Cardiovascular Systems, Inc.

NASDAQ: CSII
2nd Annual
Needham Med Tech 1x1 Conference
Boston
August 8, 2017
 Safe Harbor
FORWARD-LOOKING STATEMENTS objectives of management, and other statements
Certain statements made in this presentation are that are other than statements of historical fact.
forward-looking statements within the meaning of
the Private Securities Litigation Reform Act of 1995 These statements involve risks and uncertainties
and are provided under the protection of the safe which could cause results to differ materially from
harbor for forward-looking statements provided by those projected, including those described under the
that Act. In some cases, you can identify forward- heading Risk Factors contained in the prospectus
looking statements by terms such as may, will, filed with the Securities and Exchange Commission
should, could, would, expect, plans, (the SEC) for our recent public offering, and as
anticipates, believes, estimates, projects, detailed from time to time in CSIs SEC reports,
predicts, potential and similar expressions including its Reports on Form 10-K and Form 10-Q.
intended to identify forward-looking As a result of these matters, changes in facts,
statements. Examples of these statements include, assumptions not being realized or other
but are not limited to, statements regarding circumstances, CSI's actual results may differ
Cardiovascular System, Inc.s (CSI or the materially from the expected results discussed in the
Company) future financial performance, product forward-looking statements presented. The forward-
sales distribution, industry and market expectations looking statements are made only as of the date of
and estimates, the benefits and uses of the this presentation, and CSI undertakes no obligation
Companys products, market opportunity potential, to update them to reflect subsequent events or
clinical trials, international expansion, regulatory circumstances.
approvals, future profitability, debt capacity, use of
proceeds, results of operations, prospects, plans and

2
 Investment Merits
Multibillion dollar, underserved markets in peripheral
and coronary artery disease
Orbital atherectomy: highly differentiated technology
Uniquely and safely treats calcified arterial plaque
Effective in small vessels
Supported by medical evidence, published in peer-reviewed journals
Positioned for sustainable, profitable growth
Stable reimbursement
Large, clinically-focused U.S. sales force

3
 Peripheral Artery Disease (PAD)
Large, underdiagnosed and underserved patient population
Up to 18 Million in U.S. with PAD,
Only 2.6 Million
4 Million with Critical Limb Ischemia
Receiving Treatment
(CLI)

1.9 Million 700,000

2.6 Million Claudicant CLI
Treated

Sources: Sage Group, Millennium Research Group US Markets for Peripheral Intervention Devices 2014, iData US Market for Peripheral
Vascular Devices and Accessories 2014, and Go, et al Heart Disease and Stroke Statistics -- 2014 Update, Circulation.
4
 PAD Calcium $2B U.S. Opportunity
2.6M PAD Treatments 580,000* with Calcified Lesions
70% ATK, 30% BTK 50% ATK, 50% BTK

470,000
Interventions
170,000 160,000
160,000 Interventions Medical
Amputations Management
2.0M
Medical
Management
150,000
Amputations

*CSI estimates
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 CAD Severe Calcium $700M Opportunity
1.25 Million Coronary Artery Disease (CAD) 178,000* Patients with
Procedures
CABG, and
250MEstimated CHIP Patients Severely Calcified Lesions

250,000
CABG 30,000
CABG

48,000
120,000 100,000
880,000 CHIP Patients
PCI
CHIP Patients
PCI

CHIP: Complex Higher-Risk Indicated Patients

* 12% severe calcium in both PCIs & CABG + 48,000 estimated CHIP patients
Bourantas,C et al; Heart, 2014;0:17. 20% severe Ca++ in DES trials
Gnreux, P. et al. J Am Coll Cardiol 2014;63(18):1845-54. 6% severe Ca++ in ACS
Feldman D. et al, Circulation. 2013;127:2295-2306. 60% of PCIs ACS, 40% stable 12% severe Ca++
6
 CSI Orbital Atherectomy Systems (OAS)
Differential Sanding:
Eccentrically mounted crown bi-
directionally sands hard plaque
Healthy, elastic tissue flexes away
from crown to minimize vessel
damage

