Expand Orbital Atherectomy Across the Globe

Page 22: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

China

Canada

Southeast Asia

Middle East

Europe

Japan

Coronary Peripheral

A Steady Cadence of New Geographic Launches

FY19FY23FY23

FY19 FY24+

22

Coronary CE Mark Dossier Remains Under Active Review

Page 23: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Cardiovascular Systems, Inc. Creating Shareholder Value

Leveraging a

Strong Core Business

A Compelling

Growth Strategy

Creating

Competitive Advantage

Financially Strong

with the Team and

Talent to Win

Expanding into

new geographic markets

Driving market leading

performance in orbital

atherectomy

Developing an innovative

portfolio of new products

Positive cash flow, strong

cash position and no

long-term debt

Sustaining double digit

growth

with strong gross margins

Positioned to invest

in organic growth

A Mission driven organization

with the leadership and

talent to succeed

Innovation and robust

medical evidence

High quality

products, services

and relationships

Medical education

and superior clinical

support

Serving large and

growing markets

Proprietary

core technology

Improving outcomes for

complex coronary and

peripheral artery disease

23

Page 24: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

©2020 Cardiovascular Systems, Inc. All Rights Reserved.

Appendix

Page 25: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

US Peripheral$42.1

US Coronary$16.0

US Peripheral US Coronary International

US Peripheral revenue declined 6%

Q3 Revenues of $61.2 Million3% Decrease

US Coronary revenue declined 2%

International grew 26%

25

• Units sold decreased 6% as COVID-19 negatively impacted

procedure volumes

• Hospital revenue decreased 8%

• OBL revenue decreased 4%

• Units sold decreased 9% as COVID-19 negatively impacted

procedure volumes

• Support product revenue increased 124%

• Coronary Classic and ViperWire Flex Tip in Japan

• OAS launched in 13 countries OUS to-date

($ in millions)

Q3 FY20 Revenue Breakdown

International

$3.1

Page 26: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Steady, Asymmetric Recovery

26

• Below the knee – CLI will recover the quickest; no backlog

• Above the knee Claudicant segment recovers and backlog is

addressed as patient confidence is restored over 4-6 months

• Slow, gradual recovery over 6 months in Coronary procedures

CSI Revenue Mix: PAD 70% & CAD 30%

• Care of CLI patients in the Hospital setting is leading the way

• Patient referral channels for claudicant and coronary patients will

be restored over the next few months

• C19 may be catalyst to accelerate PAD patient migration to OBL

Site of Service: Hospital 80% & OBL 20% of Accounts

• Q1FY21 procedures will be below normal

• Q2FY21 procedures could return to a normal pace assuming that

elective procedure volumes generally normalize, patient confidence

improves, referral pipelines are restored and cath lab capacity

returns to normal

Key Assumptions

CSI Procedure Recovery by State May 29, 2020

Page 27: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Near-term Financial Commentary

• CSI withdrew fiscal 2020 financial guidance on April 1, 2020 due to the impact of COVID-19 on

US procedure volumes

• Our April US customer orders declined 53% vs. LY

• Several factors may increase or decrease our procedure volumes during fiscal Q4, including

developments relating to social restrictions and government restrictions on elective and semi-

elective cases, level of patient anxiety, availability of PPE, cath lab and workforce capacity and

sales rep access to hospitals

• We do not expect hospitals and OBLs to replenish their inventories in fiscal Q4

27

Page 28: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Cardiovascular Systems, Inc. Timeline

28

Orbital Atherectomy

Device Designed

Cardiovascular

Systems, Inc. name change

1997

2003

2007

2009

2010

2013

2015

2016

2017

2018

2019

Peripheral FDA

clearance secured

CSI goes public

(NASDAQ: CSII)

First patient enrolled

in Compliance 360

clinical trial

First patient enrolled

in Calcium 360

clinical trial

First patient enrolled

in Orbit II coronary

clinical trial

Achieved $100 million

annual revenue

Coronary FDA

approval secured

First patient enrolled in

LIBERTY 360 clinical trial

Treated 33,390 patients

with orbital atherectomy

devices

CSI moves into

new state of the art

headquarters located

in St. Paul, MN

CSI Chairman Scott

Ward named President

and CEO

Achieved $200 million

in annual revenue

Enrolled first subject in

ECLIPSE Coronary

Clinical Trial

Rhonda Robb named COO

First international commercial

launch of coronary device (Japan)

