0000950170-24-023150 | 10-K | XBRL Viewer | Organogenesis Holdings INC

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Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Mar. 24, 2019	Dec. 31, 2023	Dec. 31, 2022
Common stock, par value		$ 0.0001	$ 0.0001
Common stock, shares issued		132,044,944	131,647,677
Cash dividend		$ 0
Common Class A
Company issued acquisition of shares	728,548
Common stock voting rights		one

Acquisition - Additional Information (Detail) - USD ($) $ in Thousands		1 Months Ended	12 Months Ended
	Sep. 17, 2020	Apr. 30, 2022	Dec. 31, 2022	Jun. 30, 2022
Business Acquisitions, Contingent Consideration Liability Noncurrent	$ 3,782			$ 0
CPN Biosciences, LLC
Business Acquisitions, Aggregate Consideration	19,024
Payments to acquire businesses gross	5,820
Consideration heldback	$ 1,436
Earnout Calculation	70.00%
CPN Biosciences, LLC \| Total Consideration Including Holdback [Member]
Payments to acquire businesses gross	$ 6,427
CPN Biosciences, LLC \| Payment Of Holdback [Member]
Payments to acquire businesses gross		$ 608
Common Stock \| CPN Biosciences, LLC
Issuance of common stock associated with business acquisition	1,947,953		203,485
Common Stock \| CPN Biosciences, LLC \| Total Consideration Including Holdback [Member]
Business Acquisitions, Number Of Shares Issued	2,151,438
Business Acquisitions, Equity Interests Issued And Issuable	$ 8,815
Common Stock \| CPN Biosciences, LLC \| Payment Of Holdback [Member]
Issuance of common stock associated with business acquisition		203,485

Acquisition	12 Months Ended
Dec. 31, 2023
Business Combinations [Abstract]
Acquisition	3. Acquisition On September 17, 2020 (the "Acquisition Date"), the Company acquired certain assets and assumed certain liabilities of CPN Biosciences, LLC ("CPN") pursuant to an asset purchase agreement dated July 24, 2020. CPN offered a physician office management solution and advanced wound care products. The aggregate consideration amounted to $19,024 as of the Acquisition Date, consisting of $6,427 in cash, 2,151,438 shares of the Company’s Class A common stock with a fair value of $8,815, and contingent consideration (the "Earnout") with a fair value of $3,782. On the Acquisition Date, the Company paid $5,820 in cash and issued 1,947,953 shares of the Company’s Class A common stock. The remaining consideration of $1,436 was held back and was released in April 2022 by the Company paying $608 in cash and issuing 203,485 shares of the Company’s Class A common stock to the former equity holders of CPN. The Company was obligated to pay the Earnout to CPN’s former equity holders if CPN’s legacy product revenue in the Earnout Period (July 1, 2021 to June 30, 2022), exceeded CPN’s 2019 revenue. The amount of the Earnout, if any, would be equal to 70% of the excess and would be payable 60 days after the expiration of the Earnout Period. As of the conclusion of the Earnout Period on June 30, 2022, the Company calculated the Earnout liability to be $0. During the Earnout Period, the Company assessed the fair value of the Earnout liability at each reporting period. Subsequent changes in the estimated fair value of the liability were reflected in earnings until the liability was settled. See Note 4, Fair Value Measurement of Financial Assets and Liabilities.

Acquisition

12 Months Ended

Dec. 31, 2023

Business Combinations [Abstract]

Acquisition

3. Acquisition

On September 17, 2020 (the "Acquisition Date"), the Company acquired certain assets and assumed certain liabilities of CPN Biosciences, LLC ("CPN") pursuant to an asset purchase agreement dated July 24, 2020. CPN offered a physician office management solution and advanced wound care products.

The aggregate consideration amounted to $19,024 as of the Acquisition Date, consisting of $6,427 in cash, 2,151,438 shares of the Company’s Class A common stock with a fair value of $8,815, and contingent consideration (the "Earnout") with a fair value of $3,782. On the Acquisition Date, the Company paid $5,820 in cash and issued 1,947,953 shares of the Company’s Class A common stock. The remaining consideration of $1,436 was held back and was released in April 2022 by the Company paying $608 in cash and issuing 203,485 shares of the Company’s Class A common stock to the former equity holders of CPN.

The Company was obligated to pay the Earnout to CPN’s former equity holders if CPN’s legacy product revenue in the Earnout Period (July 1, 2021 to June 30, 2022), exceeded CPN’s 2019 revenue. The amount of the Earnout, if any, would be equal to 70% of the excess and would be payable 60 days after the expiration of the Earnout Period. As of the conclusion of the Earnout Period on June 30, 2022, the Company calculated the Earnout liability to be $0. During the Earnout Period, the Company assessed the fair value of the Earnout liability at each reporting period. Subsequent changes in the estimated fair value of the liability were reflected in earnings until the liability was settled. See Note 4, Fair Value Measurement of Financial Assets and Liabilities.

Significant Accounting Policies - Schedule of Consolidated Statements of Cash Flows (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net Income (loss)	$ 4,945	$ 15,532	$ 94,202

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

- Definition

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

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+ Details

Leases - Summary of Balance Sheet Information Related To Finance Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Lessee Disclosure [Abstract]
Property and equipment, gross	$ 3,454	$ 1,174
Accumulated depreciation	(479)	$ (1,174)
Property and equipment, net	2,975
Current portion of finance lease obligations	1,081
Finance lease obligations, net of current portion	1,888
Total lease liabilities	$ 2,969
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Property, Plant and Equipment, Net	Property, Plant and Equipment, Net

Significant Accounting Policies -Schedule of Finite-Lived Intangible Assets (Detail)	Dec. 31, 2023
Trade names and trademarks \| Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	1 year
Trade names and trademarks \| Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Developed technology \| Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	6 years
Developed technology \| Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Customer relationships
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	10 years
Non-compete agreements
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	5 years

Earnings per Share (EPS) - Basic and diluted net loss per share (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Net income	$ 4,945	$ 15,532	$ 94,202
Weighted-average common shares outstanding—basic	131,231,317	130,070,231	128,331,022
Weighted-average common shares outstanding—diluted	132,746,727	132,383,152	133,662,659
Earnings per share-basic	$ 0.04	$ 0.12	$ 0.73
Earnings per share-diluted	$ 0.04	$ 0.12	$ 0.7
Restricted Stock Units (RSUs) [Member]
Weighted-average common shares outstanding—diluted	710,813	149,215	469,123
Employee Stock Option
Weighted-average common shares outstanding—diluted	804,597	2,163,706	4,862,514

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References

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+ Details

- Definition

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

+ References

+ Details

Related Party Transactions - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Selling, General and Administrative Expenses
Related Party Transaction, Amounts of Transaction	$ 179
Option Loans
Proceeds from Collection of Long-term Loans to Related Parties	$ 334
Related Party \| Option Loans
Notes Receivable		$ 334
Related Party \| Liquidity Loan [Member]
Notes Receivable		$ 100
Maximum [Member] \| Liquidity Loan and Option Loans
Interest Rate	3.86%
Minimum [Member] \| Liquidity Loan and Option Loans
Interest Rate	2.30%

Long-Term Debt Obligations - Additional Information (Detail) - USD ($) $ in Thousands			12 Months Ended
	Aug. 06, 2021	Mar. 14, 2019	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Loss on the extinguishment of debt					$ (1,883)
Secured debt			$ 66,563	$ 71,250
Term payment			4,688	2,813	938
2019 Credit Agreement
Loss on the extinguishment of debt					$ (1,883)
Term payment	$ 70,559
2021 Credit Agreement
Financial covenants	Under the 2021 Credit Agreement, the Company is required to comply with certain financial covenants including the Consolidated Fixed Charge Coverage Ratio and Consolidated Total Net Leverage Ratio, tested quarterly. In addition, the Company is also required to make representations and warranties and comply with certain non-financial covenants that are customary in loan agreements of this type, including restrictions on the payment of dividends, repurchase of stock, incurrence of indebtedness, dispositions and acquisitions.
Debt Instrument, Description of Variable Rate Basis	For SOFR Loans, the interest rate is a per annum interest rate equal to the Adjusted Term SOFR plus an Applicable Margin between 2.00% to 3.25% based on the Total Net Leverage Ratio. For ABR Loans, the interest rate is equal to (1) the highest of (a) the Wall Street Journal Prime Rate, (b) the Federal Funds Rate plus 0.50% and (c) the Adjusted Term SOFR rate plus 1.0%, plus (2) an Applicable Margin between 1.00% to 2.25% based on the Total Net Leverage Ratio.
2021 Credit Agreement \| Maximum [Member] \| ABR Loans [Member] \| Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	2.25%
2021 Credit Agreement \| Maximum [Member] \| SOFR Loans \| Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	3.25%
2021 Credit Agreement \| Minimum [Member] \| ABR Loans [Member] \| Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	1.00%
2021 Credit Agreement \| Minimum [Member] \| SOFR Loans \| Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	2.00%
Term Loan [Member] \| 2019 Credit Agreement
Debt Instrument, Basis Spread on Variable Rate		3.75%
Debt Instrument, Description of Variable Rate Basis		annum interest rate equal to the greater of 3.75% above the Wall Street Journal Prime Rate and 9.25%
Additional Payment in Aggregate of the Principal Amount Percentage		6.50%
Fixed Interest Rate		9.25%
Debt instrument face amount		$ 40,000
Term Loan [Member] \| 2021 Credit Agreement
Secured debt			66,563	$ 71,250
Debt Issuance Costs, Net	$ 604
Debt instrument face amount	75,000
Term Loan [Member] \| 2021 Credit Agreement \| September 30, 2021 through and including June 30, 2022
Debt instrument quarterly installment payment to original principal amount	469
Term Loan [Member] \| 2021 Credit Agreement \| September 30, 2022 through and including June 30, 2023
Debt instrument quarterly installment payment to original principal amount	938
Term Loan [Member] \| 2021 Credit Agreement \| September 30, 2023 through and including June 30, 2025
Debt instrument quarterly installment payment to original principal amount	1,406
Term Loan [Member] \| 2021 Credit Agreement \| September 30, 2025 and the last day of each quarter thereafter until August 6, 2026
Debt instrument quarterly installment payment to original principal amount	1,875
Revolving Credit Facility [Member] \| 2019 Credit Agreement
Maximum borrowing capacity		$ 60,000
Line of credit maturity date		2024
Line of credit description of variable rate basis for advances under revolving facility		The interest rate for advances under the revolving facility was a floating per annum interest rate equal to the greater of the Wall Street Journal Prime Rate and 5.50%.
Revolving Credit Facility [Member] \| 2021 Credit Agreement
Line of credit			0
Maximum borrowing capacity	125,000		$ 125,000
Debt Issuance Costs, Net	$ 1,223
Revolving Credit Facility [Member] \| 2021 Credit Agreement \| Maximum [Member]
Line of credit facility unused capacity commitment fee percentage	0.45%
Revolving Credit Facility [Member] \| 2021 Credit Agreement \| Minimum [Member]
Line of credit facility unused capacity commitment fee percentage	0.25%

Earnings per Share (EPS)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Earnings per Share (EPS)

16. Earnings per Share (EPS)

Basic EPS is calculated by dividing net income by the weighted-average number of shares outstanding during the period. Diluted EPS is calculated by dividing net income by the weighted-average number of shares outstanding plus the dilutive effect, if any, of outstanding equity awards using the treasury stock method which includes consideration of unrecognized compensation expenses as additional proceeds.

A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income attributable to the Class A common stockholders is as follows:


	Year Ended December 31,
	2023		2022		2021
Numerator:
Net Income	$	4,945	$	15,532	$	94,202
Denominator:
Weighted average common shares outstanding —basic		131,231,317		130,070,231		128,331,022
Dilutive effect of restricted stock units		710,813		149,215		469,123
Dilutive effect of options		804,597		2,163,706		4,862,514
Weighted-average common shares outstanding—diluted		132,746,727		132,383,152		133,662,659
Earnings per share—basic	$	0.04	$	0.12	$	0.73
Earnings per share—diluted	$	0.04	$	0.12	$	0.70

For the years ended December 31, 2023, 2022, and 2021, outstanding stock-based awards of 3,147,503, 3,445,191 and 994,168, respectively, were excluded from the diluted EPS calculation as they were anti-dilutive.

Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property and equipment, gross	$ 130,347	$ 99,697
Accumulated depreciation	(73,186)	(62,798)
Property and Equipment, Net, Total	116,228	102,463
Leasehold improvements
Property and equipment, gross	60,819	37,607
Building
Property and equipment, gross	4,943	4,943
Furniture, computers and equipment
Property and equipment, gross	64,585	57,147
Construction in progress
Property and Equipment, Net, Total	$ 59,067	$ 65,564

Long-Term Debt Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Term loan	$ 66,563	$ 71,250
Less debt discount and debt issuance cost	(332)	(481)
Term loan, net of debt discount and debt issuance cost	$ 66,231	$ 70,769

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Thousands	1 Months Ended		12 Months Ended
	Dec. 31, 2023	Nov. 30, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Other commitments	$ 34,915		$ 34,915
License Agreement University
Accrued Royalties	1,187		1,187	$ 1,187
Royalty Expense			0	0	$ 0
License Agreement Resorba \| Selling, General and Administrative Expenses
Royalty Expense			5,456	$ 7,279	$ 5,929
Vivex
Agreement additional renewal term		1 year
Initial term of agreement expiration date		Dec. 31, 2026
Payment of upfront license fee		$ 5,000
Upfront licensing fee, Current	2,368		2,368
Upfront license fee, Noncurrent	4,737		$ 4,737
Milestone Payment	$ 2,500
Straightline basis over the estimated life period		3 years
Vivex \| Maximum
Agreement Renewal Term		5 years

Fair Value Measurement of Financial Instruments - Fair value of the Company's Earnout liability (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2021
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value		$ (3,985)
Fair Value, Inputs, Level 3
Business Acquisition, Contingent Consideration [Line Items]
Beginning balance	$ 0	3,985
Change in fair value	0	(3,985)
Ending balance	$ 0	$ 0

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 103,840	$ 102,478
Restricted cash	498	812
Accounts receivable, net	81,999	89,450
Inventories	28,253	24,783
Prepaid expenses and other current assets	10,454	5,086
Total current assets	225,044	222,609
Property and equipment, net	116,228	102,463
Intangible assets, net	15,871	20,789
Goodwill	28,772	28,772
Operating lease right-of-use assets, net	40,118	43,192
Deferred tax asset, net	28,002	30,014
Other assets	5,990	1,520
Total assets	460,025	449,359
Current liabilities:
Current portion of term loan	5,486	4,538
Current portion of finance lease obligations	1,081
Current portion of operating lease obligations - related party	3,140	3,001
Current portion of operating lease obligations	10,004	8,707
Accounts payable	30,724	32,330
Accrued expenses and other current liabilities	30,074	26,447
Total current liabilities	80,509	75,023
Term loan, net of current portion	60,745	66,231
Finance lease obligations, net of current portion	1,888
Operating lease obligations, net of current portion - related party	17,227	20,367
Operating lease obligations, net of current portion	19,780	20,947
Other liabilities	1,213	1,122
Total liabilities	181,362	183,690
Commitments and contingencies (Note 18)
Stockholders' equity:
Preferred stock, $0.0001 par value; 1,000,000 shares authorized; none issued
Common stock, $0.0001 par value; 400,000,000 shares authorized; 132,044,944 and 131,647,677 shares issued; 131,316,396 and 130,919,129 shares outstanding at December 31, 2023 and 2022, respectively	13	13
Additional paid-in capital	319,621	310,957
Accumulated deficit	(40,971)	(45,301)
Total stockholders' equity	278,663	265,669
Total liabilities and stockholders' equity	$ 460,025	$ 449,359

Goodwill and Intangible Assets - Identifiable intangible assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Original Cost	$ 58,523	$ 58,523
Accumulated Amortization	(42,652)	(37,734)
Net Book Value	15,871	20,789
Developed technology
Original Cost	32,620	32,620
Accumulated Amortization	(24,666)	(21,164)
Net Book Value	7,954	11,456
Trade names and trademarks
Original Cost	2,080	2,080
Accumulated Amortization	(1,590)	(1,393)
Net Book Value	490	687
Customer relationship
Original Cost	10,690	10,690
Accumulated Amortization	(3,519)	(2,450)
Net Book Value	7,171	8,240
Independent sales agency network
Original Cost	4,500	4,500
Accumulated Amortization	(4,500)	(4,500)
Patent
Original Cost	7,623	7,623
Accumulated Amortization	(7,623)	(7,623)
Non-compete agreements
Original Cost	1,010	1,010
Accumulated Amortization	(754)	(604)
Net Book Value	$ 256	$ 406

Long-Term Debt Obligations (Tables)

12 Months Ended

Dec. 31, 2023

Long-Term Debt, Unclassified [Abstract]

Schedule of long-term debt obligations


	December 31,
	2023			2022
Term loan		66,563			71,250
Less debt discount and debt issuance cost		(332	)		(481	)
Term loan, net of debt discount and debt issuance cost	$	66,231		$	70,769

Schedule of future payments of term loan facility

Future payments of the 2021 Credit Agreement, as of December 31, 2023, are as follows for the calendar years ending December 31:


2024		5,625
2025		6,563
2026		54,375
Total	$	66,563

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Income Taxes - Schedule of Unrecognized Tax Benefits Roll Forward (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Gross balance at beginning of year	$ 1,632	$ 1,612	$ 2,123
Additions based on tax positions related to the current period	113	206	153
Reductions for tax positions of prior years	(126)	(186)	(664)
Gross balance at end of year	$ 1,619	$ 1,632	$ 1,612

Accounts receivable, net - Summary of Allowance for Credit Losses (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Balance at beginning of period	$ 6,362	$ 5,153
Additions	1,297	1,781
Write-offs	(1,414)	(572)
Balance at end of period	6,860	6,362
Cumulative Effect of Adoption
Balance at beginning of period	$ 615
Balance at end of period		$ 615

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

Property and equipment consisted of the following:


	December 31,
	2023			2022
Leasehold improvements	$	60,819		$	37,607
Building		4,943			4,943
Furniture, computers and equipment		64,585			57,147
		130,347			99,697
Accumulated depreciation		(73,186	)		(62,798	)
Construction in progress		59,067			65,564
	$	116,228		$	102,463

Significant Accounting Policies - Property, Plant and Equipment (Detail)	Dec. 31, 2023
Leasehold improvements
Significant Accounting Policies [Line Items]
Property, Plant, and Equipment, Useful Life, Term, Description [Extensible Enumeration]	us-gaap:UsefulLifeShorterOfTermOfLeaseOrAssetUtilityMember
Building
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	30 years
Furniture and computers \| Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	3 years
Furniture and computers \| Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment \| Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment \| Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	10 years

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net Income (Loss)	$ 4,945	$ 15,532	$ 94,202

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

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+ Details

Nature of the Business and Basis of Presentation - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2023 Segments
Business Acquisition [Line Items]
Number of Operating Segments	1
Number of Reportable Segments	1

Commitments and Contingencies

12 Months Ended

Dec. 31, 2023

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies Disclosure

18. Commitments and Contingencies

License and Manufacturing Agreement

In November 2023, the Company entered into a trademark license and manufacturing agreement with Vivex Biologics, Inc. ("Vivex") to sell its CYGNUS Dual ("Dual") and CYGNUS Matrix ("Matrix") products, with the option to license the VIA Matrix ("VIA") products.

The Company paid an upfront licensing fee to Vivex to sell Dual and Matrix, and also agreed to pay a fixed milestone payment for Dual in the event that its average sales price ("ASP") is published by certain government agencies for a specified period of time. In addition, the Company is required to pay a low double digit royalty and a high single-digit royalty on the Net Sales of Dual and Matrix, respectively, during the royalty term, as defined in the agreement with Vivex. The royalty term is commensurate with the initial term of the contract and will continue for each subsequent renewal period. The initial term of the agreement expires on December 31, 2026 and can be renewed for up to five additional one-year terms.

The Company recorded $5,000 in prepaid and other current assets and other assets for the payment of the upfront licensing fee, which will be recognized as expense on a straight-line basis over the estimated life of the arrangement, which the Company determined to be three years, commensurate with the initial term of the contract. In December 2023, the Company recorded $2,500 in prepaid and other current assets, other assets, and accrued expenses and other current liabilities for the milestone payment, as the Company determined it is probable of owing such payment to Vivex. As of December 31, 2023, $2,368 and $4,737 are recorded in prepaid and other current assets and other assets in the accompanying consolidated balance sheets, respectively, for the upfront licensing fee and expected milestone payment.

Royalties

The Company entered into a license agreement with a university for certain patent rights related to the development, use and production of one of its advanced wound care products. Under this agreement, the Company incurred a royalty based on a percentage of net product sales, for the use of these patents until the patents expired, which was in November 2006. Accrued royalties totaled $1,187 as of December 31, 2023 and 2022, respectively, and were classified as part of accrued expenses and other current liabilities on the Company’s consolidated balance sheets. There was no royalty expense incurred during the years ended December 31, 2023, 2022, and 2021, related to this agreement.

In October 2017, the Company entered into a license agreement with a third party. Under the license agreement, the Company is required to pay royalties based on a percentage of net sales of the licensed product that occur, after December 31, 2017, through the expiration of the underlying patent in October 2026, subject to minimum royalty payment provisions. The Company recorded royalty expense of $5,456, $7,279 and $5,929, during the years ended December 31, 2023, 2022, and 2021, respectively, within selling, general and administrative expenses on the consolidated statements of operations and comprehensive income.

Legal Matters

In conducting its activities, the Company, from time to time, is subject to various claims and also has claims against others. In management’s opinion, the ultimate resolution of such claims would not have a material effect on the financial position, operating results or cash flows of the Company. The Company accrues for these claims when amounts due are probable and estimable.

Other Commitments

As of December 31, 2023, we had commitments totaling $34,915 that are legally binding and enforceable. These commitments include purchase obligations for goods and services.

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2023
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	During the three months ended December 31, 2023, no director or officer of the Company adopted or terminated a "Rule 10b5-1 trading arrangement" or "non-rule 10b5-1 trading arrangement," as each term is defined in item 408(a) of Regulation S-K.
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Net revenue	$ 433,140	$ 450,893	$ 467,359
Cost of goods sold	106,481	105,019	114,199
Gross profit	326,659	345,874	353,160
Operating expenses:
Selling, general and administrative	269,754	283,808	250,200
Research and development	44,380	39,762	30,742
Total operating expenses	314,134	323,570	280,942
Income from operations	12,525	22,304	72,218
Other expense, net:
Interest expense, net	(2,190)	(2,009)	(7,236)
Loss on the extinguishment of debt			(1,883)
Other income (loss), net	57	(13)	(13)
Total other expense, net	(2,133)	(2,022)	(9,132)
Net income before income taxes	10,392	20,282	63,086
Income tax (expense) benefit	(5,447)	(4,750)	31,116
Net income and comprehensive income	$ 4,945	$ 15,532	$ 94,202
Net income, per share:
Basic	$ 0.04	$ 0.12	$ 0.73
Diluted	$ 0.04	$ 0.12	$ 0.7
Weighted-average common shares outstanding
Basic	131,231,317	130,070,231	128,331,022
Diluted	132,746,727	132,383,152	133,662,659

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation (Detail)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S. federal statutory income tax rate	21.00%	21.00%	21.00%
Federal valuation allowance			(70.60%)
State valuation allowance			(9.10%)
Return to provision and other adjustments	(1.40%)	(1.60%)
Prior period correction		(8.50%)
Executive compensation limited by 162(m)	12.00%	3.10%
State and local income taxes	8.80%	6.80%	6.80%
Meals and entertainment	5.90%
Nondeductible lobbying expenses	1.70%	0.40%
Stock-based compensation	1.30%	0.30%
Foreign rate differential	(0.10%)	0.10%
Uncertain tax position reserves	0.70%	0.30%	0.90%
Nondeductible fringe benefits	1.00%	0.40%
State credits	1.10%	0.90%
Other nondeductible expenses	0.40%	0.20%	0.80%
Research and development credits			0.90%
Effective income tax rate	52.40%	23.40%	(49.30%)

Employee Benefit Plan

12 Months Ended

Dec. 31, 2023

Retirement Benefits [Abstract]

Employee Benefit Plan

20. Employee Benefit Plan

The Company maintains a 401(k) Savings Plan (the "Plan") for the U.S. employees. Under the Plan, eligible employees may contribute, subject to statutory limitations, a percentage of their salary to the Plan. Contributions made by the Company are made at the discretion of the Board of Directors and vest immediately. During the years ended December 31, 2023, 2022, and 2021, the Company made employer contributions of $7,430, $6,601 and $3,092, respectively.

Nature of Business and Basis of Presentation

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Nature of Business and Basis of Presentation

1. Nature of Business and Basis of Presentation

Organogenesis Holdings Inc. ("ORGO" or the "Company") is a leading regenerative medicine company focused on the development, manufacture, and commercialization of solutions for the Advanced Wound Care and Surgical & Sports Medicine markets. Several of the existing and pipeline products in the Company’s portfolio have Premarket Application ("PMA") approval, or Premarket Notification 510(k) clearance from the United States Food and Drug Administration ("FDA"). The Company’s customers include hospitals, wound care centers, government facilities, ambulatory surgery centers ("ASCs") and physician offices. The Company has one operating and reportable segment.