Centrifugal Force:
Increasing speed = increased orbit
radius
360 crown contact designed to
create a smooth, concentric lumen
Allows constant blood flow and
particulate flushing during orbit
Treat large vessels through small
sheaths, multiple vessels with one
crown

Crowns shown are not to scale and for illustrative purposes only.
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 Benefits of Orbital Atherectomy

3 Heart
Heart-to-heels solution
Alternate access sites
Effective in calcium
Excellent safety
Long-term durability 1 1 Above the Knee
Economical
3 3 Below the Knee

With systems for coronary or peripheral indications, the CSI product line offers heart-to-heels capability.
8
 Unique Mechanism of Action
Bi-directional and differential sanding

93% < red blood cell size

99% < lumen size of capillaries

Calculation of mean particulate size is based on particles larger than 1 micron from a
representative study using carbon blocks and cadaver model systems. 9
 Leadership in Clinical Evidence
5000+ 7000 600
Patients Lesions Physicians
Trial Size Importance
LIBERTY 360 n=1,204 All-comers trial vs. any other treatment
(Enrollment Complete) Nearly 700 Rutherford class 4, 5, or 6
PAD

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
OPTIMIZE n=50 OAS + DCB vs. DCB alone
(Enrolling) Calcified below-the-knee lesions
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
OASIS, CONFIRM series,
CALCIUM 360 and High rates of procedural success and durability
n=3,359
COMPLIANCE 360 Low adverse events/bail-out stenting

ECLIPSE Largest randomized trial to study coronary

(Enrollment Began n=2,000 atherectomy for calcified coronary lesions
March 2017) OAS + DES vs. angioplasty + DES
CAD

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ORBIT II n=443
92% freedom from revascularization at 3-years
(3-year Data) Up to $4,946 per patient cost savings at 2-years
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
COAST Supported 2nd Gen OAS in U.S. and Japan approval
(Enrollment Complete)
n=100 Japan reimbursement anticipated in late CY17

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 LIBERTY 360 6-Month Results
Change in Rutherford Classification (RC)
Following Endovascular Intervention
Patients maintained good 6
outcomes and positive 5
changes in Rutherford 4
3
classification. 2
High freedom from Major 1
Adverse Events (MAE) 0
Baseline 30 Days 6 Months
across all classes. Rutherford 2-3 Rutherford 4-5 Rutherford 6
Watchful waiting in RC 2-3
and primary amputation in Rutherford Classification
RC 6 may not be necessary. 6-Month Results
RC 2-3 RC 4-5 RC 6
78% of RC 6 subjects were
Freedom from (FF) MAE 92.6% 81.2% 73.7%
discharged to home.
FF Major Amputation 99.8% 96.8% 87.1%
FF TVR 93.0% 83.1% 85.1%
FF Death 97.1% 95.3% 85.1%

Gray, LIBERTY, ISET, Feb. 6, 2017

Adams, LIBERTY, AMP, Aug. 11, 2016 11
AHA/ACC* Guidelines Support PAD Intervention

2016 Guidelines on the Management of

Patients with Lower Extremity PAD support
data in LIBERTY 360
Revascularization is a reasonable treatment
option for claudicants with inadequate
response to medical management and exercise
CLI patients should receive an evaluation for
revascularization prior to amputation

*American Heart Association/ American College of Cardiology

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 ECLIPSE Trial Design
Evaluation of Treatment Strategies for Severe CaLcifIc Coronary Arteries:
Orbital Atherectomy vs. Conventional Angioplasty Prior to Implantation of Drug Eluting StEnts

2000 pts with severely calcified lesions; 60 US sites

Randomize
Orbital Atherectomy Strategy 1:1 Conventional Angioplasty Strategy
(1.25 mm Crown followed by non- (conventional and/or specialty
compliant balloon optimization) balloons per operator discretion)