Delivered first fiscal year

of profitability

Shared 5-year strategic plan

to broaden product offering,

expand internationally and

accelerate growth

Treated >70,000 patients with

orbital atherectomy devices

First patients treated in SE Asia

and Europe

First patients treated

in Middle East with

coronary device

Shturman Cardiology

Systems, Inc. founded

1989

Page 29: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Trial Size Importance

PAD

LIBERTY 360° (3-year Data) n=1,204• “All-comers” trial, any treatment option

• Nearly 700 Rutherford Class 4-6 patients enrolled

OPTIMIZE (Enrollment Complete) n=66• OAS + DCB vs. DCB alone

• Calcified below-the-knee lesions

OASIS, CONFIRM series, TRUTH,

CALCIUM 360, and COMPLIANCE 360n=3,359

• High rates of procedural success and durability

• Low adverse events/bail-out stenting

CAD

ECLIPSE (Enrollment Began March 2017) n=2,000

• Largest randomized trial to study coronary atherectomy for calcified

coronary lesions

• OAS + DES vs. angioplasty (including cutting/scoring balloons) + DES

• Currently paused due to Covid 19

ORBIT II (3-year Data) n=443 • High freedom from revascularization resulting in economic benefits1,2

COAST (1-year Data) n=100• Supported approvals of Coronary OAS in U.S. and Japan

• Japan commercialization began in FY18

Leadership in Medical Evidence

29

600+Physicians

5,700+Patients

~8,000Lesions

1. Lee M, et al, Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial, Cardiovasc Revasc Med (2017), http://dx.doi.org/10.1016/j.carrev.2017.01.011

2. L.P. Garrison Jr. et al., Cardiovascular Revascularization Medicine 18 (2017) 86–90

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Non-GAAP Financial MeasuresTo supplement CSI's consolidated condensed financial statements prepared in accordance with GAAP, CSI uses a non-GAAP financial measure referred to as "Adjusted EBITDA" in this presentation.

Reconciliations of this non-GAAP measure to the most comparable U.S. GAAP measure for the respective periods can be found in the following table. In addition, an explanation of the manner in which

CSI's management uses this measure to conduct and evaluate its business, the economic substance behind management's decision to use this measure, the substantive reasons why management

believes that this measure provides useful information to investors, the material limitations associated with the use of this measure and the manner in which management compensates for those limitations

is included following the reconciliation table.

Use and Economic Substance of Non-GAAP Financial Measures Used by CSI and Usefulness of Such Non-GAAP Financial Measures to Investors

CSI uses Adjusted EBITDA as a supplemental measure of performance and believes this measure facilitates operating performance comparisons from period to period and company to company by factoring out potential differences caused by

depreciation and amortization expense and non-cash charges such as stock based compensation. CSI's management uses Adjusted EBITDA to analyze the underlying trends in CSI's business, assess the performance of CSI's core operations, establish

operational goals and forecasts that are used to allocate resources and evaluate CSI's performance period over period and in relation to its competitors' operating results. Additionally, CSI's management is evaluated on the basis of Adjusted EBITDA

when determining achievement of their incentive compensation performance targets.

CSI believes that presenting Adjusted EBITDA provides investors greater transparency to the information used by CSI's management for its financial and operational decision-making and allows investors to see CSI's results "through the eyes" of

management. CSI also believes that providing this information better enables CSI's investors to understand CSI's operating performance and evaluate the methodology used by CSI's management to evaluate and measure such performance.

(in thousands)Year Ended June 30

2016 2017 2018 2019

Net income (loss) $(56,024) $(1,792) $1,712 $(255)

Less: Other (income) and expense,

net(145) 164 390 (760)

Less: Provision for income taxes 92 86 132 190

Income (loss) from operations (56,077) (1,542) 2,234 (825)

Add: Stock-based compensation 12,977 10,354 10,302 11,266

Add: Depreciation and amortization 3,917 4,135 3,934 3,446

Adjusted EBITDA $(39,183) $12,947 $16,470 $13,887

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Page 31: Cardiovascular Systems, Inc....2020/06/10  · Offering Summary 3 Issuer: Cardiovascular Systems, Inc. (NASDAQ: CSII) Base Offering Size: $125 million (100% Primary) Overallotment

Investor Contact:

Jack Nielsen

651-202-4919

[email protected]

CSI®, Diamondback®, Diamondback 360®,

GlideAssist®, ViperWire®, WIRION® and

ViperWire Advance® are trademarks of

Cardiovascular Systems, Inc.

© 2020 Cardiovascular Systems, Inc.

OrbusNeich®, Teleport® and Sapphire® are

trademarks of OrbusNeich Medical, Inc.

For more information:

www.csi360.com

Cardiovascular Systems, Inc.

CSII

@csi360

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