Goodwill and Intangible Assets - Estimated future annual amortization expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 3,403
2025	3,323
2026	3,043
2027	2,283
2028	1,968
Thereafter	1,851
Net Book Value	$ 15,871	$ 20,789

Prepaid Expenses and Other Current Assets

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Prepaid Expenses and Other Current Assets

7. Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consisted of the following:


	December 31,
	2023		2022
Subscriptions	$	5,866	$	4,211
Prepaid licensing fee (Note 18)		2,368		—
Conferences and marketing expenses		945		106
Deposits		872		635
Insurance		85		54
Other		318		80
	$	10,454	$	5,086

Deposits are funds held by vendors which are expected to be released within twelve months and therefore they are recorded as current assets.

Subsequent Events

12 Months Ended

Dec. 31, 2023

Subsequent Events [Abstract]

Subsequent Events

21. Subsequent Events

The Company has performed an evaluation of subsequent events through the time of filing this Annual Report on Form 10-K with the SEC.

Share-Based Compensation - Summary of Restricted Stock Units (Detail) - Restricted Stock Units (RSUs) [Member] - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested at December 31, 2022	1,381,500
Unvested Granted	3,192,372	979,257
Unvested Vested	(522,651)
Unvested Canceled/Forfeited	(152,890)
Unvested at December 31, 2023	3,898,331	1,381,500
Unvested at December 31, 2022	$ 7.62
Unvested Granted	2.47
Unvested Vested	7.28
Unvested Canceled/Forfeited	5.21
Unvested at December 31, 2023	$ 3.54	$ 7.62

Prepaid Expenses and Other Current Assets (Tables)

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Schedule of prepaid expenses and other current assets

Prepaid expenses and other current assets consisted of the following:


	December 31,
	2023		2022
Subscriptions	$	5,866	$	4,211
Prepaid licensing fee (Note 18)		2,368		—
Conferences and marketing expenses		945		106
Deposits		872		635
Insurance		85		54
Other		318		80
	$	10,454	$	5,086

Income Taxes - Schedule of Components of Income Tax Expense (Benefit) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current Income Tax Expense (Benefit), Continuing Operations [Abstract]
Federal	$ 1,275	$ 178
State	2,157	2,575	$ 899
Foreign	3	17	(39)
Total current tax expense	3,435	2,770	860
Deferred tax expense (benefit)
Federal	3,311	5,446	(30,506)
State	(1,312)	(3,466)	(1,470)
Foreign	13
Total deferred tax expense (benefit)	2,012	1,980	(31,976)
Total income tax expense (benefit)	$ 5,447	$ 4,750	$ (31,116)

Accrued Expenses and Other Current Liabilities

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Accrued Expenses and Other Current Liabilities

10. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following:


	December 31,
	2023		2022
Personnel costs	$	18,287	$	17,113
Royalties		3,075		3,320
Accrued but unpaid lease obligations and interest		2,326		2,463
Accrued milestone payment (Note 18)		2,500		—
Accrued taxes		2,799		2,625
Other		1,087		926
	$	30,074	$	26,447

The accrued but unpaid lease obligations and the interest accrual on these obligations are related to the buildings in Canton, Massachusetts. See Note 17, Leases.

Related Party Transactions

12 Months Ended

Dec. 31, 2023

Related Party Transactions

19. Related Party Transactions

Lease obligations to affiliates, including accrued but unpaid lease obligations, purchase of an asset under a finance lease with an affiliate, and renewal of leases with affiliates are further described in Note 17, Leases.

In 2010, the Company’s Board of Directors approved a loan program that permitted the Company to make loans to three executives of the Company (the "Employer Loans") to (i) provide them with liquidity ("Liquidity Loans") and (ii) fund the exercise of vested stock options ("Option Loans"). Two of the executives left the Company in 2014. The Employer Loans matured with all principal and accrued interest due on the tenth anniversary of the issuance date of each subject loan. Interest on the Employer Loans was at various rates ranging from 2.30%—3.86% per annum, compounded annually. The Employer Loans were secured by shares of the Company’s Class A common stock held by the former executives. With respect to the Liquidity Loans, the Company had no personal recourse against the borrowers beyond the pledged shares. As of December 31, 2020, Liquidity Loans and Option Loans to one former executive were outstanding with an aggregate principal balance of $100 and $334, respectively. During the three months ended March 31, 2021, this former executive paid off the outstanding principal balance of his Employer Loans and the related interest receivable. As a result, the Company recorded $179 as a recovery of the previously reserved related party receivables within selling, general and administrative expenses on the consolidated statements of operations and comprehensive income for the year ended December 31, 2021. The $334 of the repaid principal balance of the Option Loans was recorded to equity. See Note 14, Share-Based Compensation.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

+ Details

Earnings per Share (EPS) - Additional Information (Detail) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Earnings Per Share [Abstract]
Anti-dilutive shares excluded from the diluted EPS	3,147,503	3,445,191	994,168

Restructuring - Summary of liability related to the restructuring activities (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	$ 1,192	$ 3,168	$ 618
Expenses	3,796	2,268	4,704
Cash distributions and other adjustments	(4,084)	(4,244)	(2,154)
Liability balance as of ending	904	1,192	3,168
Employee
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	1,010	2,517	618
Expenses	3,429	1,557	3,513
Cash distributions and other adjustments	(3,535)	(3,064)	(1,614)
Liability balance as of ending	904	1,010	2,517
Other
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	182	651
Expenses	367	711	1,191
Cash distributions and other adjustments	$ (549)	(1,180)	(540)
Liability balance as of ending		$ 182	$ 651

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

15. Income Taxes

The components of the income tax expense (benefit) consisted of the following for the years ended December 31, 2023, 2022, and 2021:


	Year Ended December 31,
	2023			2022			2021
Income tax expense (benefit):
Current tax expense (benefit)
Federal	$	1,275		$	178		$	—
State		2,157			2,575			899
Foreign		3			17			(39	)
Total current tax expense		3,435			2,770			860
Deferred tax expense (benefit)
Federal		3,311			5,446			(30,506	)
State		(1,312	)		(3,466	)		(1,470	)
Foreign		13			—			—
Total deferred tax expense (benefit)		2,012			1,980			(31,976	)
Total income tax expense (benefit)	$	5,447		$	4,750		$	(31,116	)

On a periodic basis, the Company reassesses the valuation allowance on its deferred income tax assets, weighing positive and negative evidence to assess the recoverability of the deferred tax assets. In the fourth quarter of fiscal year 2021, the Company assessed the valuation allowance and considered positive evidence, including significant cumulative consolidated income over the three years ended December 31, 2021, revenue growth and expectations of future profitability, and negative evidence, including the impact of a negative change in the economic climate, significant risks and uncertainties in the business and restrictions on tax loss utilization in certain state jurisdictions. After assessing both the positive evidence and the negative evidence, the Company determined it was more likely than not that its deferred tax assets would be realized in the future and released the valuation allowance on its net deferred tax assets as of December 31, 2021, resulting in a benefit from income taxes of $48,252. The Company determined that its net U.S. deferred tax assets did not require a valuation allowance as of December 31, 2023 and 2022.

As of December 31, 2023, the Company had available for the reduction of future years’ federal taxable income, net operating loss carry-forwards of approximately $11,669, all of which can be carried forward indefinitely, but that are subject to an 80% taxable income limitation. The Company had state net operating loss carry-forwards of approximately $9,430, expiring from the year ended December 31, 2029 through 2038.

Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2023 and 2022 are as follows:


	December 31,
	2023			2022
Net operating loss carryforwards
Federal	$	2,455		$	9,327
State		665			960
Foreign		4			16
Other		6,404			5,658
Capitalized research and development		17,608			8,849
Stock-based compensation		1,699			1,453
Finance leases		—			126
Operating leases		12,503			13,164
Fixed assets		—			3,921
Net deferred tax assets before valuation allowance		41,338			43,474
Valuation allowance		—			—
Property and equipment		(1,493	)		—
Right-of-use assets		(10,002	)		(10,724	)
Intangibles		(1,841	)		(2,736	)
Net deferred tax assets	$	28,002		$	30,014

The Company’s subsidiary in Switzerland is carrying a deferred tax asset of approximately $4 relating to a net operating loss carryover that is expected to be benefited in the next couple of years. The Company has not recorded withholding taxes on the undistributed earnings of its Swiss subsidiary because it is the Company’s intent to reinvest such earnings indefinitely.

Ownership changes, as defined in the Internal Revenue Code, may limit the amount of net operating losses and research and development tax credit carryforwards that can be utilized annually to offset future taxable income. Subsequent ownership changes could further affect the limitation in future years. The Company completed an analysis in 2021 and determined that it had not experienced an ownership change during the periods 2001 through 2021.

The differences between income taxes expected at the U.S. federal statutory income tax rate of 21% and the reported consolidated income tax benefit (expense) are summarized as follows:


	December 31,
	2023			2022			2021
U.S. federal statutory income tax rate		21.0	%		21.0	%		21.0	%
Federal valuation allowance		—			—			(70.6	%)
State valuation allowance		—			—			(9.1	%)
Return to provision and other adjustments		(1.4	%)		(1.6	%)		—
Prior period correction		—			(8.5	%)		—
Executive compensation limited by 162(m)		12.0	%		3.1	%		—
State and local income taxes		8.8	%		6.8	%		6.8	%
Meals and entertainment		5.9	%		—			—
Nondeductible lobbying expenses		1.7	%		0.4	%		—
Stock-based compensation		1.3	%		0.3	%		—
Foreign rate differential		(0.1	%)		0.1	%		—
Uncertain tax position reserves		0.7	%		0.3	%		0.9	%
Nondeductible fringe benefits		1.0	%		0.4	%		—
State credits		1.1	%		0.9	%		—
Other nondeductible expenses		0.4	%		0.2	%		0.8	%
Research and development credits		—			—			0.9	%
Effective income tax rate		52.4	%		23.4	%		(49.3	%)

The Company recognizes the tax benefit from an uncertain tax position only if it is more-likely-than-not that the tax position will be sustained on examination by taxing authorities, based on the technical merits of the position. The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being

realized upon ultimate settlement. The amount of unrecognized tax benefits is $2,837, $2,642 and $2,307, as of December 31, 2023, 2022, and 2021, respectively.

A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below:


	Year Ended December 31,
	2023			2022			2021
Gross balance at beginning of year	$	1,632		$	1,612		$	2,123
Additions based on tax positions related to the current period		113			206			153
Reductions for tax positions of prior years		(126	)		(186	)		(664	)
Gross balance at end of year	$	1,619		$	1,632		$	1,612

The Company files income tax returns in the U.S. federal and state jurisdictions and Switzerland. With limited exceptions, the Company is no longer subject to federal, state, local or foreign examinations for years prior to December 31, 2019. However, carryforward attributes that were generated prior to December 31, 2019 may still be adjusted upon examination by state or local tax authorities if they either have been or will be used in a future period.

The Company recognizes interest and penalty-related expenses in tax expenses. The Company recorded $500 and $404 of interest for uncertain tax positions for the years ended December 31, 2023 and 2022, respectively, which is classified in accrued expenses and other current liabilities in the consolidated balance sheets. These amounts are not reflected in the reconciliation above.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Share-Based Compensation - Schedule of Fair Value of Stock Options Granted to Employees and Directors (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Risk-free interest rate	4.00%	1.92%
Expected term (in years)	6 years 3 months	6 years 3 months
Expected volatility	51.00%	50.66%
Expected dividend yield	0.00%	0.00%
Underlying stock price	$ 2.47	$ 7.87

Property and Equipment, Net

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

8. Property and Equipment, Net

Property and equipment consisted of the following:


	December 31,
	2023			2022
Leasehold improvements	$	60,819		$	37,607
Building		4,943			4,943
Furniture, computers and equipment		64,585			57,147
		130,347			99,697
Accumulated depreciation		(73,186	)		(62,798	)
Construction in progress		59,067			65,564
	$	116,228		$	102,463

Depreciation expense was $10,448, $5,845 and $5,781, for the years ended December 31, 2023, 2022, and 2021, respectively. Construction in progress primarily represents unfinished construction work on a purchased building located on the Company’s Canton, Massachusetts campus and improvements at the Company’s leased facilities in Canton and Norwood, Massachusetts, as well as costs incurred to implement the company-wide enterprise resource planning ("ERP") system. During the year ended December 31, 2023, the Company incurred $10,891 in costs associated with the ERP implementation.

During the year ended December 31, 2022, the Company recorded a charge of $4,200 for the sale and donation of some equipment related to the construction in progress in one of its Canton, Massachusetts facilities. The disposal was the result of a change in the design of the construction plan for the manufacturing facility and the determination that this equipment was no longer compatible with the ongoing design. During 2022, the Company decided to temporarily pause the construction of this manufacturing facility due to inflation and market conditions that adversely impacted construction projects across the biotechnology and life sciences industries. In connection with this decision, the Company recorded a charge of $632 as cancellation fees to various vendors. These charges were included in selling, general and administrative expenses on the consolidated statements of operations and comprehensive income for the year ended December 31, 2022.

