©2020 Cardiovascular Systems, Inc. All Rights Reserved.

Cardiovascular Systems, Inc.Stifel Virtual Bus Tour

December 16, 2020

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.

2

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

3

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

Company ProfileDeveloping innovative solutions for treating peripheral & coronary arterial disease

4

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 FY20

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

CSII: A Growth CompanyBroadening Our Value Streams

Financial Goal: Accelerate Profitable Revenue Growth

Strategy is supported by a strong balance sheetOver $200 million in cash and no long-term debt

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

5

6

VESSEL WALL

MEDIAL CALCIUM

CROWN

DRIVE SHAFT

INTIMAL CALCIUM

DIFFERENTIAL SANDING

MODIFIES INTIMAL

CALCIUM1

PULSATILE FORCES

FACILITATES FRACTURE OF

MEDIAL CALCIUM1,2

1.Shlofmitz E, et al. Interv Cardiol. 2019;14(3):169-173.2.Adams GL, Khanna PK, Staniloae CS, et al. Optimal techniques with the Diamondback 360° System achieve effective results for the treatment of peripheral arterial disease. J Cardiovasc Transl Res. 2011 Apr;4(2):220-9.3.Chambers J, et al. JACC Cardiovasc Interv. 2014;7(5):510-518.4.Shlofmitz E, et al. Expert Rev Med Devices. 2017;14(11):867-879. 5.Krishnan P, Martinsen BJ, Tarricone A, et al. Minimal Medial Injury After Orbital Atherectomy. J Endovasc Ther. 2017 Feb;24(1):167-168.

Crown’s diamond surface

sands intimal calcium2,3,5

Generated particulates are

average ~2 microns in size,

smaller than red blood cells 2,4

Facilitates fracture to affect

medial calcium.2

Fracture

Dual-Action Mechanism of Action

Uniquely designed for calcium:

Enables simultaneous modification of both intimal and medial calcium

Grow and Protect

the Core Business

FY19 FY21FY20

Peripheral

Radial OAS

Next Gen Diamondback®

with GlideAssist

Coronary

Sapphire NC 4.5-5.0 mm

balloons*

Coronary ScoreFlex® NC*+

Sapphire® II PRO 1.0

OTW balloon*+

Sapphire® OTW 1.0 mm

balloon*

0.035 ViperCath Fem Length+

ViperWire Advance® with

Flex Tip

Exchangeable Series

with GlideAssist®PTA balloons (inc. Radial)+

WIRION® Embolic Protection

System+

ARRIVAL™ Guiding

Sheath+

Next gen OAS with

GlideAssist

Zilient® Peripheral Guide Wire

Teleport® Microcatheter*

ViperCathTM XC

Next Gen Stealth with

GlideAssist

Next Gen Coronary

Diamondback 360®

A Strong Cadence of Innovation

Product Portfolio

80,000

350,000

FY22+

Small Vessel (BTA) +

Large Vessel ATK

Mixed Plaque+

WIRION® Radial EPD+

High-Risk PCI hemodynamic

pump platform+

CTO portfolio+

Next Gen Coronary

Diamondback 360+

PATIENTS TREATED ANNUALLY (U.S.)

+ These products are not approved for sale in the United States. Safety and effectiveness have not been established. Features and performance of future approved product may vary. All future product launch dates are current estimates and subject to change.* Product is manufactured by OrbusNeich Medical.

Next Gen PTCA Balloons+

Fiscal Year: July - June

Grow and Protect

the Core Business

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

8

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

Grow and Protect

the Core Business

9

Stable ReimbursementCPT® LER Code Review to Reflect Advances in Technologies

Code set update to reflect advances in technologies since 2011 creation of current codes.

Changes will take effect in CY 2023 at earliest and could be 2024-25.