2nd generation DES implantation 2nd generation DES implantation

and optimization and optimization

Primary endpoints: 1) Post-PCI minimal stent area assessed by OCT (N400 in imaging study)
2) 1-year TVF (all patients)

Principal investigators: Philippe Gnreux, Ajay Kirtane; Study chairman: Gregg W. Stone
Sponsor: Cardiovascular Systems Inc. 13
 Consistent, Attractive Reimbursement

2018 Proposed % Change

Hospital Procedure
Reimbursement from 2017
Inpatient PAD $11,141-$19,757 5%-0%
Inpatient CAD $11,141-$19,496 5%-1%
Outpatient PAD/CAD $10,218-$15,573 5%-5%

Non-Hospital 2018 Proposed % Change

Procedure
Facility Reimbursement from 2017
Outpatient PAD (ATK) $10,972-$14,856 (5%)-(1%)
Outpatient PAD (BTK) $10,819-$13,404 (1%)-(1%)

MS-DRG 246, 247, 248, 249, 250, 251, 252, 253, 254; CPT Codes 37225, 37227, 37229,
37231, 92933; C-APCs 5191,5192,5193,5194; HCPCS Code C9602 14
 Track Record of Revenue Growth
FY16 Slowed by Sales Force Transition
Return to Growth in FY17 $226-$233
+10-14%
$230 $204.9
+15%

$180
$ Millions

$130

$80
FY13 FY14 FY15 FY16 FY17 FY18
Guidance

Amounts exclude revenue from distribution agreement terminated on 6-30-15

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 Strong, Improving Gross Margins
Attractive ASPs, Declining Unit Costs
85%

80.8%
80.1%
80% 78.9%
78.0%
77.2%

75%

70%
FY13 FY14 FY15 FY16 FY17

Amounts exclude gross margin from distribution agreement terminated on 6-30-15

* FY17 gross margin of 80.8% includes $1.5M charge related to product recall 16
 Achieved Positive Adjusted EBITDA
Leveraging Revenue Growth for Profitability

Revenue Adjusted EBITDA

$204.9 $12.9

$178.2
$ millions

-$39.2
FY16 FY17 FY16 FY17

Reconciliations of Adjusted EBITDA to the most comparable U.S. GAAP measure for the respective
periods can be found in the appendix 17
 Solid Cash Position
Positive FY17 cash flow from operations
$21M proceeds from sale-leaseback transaction (Mar. 2017)
$10M proceeds from Japan distribution agreement (Nov. 2016)
$40M line of credit in place

$120
$108
$103
$100
$ Millions

$79
$80
$61 $58
$60

$40

$20

$0
Q4 FY16 Q1 FY17 Q2 FY17 Q3 FY17 Q4 FY17

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 Why CSI?
Multibillion dollar, underserved markets in peripheral
and coronary artery disease
Orbital atherectomy: highly differentiated technology
Uniquely and safely treats calcified arterial plaque
Effective in small vessels
Supported by medical evidence, published in peer-reviewed journals
Positioned for sustainable, profitable growth
Stable reimbursement
Large, clinically-focused U.S. sales force

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Appendix

20
IVUS Echogenicity Analysis Pre- & Post-OAS
Peripheral
angiography pre-
procedure (A), post-
OAS (B), and post-
procedure (C). The
magnified view of
the lesion of
interest is indicated
in a, b, and c.
Gray-scale IVUS
images (D and D)
and echogenicity
analyses (E, E and
Table) correspond to
the yellow
arrowhead in a and
b.
IVUS = intravascular
ultrasound
OAS = orbital
atherectomy
system.