During the years ended December 31, 2023 and 2022, the Company identified certain impairment triggers relating to its asset groups, which included incurred expenses in excess of planned expenses for the ERP implementation in 2023, and the sale and donation of equipment and the construction pause in 2022. The impairment triggers indicated that the Company’s long-lived assets might be impaired. The Company performed recoverability tests during the years ended December 31, 2023 and 2022 in accordance with ASC 360, Property, Plant and Equipment. The estimated undiscounted cash flows directly attributable to the asset group exceeded the carrying value of the asset group. Therefore, the Company did not record any impairment related to its asset group.

Leases - Summary of Cash Flow Information Related To Leases (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$ 10,401	$ 9,273
Operating cash flows for finance leases	137	7
Financing cash flows for finance leases	485	200	$ 2,630
Right-of-use assets obtained in exchange for lease obligations
Operating leases	$ 5,869	$ 1,350	$ 53,793
Weighted-average remaining lease term
Finance leases	2 years 6 months 29 days
Operating leases	6 years 5 months 26 days	7 years 6 months 14 days
Weighted-average discount rate
Finance leases	7.91%
Operating leases	4.71%	4.61%

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule Of Common Stock Shares Reserved For Future Issuance

At December 31, 2023 and 2022, the Company reserved the following shares of Class A common stock for future issuance:


	December 31,
	2023		2022
Shares reserved for issuance for outstanding options		9,340,046		5,931,742
Shares reserved for issuance for outstanding restricted stock units		3,898,331		1,381,500
Shares reserved for issuance for future grants		4,898,964		11,394,962
Total shares of authorized common stock reserved for future issuance		18,137,341		18,708,204

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net income	$ 4,945	$ 15,532	$ 94,202
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	10,448	5,845	5,781
Amortization of intangible assets	4,918	4,883	4,949
Amortization of operating lease right-of-use assets	8,083	7,303	5,946
Non-cash interest expense	427	434	346
Deferred interest expense	490	501	1,493
Deferred tax expense (benefit)	2,012	1,980	(31,976)
Loss on disposal of property and equipment	235	4,482	1,407
Loss on lease termination	559
Provision recorded for credit losses	1,297	1,781	2,999
Adjustment for excess and obsolete inventories	6,580	9,648	12,079
Stock-based compensation	8,996	6,552	3,864
Loss on extinguishment of debt			1,883
Change in fair value of earnout liability			(3,985)
Changes in operating assets and liabilities:
Accounts receivable	5,539	(8,770)	(28,654)
Inventories	(8,179)	(9,410)	(9,302)
Prepaid expenses and other current and other assets	(10,115)	(378)	(34)
Operating leases	(8,439)	(7,006)	(6,156)
Accounts payable	(108)	3,260	3,847
Accrued expenses and other current liabilities	3,138	(11,850)	9,354
Other liabilities	91	72	(6,065)
Net cash provided by operating activities	30,917	24,859	61,978
Cash flows from investing activities:
Purchases of property and equipment	(24,364)	(33,898)	(31,220)
Net cash used in investing activities	(24,364)	(33,898)	(31,220)
Cash flows from financing activities:
Line of credit repayments under the 2019 Credit Agreement			(10,000)
Term loan repayments under the 2019 Credit Agreement			(60,000)
Proceeds from term loan under the 2021 Credit Agreement, net of debt discount and issuance cost			73,174
Term loan repayments under the 2021 Credit Agreement	(4,688)	(2,813)	(938)
Principal repayments of finance lease obligations	(485)	(200)	(2,630)
Proceeds from the exercise of stock options		2,070	2,198
Payments of withholding taxes in connection with RSUs vesting	(332)	(648)	(737)
Payments of deferred acquisition consideration		(608)	(483)
Payment to extinguish debt			(1,620)
Net cash used in financing activities	(5,505)	(2,199)	(1,036)
Change in cash, cash equivalents and restricted cash	1,048	(11,238)	29,722
Cash, cash equivalents and restricted cash, beginning of year	103,290	114,528	84,806
Cash, cash equivalents and restricted cash, end of year	104,338	103,290	114,528
Supplemental disclosure of cash flow information:
Cash paid for interest	5,436	2,649	5,787
Cash paid for income taxes	3,052	1,201	607
Supplemental disclosure of non-cash investing and financing activities:
Cumulative effect adjustment for adoption of ASU No. 2016-13 (Note 2)	615
Deferred acquisition consideration and earnout liability recorded for business acquisition		828
Purchases of property and equipment in accounts payable and accrued expenses	841	1,928	3,750
Right-of-use assets obtained through operating lease obligations	5,869	$ 1,350	$ 53,793
Right-of-use assets obtained through finance lease obligations	$ 3,454

CONSOLIDATED STATEMENTS OF REDEEMABLE COMMON STOCK AND STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	CPN	Cumulative Effect of Adoption	Common Stock	Common Stock CPN	Additional Paid-in Capital	Additional Paid-in Capital CPN	Accumulated Deficit	Accumulated Deficit Cumulative Effect of Adoption
Balance at Dec. 31, 2020	$ 141,808			$ 13		$ 296,830		$ (155,035)
Balance (in shares) at Dec. 31, 2020				127,731,833
Exercise of stock options	2,198					2,198
Exercise of stock options (in shares)				760,458
Vesting of RSUs, net of shares surrendered to pay taxes	(737)					(737)
Vesting of RSUs, net of shares surrendered to pay taxes (in shares)				187,901
Stock-based compensation expense	3,864					3,864
Net income	94,202							94,202
Balance at Dec. 31, 2021	241,335			$ 13		302,155		(60,833)
Balance (in shares) at Dec. 31, 2021				128,680,192
Exercise of stock options	2,070					2,070
Exercise of stock options (in shares)				1,864,961
Vesting of RSUs, net of shares surrendered to pay taxes	(648)					(648)
Vesting of RSUs, net of shares surrendered to pay taxes (in shares)				170,491
Issuance of common stock associated with acquisition		$ 828					$ 828
Issuance of common stock associated with acquisition (in shares)					203,485
Stock-based compensation expense	6,552					6,552
Net income	15,532							15,532
Balance at Dec. 31, 2022	$ 265,669		$ (615)	$ 13		310,957		(45,301)	$ (615)
Balance (in shares) at Dec. 31, 2022	130,919,129			130,919,129
Accounting Standards Update [Extensible Enumeration]	Accounting Standards Update 2016-13 [Member]
Vesting of RSUs, net of shares surrendered to pay taxes	$ (332)					(332)
Vesting of RSUs, net of shares surrendered to pay taxes (in shares)				397,267
Stock-based compensation expense	8,996					8,996
Net income	4,945							4,945
Balance at Dec. 31, 2023	$ 278,663			$ 13		$ 319,621		$ (40,971)
Balance (in shares) at Dec. 31, 2023	131,316,396			131,316,396

Fair Value Measurement of Financial Instruments - Additional Information (Detail) - USD ($) $ in Thousands	Jun. 30, 2022	Sep. 17, 2020
Earnout liability	$ 0	$ 3,782

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	400,000,000	400,000,000
Common stock, shares issued	132,044,944	131,647,677
Common stock, shares outstanding	131,316,396	130,919,129

Accounts receivable, net

12 Months Ended

Dec. 31, 2023

Receivables [Abstract]

Accounts receivable, net

5. Accounts receivable, net

Accounts receivable consisted of the following:


	December 31,
	2023			2022
Accounts receivable	$	88,859		$	95,812
Less - allowance for credit losses		(6,860	)		(6,362	)
	$	81,999		$	89,450

The Company’s allowance for credit losses is comprised of the following:


Balance as of December 31, 2021	$	5,153
Additions		1,781
Write-offs		(572	)
Balance as of December 31, 2022	$	6,362
Cumulative-effect adjustment from adoption of ASU 2016-13, net of tax (Note 2)		615
Additions		1,297
Write-offs		(1,414	)
Balance as of December 31, 2023	$	6,860

Stockholders' Equity

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Stockholders' Equity

13. Stockholders’ Equity

As of December 31, 2023 and 2022, the issued shares of Class A common stock include 728,548 treasury shares that were reacquired in connection with the redemption of redeemable shares in March 2019.

Each share of Class A common stock entitles the holder to one vote on all matters submitted to the stockholders for a vote. Class A common stockholders are entitled to receive dividends, as may be declared by the Board of Directors to the extent permissible under the 2021 Credit Agreement. Through December 31, 2023, no cash dividends have been declared or paid.

At December 31, 2023 and 2022, the Company reserved the following shares of Class A common stock for future issuance:


	December 31,
	2023		2022
Shares reserved for issuance for outstanding options		9,340,046		5,931,742
Shares reserved for issuance for outstanding restricted stock units		3,898,331		1,381,500
Shares reserved for issuance for future grants		4,898,964		11,394,962
Total shares of authorized common stock reserved for future issuance		18,137,341		18,708,204

Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Personnel costs	$ 18,287	$ 17,113
Royalties	3,075	3,320
Accrued but unpaid lease obligations and interest	2,326	2,463
Accrued milestone payment (Note 18)	2,500
Accrued taxes	2,799	2,625
Other	1,087	926
Total Accrued Expenses and Other Current Liabilities	$ 30,074	$ 26,447

Cover Page - USD ($) $ in Millions	12 Months Ended
Cover Page - USD ($) $ in Millions	Dec. 31, 2023	Feb. 25, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Document Transition Report	false
Entity Registrant Name	ORGANOGENESIS HOLDINGS INC.
Entity Central Index Key	0001661181
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Public Float			$ 235.7
Trading Symbol	ORGO
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Address, State or Province	MA
Title of 12(b) Security	Class A Common Stock, $0.0001 par value
Security Exchange Name	NASDAQ
Document Annual Report	true
Entity Common Stock, Shares Outstanding		131,963,176
ICFR Auditor Attestation Flag	true
Securities Act File Number	001-37906
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	85 Dan Road
Entity Address, City or Town	Canton
Entity Address, Postal Zip Code	02021
Entity Tax Identification Number	98-1329150
City Area Code	781
Local Phone Number	575-0775
Auditor Name	RSM US LLP
Auditor Firm ID	49
Auditor Location	Boston, Massachusetts
Document Financial Statement Error Correction [Flag]	false

Property and Equipment, Net - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Depreciation expense	$ 10,448,000	$ 5,845,000	$ 5,781,000
Costs associated with ERP implementation	10,891,000
Sale and donation charges of equipment related to construction in progress		4,200,000
Cancellation fees to vendors		632,000
Asset impairment charges	$ 0	$ 0

Restructuring - Additional Information (Detail) $ in Thousands			3 Months Ended	12 Months Ended
	Oct. 27, 2023 Employees	Feb. 03, 2023 USD ($) Employees	Dec. 31, 2023 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Mar. 09, 2022 Employees	Oct. 21, 2020 Employees
Restructuring Cost and Reserve [Line Items]
Number of reduction in employees \| Employees	49	71
Percentage of reduction in employees	5.00%	7.00%
Employee-related charges \| $		$ 1,609	$ 1,820
Restructuring Charges \| $				$ 3,796	$ 2,268	$ 4,704
Restructuring Reserve Current \| $			$ 904	$ 904	$ 1,192
Birmingham Restructuring
Restructuring Cost and Reserve [Line Items]
Number of employees to retention Benefits \| Employees							25
La Jolla Restructuring
Restructuring Cost and Reserve [Line Items]
Number of employees to retention Benefits \| Employees								65

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Components of Income Tax Expense (Benefit)

The components of the income tax expense (benefit) consisted of the following for the years ended December 31, 2023, 2022, and 2021:


	Year Ended December 31,
	2023			2022			2021
Income tax expense (benefit):
Current tax expense (benefit)
Federal	$	1,275		$	178		$	—
State		2,157			2,575			899
Foreign		3			17			(39	)
Total current tax expense		3,435			2,770			860
Deferred tax expense (benefit)
Federal		3,311			5,446			(30,506	)
State		(1,312	)		(3,466	)		(1,470	)
Foreign		13			—			—
Total deferred tax expense (benefit)		2,012			1,980			(31,976	)
Total income tax expense (benefit)	$	5,447		$	4,750		$	(31,116	)

Component of Company's Deferred Tax Assets and Liabilities

Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2023 and 2022 are as follows:


	December 31,
	2023			2022
Net operating loss carryforwards
Federal	$	2,455		$	9,327
State		665			960
Foreign		4			16
Other		6,404			5,658
Capitalized research and development		17,608			8,849
Stock-based compensation		1,699			1,453
Finance leases		—			126
Operating leases		12,503			13,164
Fixed assets		—			3,921
Net deferred tax assets before valuation allowance		41,338			43,474
Valuation allowance		—			—
Property and equipment		(1,493	)		—
Right-of-use assets		(10,002	)		(10,724	)
Intangibles		(1,841	)		(2,736	)
Net deferred tax assets	$	28,002		$	30,014