AMA Action Plan: January 2019

Specialty Societies: SVS, SIR, ACC and ACR

Screen: In October 2018, code 37229 was identified by the High-Volume

Growth screen, for services with 2017e Medicare utilization of 10,000 or more that

has increased by at least 100% from 2012-2017

CPT descriptor: Revascularization, endovascular, open or percutaneous, tibial,

peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty

within the same vessel when performed.

The specialties will recommend referring this set of codes to CPT to update

the code descriptors and to accommodate new technologies.

AMA reasoning for review:

“We believe the growth in CPT

Code 37229 (BTK Atherectomy) is

appropriate and in line with the

best practices for limb sparing.

However, there have been many

advances in lower extremity

endovascular treatment since the

creation of the family of codes.”

Grow and Protect

the Core Business

See appendix for historical reimbursement by site of service

Excellence in Quality and ManufacturingScalable and Continuous COGS Management

Manufacturing

Initiatives

Sourcing and

Supply Chain

Volume driven overhead leverage

Scalable and

continuous reductions

to protect strong gross

margins

Labor productivity

LEAN continuous improvement

Material cost reductions

Vertical Integration

10

Grow and Protect

the Core Business

FY19 FY21FY20

Peripheral

Radial OAS

Next Gen Diamondback® with

GlideAssist

Coronary

Sapphire NC 4.5-5.0 mm

balloons*

Coronary ScoreFlex®

NC*+

Sapphire® II PRO

1.0 OTW balloon*+

Sapphire® OTW 1.0 mm

balloon*

0.035 ViperCath Fem

Length+

ViperWire Advance®

with Flex Tip

Exchangeable Series with

GlideAssist®PTA balloons

(including Radial)+

WIRION® Embolic

Protection System+

ARRIVAL™ Guiding

Sheath+

Next gen OAS with

GlideAssist

Zilient® Peripheral

Guide Wire

Teleport®

Microcatheter*

ViperCathTM XC

Next Gen Stealth with

GlideAssist

Next Gen Coronary

Diamondback 360®

A Strong Cadence of Innovation

Product Portfolio

80,000

350,000

FY22+

Small Vessel (BTA) +

Large Vessel ATK

Mixed Plaque+

WIRION® Radial EPD+

High-Risk PCI

hemodynamic pump

platform+

CTO portfolio+

Next Gen Coronary

Diamondback 360+

PATIENTS TREATED ANNUALLY (U.S.)

+ These products are not approved for sale in the United States. Safety and effectiveness have not been established. Features and performance of future approved product may vary. All future product launch dates are current estimates and subject to change.* Product is manufactured by OrbusNeich Medical.

Next Gen PTCA

Balloons+

Fiscal Year: July - June

Innovation Drives

Incremental Growth

Next Generation

Coronary Diamondback 360®Sapphire® Expansion

ScoreFlex® NC*

Sapphire® Balloons

Teleport® Microcatheter

Launched FY19Launched FY18

Sapphire II PRO 1.0-4.0 mm

Sapphire NC Plus 2.0-4.0 mm

Launched FY19

Launched FY20

• Sapphire SC II PRO 1.0 mm OTW

• Sapphire NC Plus 4.5-5.0 mm

Expected Launch H2 FY21(Spring CY21)

ViperWire Advance® with Flex Tip

Launched FY20

12

Prep. Place. Perform.

Severe coronary calcium is

present in 6-20% of patients

undergoing PCI.1,2

Calcium considered mild or

moderate by angiography may

actually be severe in advanced

imaging (IVUS or OCT).3,4

Complex Coronary Product PortfolioComprehensive portfolio to treat the most complex coronary patients

Product portfolio in collaboration with OrbusNeich®

1. Bourantas, C. V. et al. Prognostic implications of coronary calcification in patients with 1. obstructive coronary artery disease treated by percutaneous coronary intervention: a patient-level pooled analysis of 7 contemporary stent trials. Heart 100, 1158-1164, doi:10.1136/heartjnl-2013-305180 (2014).2. Genereux, P. et al. Ischemic outcomes after coronary intervention of calcified vessels in acute coronary syndromes. Pooled analysis from the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) and ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) TRIALS. J Am Coll Cardiol 63, 1845-1854, doi:10.1016/j.jacc.2014.01.034 (2014).3. Lee, M. S. & Shah, N. The Impact and Pathophysiologic Consequences of Coronary

Artery Calcium Deposition in Percutaneous Coronary Interventions. J Invasive Cardiol 28,

160-167 (2016).