Sotomi, JACC: Cardiovascular Interventions, 2015

21
 Non-GAAP Reconciliations
ADJUSTED EBITDA RECONCILIATION Twelve Months Ended
$ in thousands June 30, 2017 June 30, 2016
Net Income (loss) $(1,742) $(56,024)
Less: Other (income) and expense, net 164 (145)
Less: Provision for income taxes 86 92
Income (loss) from operations (1,542) (56,077)
Add: Stock-based compensation 10,354 12,977
Add: Depreciation and amortization 4,135 3,917
Adjusted EBITDA $12,947 $(39,183)

Non-GAAP Financial Measures

To 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. An explanation of the manner in which CSI's management uses Adjusted EBITDA to conduct and evaluate its business, the economic
substance behind management's decision to use Adjusted EBITDA, the substantive reasons why management believes that Adjusted EBITDA provides useful information to
investors, the material limitations associated with the use of Adjusted EBITDA and the manner in which management compensates for those limitations can be found in
CSIs most recent quarterly earnings release, dated, August 2, 2017.

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 Statement of Operations
(Dollars in thousands, except per share and share amounts)
Year Ended June 30,
2017 2016 2015
Net revenues
$ 204,906 $ 178,184 $ 181,544
Cost of goods sold
39,441 35,421 39,520
Gross profit
165,465 142,763 142,024
Expenses:
Selling, general and administrative
142,851 162,542 143,684
Research and development
22,911 25,934 30,977
Restructuring
2,364
Legal settlement
8,000
Total expenses
165,762 198,840 174,661
Loss from operations
(297) (56,077) (32,637)
Other (income) and expense, net
164 (145) 71
Loss before income taxes
$ (461) $ (55,932) $ (32,708)
Provision for income taxes
86 92 114
Net loss
$ (547) $ (56,024) $ (32,822)

Basic and diluted earnings per share

$ (0.02) $ (1.72) $ (1.04)

Basic and diluted weighted average shares outstanding

32,373,709 32,537,621 31,547,711

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 Balance Sheet
(Dollars in thousands, except per share and share amounts)
June 30, June 30,
2017 2016
ASSETS
Current assets
Cash and cash equivalents $ 107,912 $ 60,638
Accounts receivable, net 27,675 23,128
Inventories 16,897 17,440
Marketable securities 704 684
Prepaid expenses and other current assets 5,074 2,992
Total current assets 158,262 104,882
Property and equipment, net 29,696 32,471
Patents, net 5,056 5,013
Other assets 129 40
Total assets $ 193,143 $ 142,406
LIABILITIES AND STOCKHOLDERS EQUITY
Current liabilities
Accounts payable 9,939 8,506
Accrued expenses 28,220 26,993
Total current liabilities 38,159 35,499
Long-term liabilities
Financing obligation 21,100
Deferred revenue 10,000
Other liabilities 4,250 6,010
Total liabilities 73,509 41,509
Commitments and contingencies
Common stock, $0.001 par value at June 30, 2017 and 2016; authorized 100,000,000
common shares at June 30, 2017 and 2016; issued and outstanding 32,849,563 at
June 30, 2017 and 32,792,497 at June 30, 2016 33 33
Additional paid in capital 447,559 428,235
Accumulated other comprehensive income 100 40
Accumulated deficit (328,058) (327,411)
Total stockholders equity 119,634 100,897
Total liabilities and stockholders equity $ 193,143 $ 142,406