Schedule of Effective Income Tax Rate Reconciliation

The differences between income taxes expected at the U.S. federal statutory income tax rate of 21% and the reported consolidated income tax benefit (expense) are summarized as follows:


	December 31,
	2023			2022			2021
U.S. federal statutory income tax rate		21.0	%		21.0	%		21.0	%
Federal valuation allowance		—			—			(70.6	%)
State valuation allowance		—			—			(9.1	%)
Return to provision and other adjustments		(1.4	%)		(1.6	%)		—
Prior period correction		—			(8.5	%)		—
Executive compensation limited by 162(m)		12.0	%		3.1	%		—
State and local income taxes		8.8	%		6.8	%		6.8	%
Meals and entertainment		5.9	%		—			—
Nondeductible lobbying expenses		1.7	%		0.4	%		—
Stock-based compensation		1.3	%		0.3	%		—
Foreign rate differential		(0.1	%)		0.1	%		—
Uncertain tax position reserves		0.7	%		0.3	%		0.9	%
Nondeductible fringe benefits		1.0	%		0.4	%		—
State credits		1.1	%		0.9	%		—
Other nondeductible expenses		0.4	%		0.2	%		0.8	%
Research and development credits		—			—			0.9	%
Effective income tax rate		52.4	%		23.4	%		(49.3	%)

Schedule of Unrecognized Tax Benefits Roll Forward

A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below:


	Year Ended December 31,
	2023			2022			2021
Gross balance at beginning of year	$	1,632		$	1,612		$	2,123
Additions based on tax positions related to the current period		113			206			153
Reductions for tax positions of prior years		(126	)		(186	)		(664	)
Gross balance at end of year	$	1,619		$	1,632		$	1,612

Share-Based Compensation - Parenthetical (Detail) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Options granted	3,554,528	1,418,224

Leases - Schedule of Accrued but Unpaid Lease Obligations (Detail) - Accrued But Unpaid Lease Obligation [Member] - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Schedule Of Accrued But Unpaid Lease Obligations [Line Items]
Accrued interest on accrued but unpaid lease obligations	$ 2,326	$ 1,956
Principal [Member]
Schedule Of Accrued But Unpaid Lease Obligations [Line Items]
Total accrued but unpaid lease obligations	$ 5,273	$ 5,779

Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Use of Estimates

The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the United States of America ("GAAP") requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported results of operations during the reporting periods. In preparing the consolidated financial statements, the estimates and assumptions that management considers to be significant and that present the greatest amount of uncertainty include revenue recognition; sales returns and credit losses; inventory reserve; recognition and measurement of current and deferred income tax assets and liabilities; the assessment of recoverability of long-lived assets, and the valuation and recognition of stock-based compensation. Actual results and outcomes may differ significantly from those estimates and assumptions.

Principles of Consolidation

The consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc., and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Foreign Currency

The Company’s functional currency, including the Company’s Swiss subsidiary, Organogenesis GmbH, is the U.S. dollar. Foreign currency gains and losses resulting from re-measurement of assets and liabilities held in foreign currencies and transactions settled in a currency other than the functional currency are included separately as non-operating income or expense in the consolidated statements of operations and comprehensive income as a component of other expense, net. The foreign currency amounts recorded for all periods presented were insignificant.

Segment Reporting

Operating segments are defined as components of an enterprise about which discrete financial information is available that is evaluated regularly by the chief operating decision maker, or decision-making group, in making decisions on how to allocate resources and assess performance for the organization. The Company’s chief operating decision maker is the Chief Executive Officer. The Company’s chief operating decision maker reviews consolidated operating results to make decisions about allocating resources and assessing performance for the entire Company. Accordingly, the Company has determined that it has a single operating segment—regenerative medicine.

The Company manages its operations as a single operating segment for the purposes of assessing performance and making operating decisions. The Company’s portfolio includes regenerative medicine products in various stages, ranging from preclinical to late stage development, and commercialized advanced wound care and surgical and sports medicine products which support healing across a wide variety of wound types at many different types of facilities.

Cash and Cash Equivalents

The Company primarily maintains its cash in bank deposit accounts in the United States which, at times, may exceed the federally insured limits. The Company has not experienced losses in such accounts and believes it is not exposed to significant credit risk on cash. The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents.

Restricted Cash

The Company had restricted cash of $498 and $812 as of December 31, 2023 and 2022, respectively. Restricted cash represents employee deposits in connection with the Company’s health benefit plan.

Accounts Receivable, Net

Accounts receivable are stated at invoice value less estimated allowances for credit losses. The Company evaluates expected credit losses on accounts receivable considering historical experience, credit quality, age of the accounts receivable balances, geography-related risks and current and expected economic conditions that may affect a customer’s ability to pay. The Company continually monitors customer payments and in cases where there are circumstances that may impair a specific customer’s ability to meet its financial obligations, a specific allowance is recorded against amounts due, thereby reducing the net recognized receivable to the amount reasonably believed to be collectible. Accounts receivable are charged against the allowance when deemed uncollectible. Recoveries of accounts receivables previously written off are recorded when received.

Inventories

Inventories are stated at the lower of cost (determined using the first-in first-out method) or net realizable value. Work in process and finished goods include materials, labor and allocated overhead. Inventories also include cell banks and the cost of tests mandated by regulatory agencies of the materials to qualify them for production.

The Company regularly reviews inventory quantities on hand and records a provision to write down excess and obsolete inventory to its estimated net realizable value based upon management’s assumptions of future material usage, yields and obsolescence, which are a result of future demand and market conditions and the effective life of certain inventory items.

The Company also tests other components of its inventory for future growth projections. The Company determines the average yield of the component and compares it to projected revenue to ensure it is properly reserved.

Property and Equipment, Net

Property and equipment are stated at cost less accumulated depreciation. As of December 31, 2023 and 2022, the Company’s property and equipment consisted of leasehold improvements, building, furniture and computers, and equipment. Depreciation expense is recognized using the straight-line method over the useful lives of the assets, which are as follows:


Leasehold improvements		Lesser of the life of the lease or the economic life of the asset
Building		30 years
Furniture and computers		3 - 5 years
Equipment		5 - 10 years

Construction in progress costs are capitalized when incurred until the assets are placed in service, at which time the costs will be transferred to the related property and equipment, and depreciated over their respective useful lives. Upon retirement or sale, the cost and related accumulated depreciation of assets disposed of are removed from the accounts and any resulting gain or loss is included in the consolidated statements of operations and comprehensive income. Expenditures for repairs and maintenance are charged to expense as incurred. Expenditures for major improvements that extend the useful lives of the related asset are capitalized and depreciated over their remaining estimated useful lives.

Goodwill

Goodwill represents the excess of the purchase price of an acquired business over the fair value of the identifiable assets acquired and liabilities assumed. Goodwill is not amortized, but is tested for impairment at least annually (as of December 31), or more frequently if events or circumstances indicate the carrying value may no longer be recoverable and that an impairment loss may have occurred. Circumstances that could trigger an impairment test include, but are not limited to, a significant adverse change in the business climate or legal factors, an adverse action or assessment by a regulator, or unanticipated competition. The Company operates as one segment, which is considered to be the sole reporting unit, and therefore goodwill is tested for impairment at the consolidated level.

In accordance with ASC Topic 350, Intangibles - Goodwill and Other, the Company may first assess qualitative factors to determine whether it is necessary to perform the quantitative goodwill impairment test. If after assessing the totality of events or circumstances, the Company determines that it is more likely than not (i.e. greater than 50% likelihood) that the fair value of the reporting unit is less than its carrying amount, then the quantitative test is required. Otherwise, no further testing is required.

Alternatively, the Company can bypass the qualitative assessment and proceed directly to the quantitative test. The quantitative goodwill impairment test requires the Company to estimate and compare the fair value of the reporting unit with its carrying value. If the fair value of the reporting unit exceeds the carrying value of the net assets, goodwill is not impaired. If the fair value of the reporting unit is less than the carrying value, the difference is recorded as an impairment loss up to the amount of goodwill. At December 31, 2023, we elected to perform a quantitative analysis directly. We used the Company’s market capitalization to approximate the fair value of the reporting unit. The fair value exceeded the carrying value and no impairment was recorded.

Intangible Assets Subject to Amortization

Intangible assets include intellectual property either owned by the Company or to which the Company has a license. Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired. Intangible assets are reported net of accumulated amortization, separately from goodwill. Intangible assets with finite lives are amortized over their estimated useful lives. Intangible assets include developed technology and patents, trade names, trademarks, customer relationships and non-compete agreements obtained through business acquisitions. Amortization of intangible assets with finite lives is calculated on the straight-line or accelerated method based on the following estimated useful lives:


Trade names and trademarks		1-12 years
Developed technology		6-12 years
Customer relationships		10 years
Non-compete agreements		5 years

Impairment of Long-Lived Assets

Long-lived assets include property and equipment, definite-lived intangible assets, and right-of-use assets associated with our lease agreements. The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. Factors that the Company considers in deciding when to perform an impairment review include, but are not limited to, significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets. When such an event occurs, the Company determines whether there has been impairment by comparing the anticipated undiscounted future net cash flows to the related asset group’s carrying value. If an asset is determined to be impaired, the asset is written down to fair value, which is determined based on discounted cash flows or appraised value, depending on the nature of the asset. The Company did not record any impairment of long-lived assets during the years ended December 31, 2023, 2022, or 2021.

Revenue Recognition

Product Revenue

The Company generates revenue through the sale of Advanced Wound Care and Surgical & Sports Medicine products. There is a single performance obligation in all of the Company’s contracts, which is the Company’s promise to transfer the Company’s product to customers based on specific payment and shipping terms in the arrangement. The entire transaction price is allocated to this single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s product which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract.

Reserves for Variable Consideration

Revenues from product sales are recorded net of reserves for variable consideration which includes but is not limited to product return, discounts, rebates and GPO fees that are offered within contracts between the Company and its customers relating to the Company’s sales of its products. These reserves are based on the amounts earned or to be claimed by its customers on the related sales and are recorded as a reduction of accounts receivable or an establishment of a liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract and is included in the net sales price to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately paid may differ from the Company’s estimates. If actual results vary from the Company’s estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known.

Product Returns

Consistent with industry practice, the Company generally offers customers a limited right of return for product purchased. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period in which the related product revenue is recognized. The Company currently estimates product return reserves using its historical return rates as well as factors that it becomes aware of that it believes could significantly impact its expected returns, including product recalls, pricing changes, or changes in reimbursement rates. The Company does not record an asset for the returned product as the product is discarded upon receipt.

Rebates and Allowances

The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts, resulting in a reduction of revenue and the establishment of a liability that is included in accrued expenses in the accompanying consolidated balance sheets in the period the related product revenue is recognized.

GPO Fees

The Company pays fees to GPOs for administrative services that the GPOs perform in connection with the purchases of the product by the GPO members. These fees are based on a contractually-determined percentage of the Company’s applicable sales. The Company classifies these GPO fees as a reduction of revenue based on the substance of the relationship of all parties involved in the transaction. For the years ended December 31, 2023, 2022, and 2021, the Company recorded GPO fees of $5,623, $6,654 and $3,663, respectively, as a direct reduction of revenue.

Other Revenue Policies

Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue.

Applying the practical expedient in paragraph ASC 606-10-32-18, the Company does not assess whether a contract has a significant financing component if the expectation at contract inception is such that the period between payment by the customer and the transfer of the promised products to the customer will be one year or less, which is the case with substantially all customers.

Applying the practical expedient in ASC 340-40-25-4, the Company recognizes the incremental costs of obtaining contracts as an expense when incurred if the amortization period of the assets that the Company otherwise would have recognized is one year or less. These costs are included in selling, general, and administrative expenses.

Applying the practical expedient in ASC 606-10-25-18B, the Company accounts for shipping and handling activities related to contracts with customers as costs to fulfill the promise to transfer the associated products. The Company records the related costs as part of the cost of goods sold.

Disaggregation of Revenue

The following table sets forth revenue by product category:


	Year Ended December 31,
	2023		2022		2021
Advanced Wound Care	$	405,514	$	422,231	$	430,237
Surgical and Sports Medicine		27,626		28,662		37,122
Total revenue	$	433,140	$	450,893	$	467,359

For all periods presented, net revenue generated outside the United States represented less than 1% of total net revenue.

License and Manufacturing Agreement

License and manufacturing agreement

The Company licenses the rights to sell certain of its products, which are manufactured by third parties, including the trademarks and other license rights associated with such products. Payments to the third parties under these arrangements typically include one or more of the following: non-refundable, upfront license fees; manufacturing supply services and associated purchase commitments at specified prices; milestone payments; and royalties on future product sales. The Company allocates payments in these arrangements based on the relative fair value of the goods and services received, and recognizes the expenses associated with each good or service as it receives the associated benefit.