4. Mintz, G. S. Intravascular imaging of coronary calcification and its clinical implications.

JACC Cardiovasc Imaging 8, 461-471, doi:10.1016/j.jcmg.2015.02.003 (2015).

*Not approved for sale in the United States. Future product launch date is a current estimate and subject to change.

Innovation Drives

Incremental Growth

Peripheral Product PortfolioRobust portfolio of options to treat multi-level peripheral disease

13

Exchangeable Series with

GlideAssist®

Femoral length

ViperCath™ XC*

WIRION® Embolic

Protection System

Zilient® Peripheral

Guidewire

Launched FY20 Launch FY21(Spring/Summer CY21)

Launch FY21(Spring CY21)

Launch FY21(Spring CY21)

Launched FY19

JADE® OTW and

Sapphire® 1.0 mm

Balloons

Increased flexibility to

treat different size

vessels above and

below the knee in a

single procedure.

Over 50% of patients

undergoing a PVI have multi-

level disease.1

~50% of the time ATK and BTK are

treated in separate procedures.1

Product portfolio in collaboration with OrbusNeich®

Teleport® Microcatheter

Launched FY19

1. CSI Proprietary Research (n=251

*Not approved for sale in the United States. Future product launch date is a current estimate and subject to change.

Innovation Drives

Incremental Growth

Radial Product PortfolioEnabling a complete peripheral intervention from the radial artery

14

Extended length

Orbital Atherectomy System

ARRIVAL™

Guiding Sheath*

Optimize the patient

experience. CSI offers the

first and only atherectomy

devices enabling radial

access to deliver

significant patient, clinical,

and economic benefits.

Femoral access is not possible

with some patients.

Lack of longer-length products

limits the ability to perform

peripheral interventions from

a radial access site.

ViperCath™ XC

Extended length PTA

Balloons*

* Not approved for sale in the United States. Safety and effectiveness have not been established. Features and performance of future approved product may vary.

Launched FY19 Launch FY22Launched FY19

FY21Launch FY21(Spring CY21)

Extended length

WIRION® Embolic

Protection System*

Expected Launch H2 FY22(1H CY22)

Innovation Drives

Incremental Growth

Percutaneous Ventricular Assist Device (pVAD) System

Providing temporary hemodynamic support for use in high risk PCI procedures

15* Product is in development and not approved for sale in the United States. Safety and effectiveness have not been established. Features and performance of future approved product may vary.

Provide optimal Profile-to-Output (PTO) to support

high risk interventions• Flow: 3-5 LPM

• Crossing Profile: 10-14 Fr Access

• Catheter Profile: 6-8 Fr

Deliver hemodynamic support to aide in

complete revascularization during high risk

PCI procedures

Physician control and flow monitoring within the

sterile field

Improving ease of use, simplified user interface,

hospital mobility, and increased runtime (12+ hours),

Compact console design (<15 lbs)

Marker band

Innovation Drives

Incremental Growth

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

16

Partnerships to Expand Orbital Atherectomy Across the Globe

Global Expansion Accelerates

Growth of Core Business

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

17

©2020 Cardiovascular Systems, Inc. All Rights Reserved.