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Statement of Cash Flows
(Dollars in thousands) Year Ended June 30,
2017 2016 2015
Cash flows from operating activities
Net loss
$ (547) $ (56,024) $ (32,822)
Adjustments to reconcile net loss to net cash used in operations
Depreciation of property and equipment
3,917 3,686 2,150
Provision for doubtful accounts (including note receivable)
465 725 1,121
Amortization of patents
218 231 171
Write-off of patent costs
733 168 43
Loss on disposal of property and equipment
158 170 121
Stock-based compensation
10,354 12,977 14,718
Changes in assets and liabilities
Accounts receivable
(5,012) 7,327 (10,568)
Inventories
543 (3,474) (1,076)
Prepaid expenses and other assets
(1,823) 728 (1,183)
Accounts payable
964 (970) 581
Accrued expenses and other liabilities
(520) 10,873 4,387
Deferred revenue
10,000
Net cash provided by (used in) operations
19,450 (23,583) (22,357)
Cash flows from investing activities
Expenditures for property and equipment
(981) (3,818) (20,325)
Issuance of convertible note receivable
(350)
Purchases of marketable securities
(37) (2,112)
Sales of marketable securities
46 1,249 365
Costs incurred in connection with patents
(844) (813) (955)
Net cash used in investing activities
(1,779) (3,769) (23,027)
Cash flows from financing activities
Proceeds from the employee stock purchase plan
3,254 3,142 2,882
Exercise of stock options
5,263 1,006 2,152
Payments on borrowings
(2,400)
Proceeds from financing
20,944
Change in financing obligation
142
Net cash provided by financing activities
29,603 4,148 2,634
Net change in cash and cash equivalents
47,274 (23,204) (42,750)
Cash and cash equivalents
Beginning of period
60,638 83,842 126,592
End of period
$ 107,912 $ 60,638 $ 83,842
Noncash investing and financing activities
Change in equipment included in accounts payable
$ (319) $ (374) $ (469)
Change in patent costs included in accounts payable
(150) 87 (52)
Supplemental cash flow information
Interest paid
$ 66 $ $ 23

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DIAMONDBACK 360 Coronary Orbital Atherectomy System
Indications: The DIAMONDBACK 360 Coronary Orbital Atherectomy System
(OAS) is a percutaneous orbital atherectomy system indicated to facilitate
stent delivery in patients with coronary artery disease (CAD) who are
acceptable candidates for PTCA or stenting due to de novo, severely calcified
coronary artery lesions.
Contraindications: The OAS is contraindicated when the VIPERWIRE guide
wire cannot pass across the coronary lesion or the target lesion is within a
bypass graft or stent. The OAS is contraindicated when the patient is not an
appropriate candidate for bypass surgery, angioplasty, or atherectomy
therapy, or has angiographic evidence of thrombus, or has only one open
vessel, or has angiographic evidence of significant dissection at the
treatment site and for women who are pregnant or children.
Warnings/Precautions:; Performing treatment in excessively tortuous vessels
or bifurcations may result in vessel damage; The OAS was only evaluated in
severely calcified lesions, A temporary pacing lead may be necessary when
treating lesions in the right coronary and circumflex arteries; On-site surgical
back-up should be included as a clinical consideration; Use in patients with
an ejection fraction (EF) of less than 25% has not been evaluated. See the
instructions for use before performing DIAMONDBACK 360 coronary orbital
atherectomy procedures for detailed information regarding the procedure,
indications, contraindications, warnings, precautions, and potential adverse
events. For further information call CSI at 1-877-274-0901 and/or consult
CSIs website at www.csi360.com.
Caution: Federal law (USA) restricts this device to sale by or on the order of a
physician.
Diamondback 360 and Stealth 360Peripheral Atherectomy Systems
The Diamondback 360 and Stealth 360 PAD Systems are
percutaneous orbital atherectomy systems indicated for use as therapy
in patients with occlusive atherosclerotic disease in peripheral arteries
and stenotic material from artificial arteriovenous dialysis fistulae. The
Systems are
contraindicated for use in coronary arteries, bypass grafts, stents, or
where thrombus or dissections are present. Although the incidence of
adverse events is rare, potential events that can occur with
atherectomy include: pain, hypotension, CVA/TIA, death, dissection,
perforation, distal embolization, thrombus formation, hematuria,
abrupt or acute vessel closure, or arterial spasm. For further
information call CSI at 1-877-274-0901 and/or consult CSIs website at
www.csi360.com.
Caution: Federal law (USA) restricts this device to sale by or on the
order of a physician.
26
Investor Contact:
Jack Nielsen
651-202-4919
j.nielsen@csi360.com

2017 Cardiovascular Systems, Inc.

All Rights Reserved
Diamondback 360 and CSI are registered
trademarks of Cardiovascular Systems, Inc.
www.csi360.com

NASDAQ: CSII