Stock-Based Compensation

The Company measures stock-based awards granted to employees, non-employees, and directors based on the fair value of the awards on the date of grant and recognizes compensation expense for those awards over the requisite service period, which is generally the vesting period of the respective award. Generally, the Company issues stock options, restricted stock units and restricted stock awards with only service-based vesting conditions and records the expense for these awards using the straight-line method. The Company has not issued any stock-based awards with performance-based vesting conditions.

Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. The Company recognizes stock-based compensation expense within selling, general and administrative expenses in the consolidated statements of operations and comprehensive income for all share-based payments based upon the estimated grant-date fair value for the awards expected to ultimately vest.

The fair value of each restricted stock unit grant is based on the fair market value of the Company’s Class A common stock on the date of grant. The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option-pricing model. The Company has been a public company for a short period of time, has limited public float and lacks company-specific historical and implied volatility information for its Class A common stock. Therefore, it estimates its expected stock price volatility based on the historical volatility of publicly traded peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The expected term of the Company’s stock options has been determined utilizing the "simplified" method for awards that qualify as "plain-vanilla" options. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is based on the fact that the Company has never paid cash dividends on its Class A common stock and does not expect to pay any cash dividends in the foreseeable future.

Advertising

Advertising costs are expensed as incurred and are included in selling, general and administrative expenses in the consolidated statements of operations and comprehensive income. Advertising costs were approximately $5,225, $4,812, and $5,522, for the years ended December 31, 2023, 2022, and 2021, respectively.

Research and Development Costs

Research and development expenses include personnel costs for the Company’s research and development personnel, expenses related to improvements in manufacturing processes, enhancements to the Company’s currently available products, and additional investments in the product and platform development pipeline. Research and development expenses also include expenses for clinical trials. The Company expenses research and development costs as incurred.

Valuation of Contingent Purchase Earnout

In connection with the acquisition of CPN, the Company recognized a non-current liability for the fair value of the contingent consideration (the "Earnout") at the time of the acquisition in 2020. The Earnout liability was classified as a Level 3 measurement for which fair value was derived from inputs that were unobservable and significant to the overall fair value measurement. The fair value of such Earnout liability was estimated using a Monte Carlo simulation model that utilized key assumptions including forecasted revenues and volatilities of the underlying financial metrics during the Earnout period. The Company assessed the fair value of the Earnout liability at each reporting period. Any subsequent changes in the estimated fair value of the liability were reflected in selling, general and administrative expenses until the Earnout period ended and the liability was settled, during the year ended December 31, 2022.

Income Taxes

The Company accounts for income taxes using the asset and liability method which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the consolidated financial statements or in the Company’s tax returns. Deferred tax assets and liabilities are determined on the basis of the differences between the consolidated financial statement and the tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company quarterly assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. In determining whether a valuation allowance for deferred tax assets is necessary, the Company analyzes both positive and negative evidence related to the realization of deferred tax assets, including projected future taxable income, recent financial results and estimates of future reversals of deferred tax assets and liabilities. In addition, the Company considers whether it is more likely than not that the tax position will be sustained on

examination by taxing authorities based on the technical merits of the position. In consideration of the factors discussed above, in the fourth quarter of 2021, the Company determined it was more likely than not that its deferred tax assets would be realized in the future and released the valuation allowance on the net U.S. deferred tax assets as of December 31, 2021, resulting in a benefit of $48.3 million in income taxes. See Note 15, Income Taxes.

The Company accounts for uncertain income tax positions recognized in the consolidated financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more-likely-than-not to be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the consolidated financial statements. The amount of the benefit that may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered appropriate as well as the related net interest and penalties.

Fair Value of Financial Instruments

Certain assets and liabilities of the Company are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable:

•

Level 1—Quoted prices in active markets for identical assets or liabilities.

•

Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data.

•

Level 3—Unobservable inputs that are supported by little or no market activity that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques.

The carrying values of accounts receivable, inventories, prepaid expenses and other current assets, accounts payable and accrued expenses and other assets and liabilities approximate their fair values due to the short-term nature of these assets and liabilities. The carrying values of outstanding borrowings under the Company’s debt arrangements (see Note 12, Long-Term Debt Obligations) approximate their fair values as determined based on a discounted cash flow model, which represents a Level 3 measurement.

Earnings per Share (EPS)

The Company determines earnings per share in accordance with the authoritative guidance in ASC Topic 260, Earnings Per Share. The Company has one class of common stock (Class A common stock) for purposes of the EPS calculation and therefore computes basic EPS by dividing net income by the weighted average number of common shares outstanding for the applicable period. Diluted EPS is computed in the same manner as basic EPS, except that the number of shares is computed by giving effect to all potential dilutive common shares. For purpose of this calculation, outstanding stock options, and unvested restricted stock are considered potential dilutive common shares.

Recently Adopted Accounting Pronouncements

In June 2016, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments ("ASC 326"). The FASB subsequently issued a few amendments to ASC 326. ASC 326 and all the related updates replace the incurred loss impairment methodology previously required under GAAP, with an expected loss methodology that requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates.

The Company adopted the standard as of January 1, 2023 using the modified retrospective method. Under this method, the Company applied the new credit loss measurement guidance to trade accounts receivable, the only financial asset of the Company that is impacted by ASC 326 and the related updates. The Company recorded a net reduction of $615 to the opening balance of retained earnings as the cumulative effect of initially applying the standard. Results for reporting periods beginning after January 1, 2023 are presented in accordance with ASC 326. Prior period amounts have not been restated and are reported in accordance with legacy GAAP requirements.

Recently Issued Accounting Pronouncements Not Yet Adopted

In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, which requires public entities to disclose information about their reportable segments’ significant expenses and other segment items on an interim and annual basis. Public entities with a single reportable segment are required to apply the disclosure requirements in ASU 2023-07, as well as all existing segment disclosures and reconciliation requirements in ASC 280. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of adopting ASU 2023-07.

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, which requires public entities to disclose specific categories in the effective tax rate reconciliation, as well as additional information for reconciling items that exceed a quantitative threshold. ASU 2023-09 also requires all entities to disclose income taxes paid disaggregated by federal, state and foreign taxes, and further disaggregated for specific jurisdictions that exceed 5% of total income taxes paid, among other expanded disclosures. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of adopting ASU 2023-09.

Restructuring (Tables)

12 Months Ended

Dec. 31, 2023

Restructuring and Related Activities [Abstract]

Summary of liability related to the restructuring activities

The following table provides a rollforward of the restructuring liability.


	Employee			Other			Total
Liability balance as of December 31, 2020		618			—			618
Expenses		3,513			1,191			4,704
Cash distributions		(1,614	)		(540	)		(2,154	)
Liability balance as of December 31, 2021		2,517			651			3,168
Expenses		1,557			711			2,268
Cash distributions		(3,064	)		(1,180	)		(4,244	)
Liability balance as of December 31, 2022		1,010			182			1,192
Expenses		3,429			367			3,796
Cash distributions and other adjustments		(3,535	)		(549	)		(4,084	)
Liability balance as of December 31, 2023	$	904		$	—		$	904

Leases (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Schedule of Accrued But Unpaid Lease Obligations

The accrued but unpaid lease obligations as well as the related accrued interest with respect to the remaining three Related-Party Leases are shown below:


	December 31,
	2023		2022
Principal portion of rent in arrears	$	5,273	$	5,779
Accrued interest on accrued but unpaid lease obligations	$	2,326	$	1,956

Schedule of Lease Cost

The components of lease cost were as follows:


	Classification	Year Ended December 31, 2023		Year Ended December 31, 2022
Finance lease
Amortization of right-of-use assets	COGS and SG&A	$	479	$	213
Interest on lease liabilities	Interest Expense		137		7
Total Finance lease cost			616		220
Operating lease cost	COGS, R&D, SG&A		10,052		9,570
Short-term lease cost	COGS, R&D, SG&A		2,921		2,951
Variable lease cost	COGS, R&D, SG&A		5,595		5,082
Total lease cost		$	19,184	$	17,823

Summary of Balance Sheet Information Related To Finance Leases

Supplemental balance sheet information related to finance leases was as follows:


	December 31,			December 31,
	2023			2022
Property and equipment, gross	$	3,454		$	1,174
Accumulated depreciation		(479	)		(1,174	)
Property and equipment, net	$	2,975		$	—

Current portion of finance lease obligations	$	1,081		$	—
Finance lease obligations, net of current portion		1,888			—
Total finance lease liabilities	$	2,969		$	—

Summary of Cash Flow Information Related To Leases

Supplemental cash flow information related to leases was as follows:


	Year Ended December 31, 2023		Year Ended December 31, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	10,401	$	9,273
Operating cash flows for finance leases	$	137	$	7
Financing cash flows for finance leases	$	485	$	200


	December 31,			December 31,
	2023			2022
Weighted-average remaining lease term
Finance leases		2.58			—
Operating leases		6.49			7.54

	December 31,			December 31,
	2023			2022
Weighted-average discount rate
Finance leases		7.91	%		—
Operating leases		4.71	%		4.61	%

Summary of Maturities of Lease Liabilities

As of December 31, 2023, the maturities of lease liabilities were as follows:


	Operating leases			Finance leases
2024	$	9,799		$	1,278
2025		8,823			1,278
2026		7,542			737
2027		13,275			—
2028		3,570			—
Thereafter		15,108			—
Total lease payments		58,117			3,293
Less: interest		(7,966	)		(324	)
Total lease liabilities	$	50,151		$	2,969

Inventories (Tables)

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Schedule of Inventory, Current

Inventories, net of related reserves for excess and obsolescence, consist of the following:


	December 31,
	2023		2022
Raw materials	$	12,988	$	12,282
Work in process		810		1,022
Finished goods		14,455		11,479
	$	28,253	$	24,783

Significant Accounting Policies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Jan. 01, 2023
Significant Accounting Policies [Line Items]
GPO Fees	$ 5,623,000	$ 6,654,000	$ 3,663,000
Restricted Cash, Current	498,000	812,000
Impairment of goodwill	0	0	0
Impairment of long-lived assets	0	0	0
Deferred Income tax benefit			48,252,000
Net reduction retained earnings	$ (40,971,000)	(45,301,000)
Accounting Standards Update [Extensible Enumeration]	ASU 2016-13
ASU 2016-13
Significant Accounting Policies [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2023
Net reduction retained earnings				$ (615,000)
Selling, General and Administrative Expenses
Significant Accounting Policies [Line Items]
Advertising Expense	$ 5,225,000	$ 4,812,000	$ 5,522,000

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Inventory reserve and obsolescence charged to cost of goods	$ 6,580	$ 9,648	$ 12,079

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

9. Goodwill and Intangible Assets

Goodwill was $28,772 as of December 31, 2023 and 2022. There was no impairment of goodwill recorded during the years ended December 31, 2023, 2022, or 2021.

Identifiable intangible assets consisted of the following as of December 31, 2023:


	Original		Accumulated			Net Book
	Cost		Amortization			Value
Developed technology	$	32,620	$	(24,666	)	$	7,954
Customer relationship		10,690		(3,519	)		7,171
Patent		7,623		(7,623	)		—
Independent sales agency network		4,500		(4,500	)		—
Trade names and trademarks		2,080		(1,590	)		490
Non-compete agreements		1,010		(754	)		256
Total	$	58,523	$	(42,652	)	$	15,871

Identifiable intangible assets consisted of the following as of December 31, 2022:


	Original		Accumulated			Net Book
	Cost		Amortization			Value
Developed technology	$	32,620	$	(21,164	)	$	11,456
Customer relationship		10,690		(2,450	)		8,240
Patent		7,623		(7,623	)		—
Independent sales agency network		4,500		(4,500	)		—
Trade names and trademarks		2,080		(1,393	)		687
Non-compete agreements		1,010		(604	)		406
Total	$	58,523	$	(37,734	)	$	20,789

Amortization of intangible assets, calculated on a straight-line basis or using an accelerated method, which reflects the pattern in which the economic benefits of the intangible assets are consumed, was $4,918, $4,883 and $4,949 for the years ended December 31, 2023, 2022, and 2021, respectively. Estimated future annual amortization expense related to these intangible assets is as follows:


2024	$	3,403
2025		3,323
2026		3,043
2027		2,283
2028		1,968
Thereafter		1,851
Total	$	15,871

Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Estimated Useful Lives of Property Plant and Equipment


Leasehold improvements		Lesser of the life of the lease or the economic life of the asset
Building		30 years
Furniture and computers		3 - 5 years
Equipment		5 - 10 years

Schedule of Finite-Lived Intangible Assets

Amortization of intangible assets with finite lives is calculated on the straight-line or accelerated method based on the following estimated useful lives:


Trade names and trademarks		1-12 years
Developed technology		6-12 years
Customer relationships		10 years
Non-compete agreements		5 years

Schedule of Revenue by Product Category

The following table sets forth revenue by product category:


	Year Ended December 31,
	2023		2022		2021
Advanced Wound Care	$	405,514	$	422,231	$	430,237
Surgical and Sports Medicine		27,626		28,662		37,122
Total revenue	$	433,140	$	450,893	$	467,359

Accounts receivable, net - Summary of Accounts Receivable (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Accounts receivable	$ 88,859	$ 95,812
Less - allowance for credit losses	(6,860)	(6,362)
Accounts receivable	$ 81,999	$ 89,450

Income Taxes - Component of Company's Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred Tax Assets, Operating Loss Carryforwards, Components [Abstract]
Federal	$ 2,455	$ 9,327
State	665	960
Foreign	4	16
Other	6,404	5,658
Capitalized research and development	17,608	8,849
Stock-based compensation	1,699	1,453
Finance leases		126
Operating leases	12,503	13,164
Fixed assets		3,921
Net deferred tax assets before valuation allowance	41,338	43,474
Property and equipment	(1,493)
Right-of-use assets	(10,002)	(10,724)
Intangibles	(1,841)	(2,736)
Net deferred tax assets	$ 28,002	$ 30,014

Inventories

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Inventories

6. Inventories

Inventories, net of related reserves for excess and obsolescence, consist of the following:


	December 31,
	2023		2022
Raw materials	$	12,988	$	12,282
Work in process		810		1,022
Finished goods		14,455		11,479
	$	28,253	$	24,783

Raw materials include various components used in the Company’s manufacturing process. The Company’s excess and obsolete inventory review process includes analysis of sales forecasts and historical sales as compared to inventory levels and working with operations to maximize recovery of excess inventory. During the years ended December 31, 2023, 2022, and 2021, the Company charged $6,580, $9,648, and $12,079, respectively, for inventory excess and obsolescence to cost of goods sold within the consolidated statements of operations and comprehensive income.