Appendix

US Peripheral$42.9

US Coronary$15.9

US Peripheral US Coronary International

US Peripheral revenue increased 40.0% sequentially

Q1 FY21 Revenues of $60.5 Million42% Sequential Quarterly Increase

US Coronary revenue increased 62.5% sequentially

International declined 18.2% sequentially

19

• Units sold increased 39.9% sequentially as procedure

volumes rebounded

• Units sold increased 62.6% sequentially as procedure

volumes rebounded

• Support product revenue increased to $543 per coronary

OAS sold

• Ability to enroll new accounts and drive adoption outside

the U.S. is hindered by international travel restrictions

• OAS launched in 13 countries OUS to-date

($ in millions)

Q1 FY21 Revenue Breakdown

International

$1.7

Q1 FY20 Q2 FY20 Q3 FY20 Q4 FY20 Q1 FY21

Financial Results ($ in millions): Q1 FY21

Q1 FY20 Q2 FY20 Q3 FY20 Q4 FY20 Q1 FY21

$20.8$18.5

$11.9

$17.6$19.0

$42.9

$30.6

$42.6$47.6$45.5

Worldwide Peripheral Revenue Worldwide Coronary Revenue

Gross Margin

Q1 FY20 Q2 FY20 Q3 FY20 Q4 FY20 Q1 FY21

80.4% 79.2%76.2%80.0%79.9%

Q1 FY20 Q2 FY20 Q3 FY20 Q4 FY20 Q1 FY21

Cash and Marketable Securities

$105.0 $109.4 $107.3

$232.2 $222.9

6% YOY

decline

WW in Q1

due to

Covid-19

7% YOY

decline

WW in Q4

due to

Covid-19

300 basis

point

sequential

improvement

20

Quarterly Scorecard: Q1 FY21

$ in (000) Q1 FY21 YOY Sequential

Total Revenue $60,544 -6.1% 42.3%

Worldwide Peripheral Revenue $42,932 -5.7% 40.0%

Worldwide Coronary Revenue $17,612 -7.1% 48.4%

US Revenue $58,831 -4.4% 45.4%

US Peripheral Revenue $42,932 -5.2% 40.0%

US Peripheral Unit Growth - -2.7% 39.9%

US Coronary Revenue $15,899 -2.2% 62.5%

US Coronary Unit Growth - -5.9% 62.6%

International Revenue $1,713 -42.1% -18.2%

21

Highlights: Q1 FY21

Highlights

Financial

Revenues -6.1% vs. LY

Gross Margin 79.2%

SGA Expenses -13.8% to $40.3M

R&D Expenses -15.9% to $9.1M

Net Loss of $(2.1)M

Cash and marketable securities

decreased to $222.9M

No long-term debt

Operational - Peripheral

• Peripheral franchise performed

better than expected, led by an

8% year-over-year growth in the

OBL segment.

• Peripheral units sold were 97%

compared to last year.

• Exchangeable OAS now

represents nearly 20% of

peripheral volume.

• Targeting launch of WIRION

EPD in November

• Targeting launch of peripheral

support products in 2H FY21

• 7,900 patients clicked through to

identify physician using www.standagainstamputation.com

Operational - Coronary

• Coronary OAS units increased

63% compared to Q4 and were

94% compared to Q1 last year

• Continued adoption of coronary

toolkit featuring OAS with

GlideAssist, 1.0mm Sapphire

angioplasty balloons, Teleport

Microcatheter and nitinol

ViperWire with Flex Tip drove

$543 of incremental revenue

for every coronary OAS sold in

Q1

• Anticipate CE Mark in FY21

• ECLIPSE enrollment resumed

October 1, 2020

Other

• Sold 20,000 OAS units

• Nearly 1,000 medical

professionals attended CSI

virtual education programs

• Targeting FIH experience for

pVAD device in FY21

• Review of lower extremity

endovascular code set was

withdrawn from October 2020

CPT Editorial Panel agenda

• Amputation Reduction and

Compassion Act introduced in

U.S. House of

Representatives to cover PAD

screening, require diagnostic

testing prior to amputation

and increased PAD education

23

Stable Reimbursement: Peripheral

24

Stable Reimbursement: Coronary

Investor Contact:

Jack Nielsen

651-202-4919

j.nielsen@csi360.com

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

25