Fresenius Medical Care (FMS) Cash Flow: Operating & Free Cash Flow

Fresenius Medical Care (FMS) Cash Flow Statement

In fiscal 2025 (fiscal year ended Dec 31, 2025), Fresenius Medical Care generated EUR 2.58B of operating cash flow and spent EUR 879.24M on capital expenditures. That left free cash flow of EUR 1.70B, up 0.5% from EUR 1.69B a year earlier, or 8.6% of revenue. It returned EUR 968.02M to shareholders through EUR 405.84M in dividends and EUR 562.19M in share buybacks.

Fresenius Medical Care Cash Flow Statement Analysis

Values in billions EUR

Income Statement Balance Sheet Cash Flow Ratios

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Cash flow statement showing operating, investing, and financing activities for Fresenius Medical Care AG (FMS) - Annual data in billions EUR
Breakdown	FY 2025	FY 2024	FY 2023	FY 2022	FY 2021	FY 2020	FY 2019	FY 2018	FY 2017
Period ending	Dec 2025	Dec 2024	Dec 2023	Dec 2022	Dec 2021	Dec 2020	Dec 2019	Dec 2018	Dec 2017
Operating Activities
Net Income	0.94	0.74	0.73	0.89	1.22	1.16	1.44	2.23	1.55
Depreciation & Amortization	1.41	1.74	1.75	1.84	1.62	1.59	1.59	0.73	0.74
Deferred Income Tax	-0.03	-0.07	-0.12	-0.04	0.07	0.11	0.06	0.09	-0.20
Stock Based Compensation	0.00	0.00	0.03	0.00	0.00	0.00	0.00	0.01	0.05
Change in Working Capital	0.13	0.44	0.56	-0.13	-0.10	1.24	-0.01	-0.89	-0.10
Change in Accounts Receivable	-0.07	-0.07	-0.15	-0.05	-0.16	0.07	-0.06	-0.17	-0.09
Change in Inventory	-0.24	0.11	-0.01	-0.20	-0.05	-0.36	-0.12	-0.16	-0.06
Change in Accounts Payable	-0.01	0.16	0.11	-0.36	-0.36	1.37	-0.16	0.37	0.52
Change in Other Working Capital	0.45	0.25	-0.35	0.48	0.48	-0.18	0.33	-0.93	-0.47
Other Operating Activities	0.12	-0.47	0.08	-0.40	-0.32	0.20	-0.52	-0.10	0.16
Net Cash from Operating Activities	2.58	2.39	2.63	2.17	2.49	4.23	2.57	2.06	2.19
Investing Activities
Capital Expenditures	-0.88	-0.70	-0.68	-0.72	-0.85	-1.05	-1.12	-2.06	-1.79
Acquisitions	0.22	0.61	-0.04	0.00	-0.38	-0.21	-2.18	0.76	-0.15
Purchases of Investments	-0.09	-0.08	-0.10	-0.11	-0.13	-0.07	-0.01	-0.93	-0.15
Sales/Maturities of Investments	0.08	0.08	0.09	0.06	0.14	-0.03	0.02	0.00	-0.42
Other Investing Activities	0.00	0.01	0.02	0.04	0.02	0.02	0.01	1.98	1.51
Net Cash from Investing Activities	-0.67	-0.08	-0.54	-0.73	-1.20	-1.33	-3.29	-0.25	-0.99
Financing Activities
Debt Repayment	0.77	-1.91	-0.70	-1.12	-0.36	-4.56	0.32	0.16	-0.31
Common Stock Issued	0.00	0.00	0.00	0.00	0.00	0.01	0.00	0.00	0.00
Common Stock Repurchased	-0.56	0.00	0.00	0.00	0.00	-0.37	-0.60	-0.04	-0.06
Dividends Paid	-0.41	-0.35	-0.33	-0.40	-0.39	-0.35	-0.35	-0.32	-0.29
Other Financing Activities	-1.17	-0.31	-0.27	-0.10	-0.27	-0.32	0.17	-0.48	-0.14
Net Cash from Financing Activities	-1.38	-2.57	-1.86	-1.62	-1.02	-2.66	-0.47	-0.68	-0.80
Summary
Effect of Forex Changes on Cash	0.02	0.03	-0.07	-0.02	0.13	-0.16	0.05	0.03	-0.13
Net Change in Cash	0.56	-0.24	0.15	-0.21	0.40	0.07	-1.14	1.17	0.27
Cash at Beginning of Period	1.04	1.43	1.27	1.48	1.08	1.01	2.15	0.98	0.71
Cash at End of Period	1.60	1.19	1.43	1.27	1.48	1.08	1.01	2.15	0.98
Free Cash Flow	1.70	1.69	1.94	1.44	1.64	3.18	1.44	0.00	0.41
Supplemental Disclosures
Interest Paid	-	0.38	0.39	0.35	0.34	0.38	-	-	-
Income Taxes Paid	-	0.44	0.41	0.33	0.35	0.30	-	-	-

Source: Company financial statements from annual and quarterly filings. Data as of Jun 30, 2026. Data sources and methodology

Frequently Asked Questions About Fresenius Medical Care Cash Flow

What is Fresenius Medical Care's free cash flow?

Fresenius Medical Care generated free cash flow of EUR 1.70B in fiscal 2025 (fiscal year ended Dec 31, 2025), operating cash flow of EUR 2.58B minus EUR 879.24M of capital expenditures. That was up 0.5% from EUR 1.69B a year earlier. Free cash flow equaled 8.6% of revenue.

How much does Fresenius Medical Care spend on capital expenditures?

Fresenius Medical Care spent EUR 879.24M on capital expenditures in fiscal 2025, compared with EUR 699.36M a year earlier. That equals 34.1% of operating cash flow.

Does Fresenius Medical Care pay dividends or buy back shares?

Yes. In fiscal 2025 Fresenius Medical Care returned EUR 405.84M in dividends and EUR 562.19M in share buybacks to shareholders, according to its cash flow statement.

What is free cash flow?

Free cash flow is operating cash flow minus capital expenditures. It is the cash a company has left for dividends, buybacks, debt repayment or acquisitions after funding its operations and investment. Full definition