Stockholders' Equity - Schedule Of Common Stock Shares Reserved For Future Issuance (Detail) - shares	Dec. 31, 2023	Dec. 31, 2022
Equity [Abstract]
Shares reserved for issuance for outstanding options	9,340,046	5,931,742
Shares reserved for issuance for outstanding restricted stock units	3,898,331	1,381,500
Shares reserved for issuance for future grants	4,898,964	11,394,962
Total shares of authorized common stock reserved for future issuance	18,137,341	18,708,204

Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases

17. Leases

The Company’s leases consist primarily of real estate, equipment and vehicle leases.

The Company leases real estate for office, lab, warehouse and production space under noncancelable leases that expire at various dates through 2035, subject to the Company’s options to terminate or renew certain leases for an additional five to ten years.

The Company leases vehicles under operating leases for certain employees and has fleet services agreements for service on these vehicles. The minimum lease term for each newly leased vehicle is 367 days with renewal options. The Company may terminate the vehicle lease after the minimum lease term upon thirty days’ prior notice.

The Company also leases other equipment under noncancelable operating leases that expire at various dates through 2025, and certain equipment required for its cleanroom facilities under finance leases that expire in 2026.

The Company determines if an arrangement is a lease at lease inception. The options to extend or terminate a lease are included in the lease terms when it is reasonably certain that the Company will exercise the options. Operating leases are included in operating lease right-of-use assets and operating lease obligations on the consolidated balance sheets. Finance lease right-of-use assets are included in property and equipment, net, and the related liabilities are included in finance lease obligations on the consolidated balance sheets.

Right-of-use assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the leases. Right-of-use assets and lease liabilities are recognized based on the present value of the fixed lease payments over the lease term at the commencement date. The right-of-use assets also include any initial direct costs incurred and lease payments made at or before the commencement date and are reduced by lease incentives. The Company uses its incremental borrowing rate as the discount rate to determine the present value of the lease payments for leases that do not have a readily determinable implicit discount rate. The Company’s incremental borrowing rate is the rate of interest that it would have to borrow on a collateralized basis over a similar term and amount in a similar economic environment. The Company determines the incremental borrowing rates for its leases by adjusting the risk-free interest rate with a credit risk premium corresponding to the Company’s credit rating.

The Company records rent expense for its operating leases on a straight-line basis from the lease commencement date until the end of the lease term. The Company records finance lease cost as a combination of the depreciation expense for the right-of-use assets and interest expense for the outstanding lease liabilities using the discount rate discussed above. Variable lease payments are primarily related to the office and fleet leases which include but are not limited to taxes, insurance, common area maintenance and maintenance programs for leased vehicles.

On January 1, 2013, the Company entered into finance lease arrangements with 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC for office and laboratory space in Canton, Massachusetts (the

“Related-Party Leases”). 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC are related parties as the owners of these entities are also directors, former directors and / or stockholders of the Company.

In August 2021, the Company purchased the building (the "275 Dan Road Building") under the lease with 275 Dan Road SPE, LLC for $6,013 and the lease was terminated. The Company recorded an asset of $4,943 to buildings within property and equipment, net in accordance with ASC 842-20-40-2, Purchase of the Underlying Asset, to account for the purchase of the leased asset.

The remaining three Related-Party Leases were set to terminate on December 31, 2022 and each contained a renewal option for a five-year period with a rental rate at the greater of (i) rent for the last year of the prior term, or (ii) the then fair market value. In November 2021, the Company exercised the option to extend the leases for an additional five years, and at such time, remeasured the right of use assets and lease liabilities based on its best estimate of the market rental rate in the renewal period and reassessed the classification for these leases. As a result, these leases were reclassified from finance leases to operating leases on the consolidated balance sheets as of December 31, 2021. In December 2022, the Company and the landlord finalized the market rental rate in the renewal period for these properties, resulting in an additional $8,060 to be recorded as variable lease expenses over the renewal period.

In May 2023, the Company amended its lease of its research and development facility in Birmingham, Alabama. The lease amendment extended the term of the lease through September 30, 2031 and was accounted for as a modification to the existing lease contract.

In June 2023, the Company amended a contract with a contract manufacturing organization, which had previously been determined to contain an embedded operating lease for dedicated manufacturing space. The lease amendment extended the term of the lease through July 31, 2026. The Company accounted for the lease amendment as a modification to the existing lease, and accordingly increased the associated right-of-use asset and lease liability by $2,106.

During the year ended December 31, 2023, the Company terminated an existing agreement for the rental of certain medical garments. The Company recorded a loss of $559 in connection with the lease termination.

During the year ended December 31, 2023, the Company executed agreements for the rental of certain medical garments. The Company classified these rental agreements as finance leases and the leases commenced in April 2023 and September 2023. At each lease commencement date, the Company recorded equipment within property and equipment and associated lease liabilities of $750 and $2,701, respectively.

Effective April 1, 2019, the Company agreed to accrue interest on accrued but unpaid lease obligations owed for rent in arrears to the owners of the buildings subject to the Related-Party Leases, at an interest rate equal to the rate charged under the 2019 Credit Agreement. In connection with the purchase of the 275 Dan Road Building in August 2021, the Company paid 50% of the accrued but unpaid lease obligations, including accrued interest, associated with the 275 Dan Road Building. The remaining accrued but unpaid lease obligation for this building was paid in five quarterly installments through January 3, 2023, and accordingly at December 31, 2023, there is no remaining balance or accrued interest associated with the 275 Dan Road Building. The accrued but unpaid lease obligations as well as the related accrued interest with respect to the remaining three Related-Party Leases are shown below:


	December 31,
	2023		2022
Principal portion of rent in arrears	$	5,273	$	5,779
Accrued interest on accrued but unpaid lease obligations	$	2,326	$	1,956

The accrued but unpaid lease obligations owed for rent in arrears was included in current portion of operating lease obligations, other than the balance related to the 275 Dan Road Building, which was included in accrued expenses and other current liabilities on the consolidated balance sheets, as of December 31, 2023 and 2022. The accrued interest on the accrued but unpaid lease obligations was included in accrued expenses and other current liabilities on the consolidated balance sheets as of December 31, 2023 and 2022.

The components of lease cost were as follows:


	Classification	Year Ended December 31, 2023		Year Ended December 31, 2022
Finance lease
Amortization of right-of-use assets	COGS and SG&A	$	479	$	213
Interest on lease liabilities	Interest Expense		137		7
Total Finance lease cost			616		220
Operating lease cost	COGS, R&D, SG&A		10,052		9,570
Short-term lease cost	COGS, R&D, SG&A		2,921		2,951
Variable lease cost	COGS, R&D, SG&A		5,595		5,082
Total lease cost		$	19,184	$	17,823

Supplemental balance sheet information related to finance leases was as follows:


	December 31,			December 31,
	2023			2022
Property and equipment, gross	$	3,454		$	1,174
Accumulated depreciation		(479	)		(1,174	)
Property and equipment, net	$	2,975		$	—

Current portion of finance lease obligations	$	1,081		$	—
Finance lease obligations, net of current portion		1,888			—
Total finance lease liabilities	$	2,969		$	—

Supplemental cash flow information related to leases was as follows:


	Year Ended December 31, 2023		Year Ended December 31, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	10,401	$	9,273
Operating cash flows for finance leases	$	137	$	7
Financing cash flows for finance leases	$	485	$	200


	December 31,			December 31,
	2023			2022
Weighted-average remaining lease term
Finance leases		2.58			—
Operating leases		6.49			7.54

	December 31,			December 31,
	2023			2022
Weighted-average discount rate
Finance leases		7.91	%		—
Operating leases		4.71	%		4.61	%

As of December 31, 2023, the maturities of lease liabilities were as follows:


	Operating leases			Finance leases
2024	$	9,799		$	1,278
2025		8,823			1,278
2026		7,542			737
2027		13,275			—
2028		3,570			—
Thereafter		15,108			—
Total lease payments		58,117			3,293
Less: interest		(7,966	)		(324	)
Total lease liabilities	$	50,151		$	2,969

Inventories - Summary of Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Raw materials	$ 12,988	$ 12,282
Work in process	810	1,022
Finished goods	14,455	11,479
Inventory	$ 28,253	$ 24,783

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Finite-Lived Intangible Assets

Identifiable intangible assets consisted of the following as of December 31, 2023:


	Original		Accumulated			Net Book
	Cost		Amortization			Value
Developed technology	$	32,620	$	(24,666	)	$	7,954
Customer relationship		10,690		(3,519	)		7,171
Patent		7,623		(7,623	)		—
Independent sales agency network		4,500		(4,500	)		—
Trade names and trademarks		2,080		(1,590	)		490
Non-compete agreements		1,010		(754	)		256
Total	$	58,523	$	(42,652	)	$	15,871

Identifiable intangible assets consisted of the following as of December 31, 2022:


	Original		Accumulated			Net Book
	Cost		Amortization			Value
Developed technology	$	32,620	$	(21,164	)	$	11,456
Customer relationship		10,690		(2,450	)		8,240
Patent		7,623		(7,623	)		—
Independent sales agency network		4,500		(4,500	)		—
Trade names and trademarks		2,080		(1,393	)		687
Non-compete agreements		1,010		(604	)		406
Total	$	58,523	$	(37,734	)	$	20,789

Schedule of Finite-Lived Intangible Assets, Future Amortization Expense

Estimated future annual amortization expense related to these intangible assets is as follows:


2024	$	3,403
2025		3,323
2026		3,043
2027		2,283
2028		1,968
Thereafter		1,851
Total	$	15,871

Employee Benefit Plan - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Retirement Benefits [Abstract]
Company made employer contributions	$ 7,430	$ 6,601	$ 3,092

Earnings per Share (EPS) (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Schedule of Earnings Per Share, Basic and Diluted

A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income attributable to the Class A common stockholders is as follows:


	Year Ended December 31,
	2023		2022		2021
Numerator:
Net Income	$	4,945	$	15,532	$	94,202
Denominator:
Weighted average common shares outstanding —basic		131,231,317		130,070,231		128,331,022
Dilutive effect of restricted stock units		710,813		149,215		469,123
Dilutive effect of options		804,597		2,163,706		4,862,514
Weighted-average common shares outstanding—diluted		132,746,727		132,383,152		133,662,659
Earnings per share—basic	$	0.04	$	0.12	$	0.73
Earnings per share—diluted	$	0.04	$	0.12	$	0.70

Accrued Expenses and Other Current Liabilities (Tables)

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Schedule of Accounts Payable and Accrued Liabilities

Accrued expenses and other current liabilities consisted of the following:


	December 31,
	2023		2022
Personnel costs	$	18,287	$	17,113
Royalties		3,075		3,320
Accrued but unpaid lease obligations and interest		2,326		2,463
Accrued milestone payment (Note 18)		2,500		—
Accrued taxes		2,799		2,625
Other		1,087		926
	$	30,074	$	26,447

Share-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Jun. 30, 2022	Dec. 31, 2019	Dec. 31, 2018
Fair value of option vested	$ 3,117	$ 2,082
Weighted average grant-date fair value	$ 1.32	$ 3.94
Options granted	3,554,528	1,418,224
Restricted Stock Units [Member]
Unrecognized stock compensation expense	$ 7,316
Share-based compensation expected to be recognized over a weighted-average period	2 years 6 months 10 days
RSU granted during the period	3,192,372	979,257
Option Loans
Number of shares as collateral for options loans					675,990
Number of options exercised			195,278
Option
Unrecognized stock compensation expense	$ 6,295
Share-based compensation expected to be recognized over a weighted-average period	2 years 4 months 6 days
Selling, General and Administrative Expenses
Stock-based compensation expense	$ 8,996	$ 6,552	$ 3,864
2003 and 2018 Stock Incentive Plan \| Maximum
Stock option granted vesting period	5 years
2003 and 2018 Stock Incentive Plan \| Minimum
Stock option granted vesting period	4 years
2003 and 2018 Stock Incentive Plan \| Option
Stock option expiration period	10 years
Common Class A \| 2018 Stock Incentive Plan
Common stock awards authorized				7,826,970		9,198,996

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Federal corporate income tax rate	21.00%	21.00%	21.00%
Unrecognized tax benefits	$ 2,837	$ 2,642	$ 2,307
Description of tax benefits upon ultimate settlement	The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement.
Income tax penalities and interest expense	$ 500	$ 404
Deferred income tax (expense) benefit			$ 48,252
Subsidiaries [Member]
Net operating loss cary forward	$ 4
Domestic Tax Authority [Member]
Percentage of taxable income limitation	80.00%
Operating Loss Carryforwards	$ 11,669
State and Local Jurisdiction [Member] \| Expiration December 31, 2031 through 2038
Operating Loss Carryforwards	$ 9,430

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill	$ 28,772,000	$ 28,772,000
Impairment of goodwill	0	0	$ 0
Amortization of Intangible Assets	$ 4,918,000	$ 4,883,000	$ 4,949,000

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Fair Value Measurement of Financial Instruments

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Fair Value Measurement of Financial Instruments

4. Fair Value Measurement of Financial Instruments

Earnout Liability

In connection with accounting for the CPN acquisition on September 17, 2020, the Company recorded an Earnout liability of $3,782 on the Acquisition Date, representing the fair value of contingent consideration payable upon the achievement of a certain revenue target. The Earnout liability was classified as a Level 3 measurement within the fair value hierarchy for which fair value was derived from inputs that were unobservable and significant to the overall fair value measurement. The fair value of such Earnout liability was estimated using a Monte Carlo simulation model that utilized key assumptions including forecasted revenues and volatilities of the underlying financial metrics during the Earnout Period. The Earnout Period ended on June 30, 2022 and the Company calculated the Earnout liability to be $0. Before its settlement, the Company assessed the fair value of the Earnout liability at each reporting period. Any subsequent changes in the estimated fair value of the liability were reflected in selling, general and administrative expenses until the liability was settled. For more information about the Earnout liability, refer to Note 3, Acquisition.

The following table provides a roll-forward of the fair value of the Company’s Earnout liability, for which fair value was determined using Level 3 inputs until the end of the Earnout Period on June 30, 2022.


	Earnout liability
Balance as of December 31, 2020	$	3,985
Change in fair value		(3,985	)
Balance as of December 31, 2021		—
Change in fair value		—
Balance as of June 30, 2022	$	—

The Company did not have any financial assets and liabilities measured at fair value on a non-recurring basis as of December 31, 2023 and 2022.

Leases - Schedule of Lease Cost (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Finance lease Amortization of right-of-use assets	$ 479	$ 213
Finance lease Interest on lease liabilities	137	7
Total Finance lease cost	616	220
Operating lease cost	10,052	9,570
Short-term lease cost	2,921	2,951
Variable lease cost	5,595	5,082
Total lease cost	$ 19,184	$ 17,823

Long-Term Debt Obligations

12 Months Ended

Dec. 31, 2023

Long-Term Debt, Unclassified [Abstract]

Long-Term Debt Obligations

12. Long-Term Debt Obligations


	December 31,
	2023			2022
Term loan		66,563			71,250
Less debt discount and debt issuance cost		(332	)		(481	)
Term loan, net of debt discount and debt issuance cost	$	66,231		$	70,769

2021 Credit Agreement

In August 2021, the Company, as borrower, its subsidiaries, as guarantors, and Silicon Valley Bank ("SVB"), and the several other lenders thereto (collectively, the "Lenders") entered into a credit agreement, as amended (the "2021 Credit Agreement"), providing for a term loan facility not to exceed $75,000 (the "Term Loan Facility") and a revolving credit facility not to exceed $125,000 (the "Revolving Facility" and, together with the Term Loan Facility, the "Facilities"). The Company’s obligations to the Lenders are secured by substantially all of the Company’s assets, including intellectual property. Capitalized terms used herein and not otherwise defined are defined as set forth in the 2021 Credit Agreement.

Advances made under the 2021 Credit Agreement may be either SOFR Loans or ABR Loans, at the Company’s option. For SOFR Loans, the interest rate is a per annum interest rate equal to the Adjusted Term SOFR plus an Applicable Margin between 2.00% to 3.25% based on the Total Net Leverage Ratio. For ABR Loans, the interest rate is equal to (1) the highest of (a) the Wall Street Journal Prime Rate, (b) the Federal Funds Rate plus 0.50% and (c) the Adjusted Term SOFR rate plus 1.0%, plus (2) an Applicable Margin between 1.00% to 2.25% based on the Total Net Leverage Ratio.

The 2021 Credit Agreement requires the Company to make consecutive quarterly installment payments equal to the following: (a) from September 30, 2021 through and including June 30, 2022, $469; (b) from September 30, 2022 through and including June 30, 2023, $938; (c) from September 30, 2023 through and including June 30, 2025, $1,406 and (d) from September 30, 2025 and the last day of each quarter thereafter until August 6, 2026 (the "Term Loan Maturity Date"), $1,875. The Company may prepay the Term Loan Facility. Once repaid, amounts borrowed under the Term Loan Facility may not be re-borrowed.

The Company must pay in arrears, on the first day of each quarter prior to August 6, 2026 (the "Revolving Termination Date") and on the Revolving Termination Date, a fee for the Company’s non-use of available funds (the "Commitment Fee"). The Commitment Fee rate is between 0.25% to 0.45% based on the Total Net Leverage Ratio. The Company may elect to reduce or terminate the Revolving Facility in its entirety at any time by repaying all outstanding principal and unpaid accrued interest.

Under the 2021 Credit Agreement, the Company is required to comply with certain financial covenants including the Consolidated Fixed Charge Coverage Ratio and Consolidated Total Net Leverage Ratio, tested quarterly. In addition, the Company is also required to make representations and warranties and comply with certain non-financial covenants that are customary in loan agreements of this type, including restrictions on the payment of dividends, repurchase of stock, incurrence of indebtedness, dispositions and acquisitions.

The Company recorded debt issuance costs and related fees of $604 in connection with entering into the Term Loan Facility, which are recorded as a reduction of the carrying value of the term loan on the Company’s consolidated balance sheets. In connection with entering into the Revolving Facility, the Company recorded debt issuance costs and related fees of $1,223, which are recorded as other assets. Both of these costs are being amortized to interest expense through the maturity date of the Facilities.

As of December 31, 2023 and 2022, the Company had outstanding borrowings of $66,563 and $71,250 under the Term Loan Facility, respectively, and $0 under the Revolving Facility with $125,000 available for future revolving borrowings.

Future payments of the 2021 Credit Agreement, as of December 31, 2023, are as follows for the calendar years ending December 31:


2024		5,625
2025		6,563
2026		54,375
Total	$	66,563

2019 Credit Agreement

In March 2019, the Company, its subsidiaries and SVB, and the several other lenders thereto entered into a credit agreement, as amended (the "2019 Credit Agreement"), providing for a term loan facility of $40,000 and a revolving credit facility of up to $60,000. Both facilities were set to mature in 2024. The interest rate for the term loan facility was a floating per annum interest rate equal to the greater of 3.75% above the Wall Street Journal Prime Rate and 9.25%. The interest rate for advances under the revolving facility was a floating per annum interest rate equal to the greater of the Wall Street Journal Prime Rate and 5.50%. If the Company elected to prepay the loan or terminate the facilities, the Company was required to pay a certain percentage of the outstanding principal as a prepayment fee. A final payment fee (the "Final Payment") of 6.5% multiplied by the original aggregate principal amount of term loan facility was due upon the earlier to occur of the maturity date of the term loan or prepayment of all outstanding principal.

In August 2021, upon entering into the 2021 Credit Agreement, the Company paid an aggregate amount of $70,559 due under the 2019 Credit Agreement, including unpaid principal, accrued interest, the Final Payment and a prepayment fee, with proceeds from the 2021 Credit Agreement, and the 2019 Credit Agreement was terminated. Upon termination of the 2019 Credit Agreement, the Company recognized $1,883 as loss on the extinguishment of the loan for the year ended December 31, 2021.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

Share-Based Compensation

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Share-Based Compensation

14. Share-Based Compensation

Stock Incentive Plans-the 2018 Plan

On November 28, 2018, the Board of Directors of the Company adopted, and on December 10, 2018, the Company’s stockholders approved, the Organogenesis 2018 Equity and Incentive Plan (the "2018 Plan"). The purposes of the 2018 Plan are to provide long-term incentives and rewards to the Company’s employees, officers, directors and other key persons (including consultants), to attract and retain persons with the requisite experience and ability, and to more closely align the interests of such employees, officers, directors and other key persons with the interests of the Company’s stockholders.

The 2018 Plan authorizes the Company’s Board of Directors or a committee of not less than two independent directors (in either case, the "Administrator") to grant the following types of awards: non-statutory stock options; incentive stock options; restricted stock awards; restricted stock units; stock appreciation rights; unrestricted stock awards; performance share awards; and dividend equivalent rights. The 2018 Plan is administered by the Company’s Board of Directors.

At the adoption of the 2018 Plan, a total of 9,198,996 shares of Class A common stock was authorized to be issued (subject to adjustment in the case of any stock dividend, stock split, reverse stock split, or similar change in capitalization of the Company). In June 2022, the 2018 Plan was amended to increase the number of shares of Class A common stock reserved for issuance by 7,826,970 shares.

Stock Incentive Plans-the 2003 Plan

The Organogenesis 2003 Stock Incentive Plan (the "2003 Plan"), provided for the Company to issue restricted stock awards, or to grant incentive stock options or non-statutory stock options. Incentive stock options were granted only to the Company’s employees. Restricted stock awards and non-statutory stock options were granted to employees, members of the Board of Directors, outside advisors and consultants of the Company.

Effective December 10, 2018, no additional awards may be made under the 2003 Plan and as a result (i) any shares in respect of stock options that are expired or terminated under the 2003 Plan without having been fully exercised will not be available for future awards; (ii) any shares in respect of restricted stock that are forfeited to, or otherwise repurchased by the Company, will not be available for future awards; and (iii) any shares of Class A common stock that are tendered to the Company by a participant to exercise an award will not be available for future awards.

Stock-Based Compensation Expense

Stock options awarded under the stock incentive plans expire 10 years after the grant date and typically vest over four or five years. Restricted stock units awarded typically vest over four years.

During the years ended December 31, 2023, 2022, and 2021, the Company recorded stock-based compensation expense of $8,996, $6,552 and $3,864, respectively, within selling, general and administrative expenses on the consolidated statements of operations and comprehensive income.

Restricted Stock Units (RSUs)

During the years ended December 31, 2023 and 2022, the Company granted 3,192,372 and 979,257 time-based restricted stock units to its employees, executives and the Board of Directors. Each restricted stock unit represents the contingent right to receive one share of the Company’s Class A common stock. The fair value of the restricted stock units is based on the fair market value of the Company’s stock on the date of grant.

The activity of restricted stock units is set forth below:


				Weighted
				Average
	Number			Grant Date
	of Shares			Fair Value
Unvested at December 31, 2022		1,381,500		$	7.62
Granted		3,192,372		$	2.47
Vested		(522,651	)	$	7.28
Canceled/Forfeited		(152,890	)	$	5.21
Unvested at December 31, 2023		3,898,331		$	3.54

As of December 31, 2023, the total unrecognized compensation cost related to unvested restricted stock units expected to vest was $7,316 and the weighted average remaining recognition period for unvested awards was 2.53 years.

Stock Options

The stock options granted during the years ended December 31, 2023 and 2022 were 3,554,528 and 1,418,224, respectively. The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods are as follows, presented on a weighted-average basis:


	Year Ended
	December 31,
	2023			2022

Risk-free interest rate		4.00	%		1.92	%
Expected term (in years)		6.25			6.25
Expected volatility		51.00	%		50.66	%
Expected dividend yield		0.0	%		0.0	%
Underlying stock price	$	2.47		$	7.87

These assumptions resulted in an estimated weighted-average grant-date fair value per share of stock options granted during the years ended December 31, 2023 and 2022 of $1.32 and $3.94, respectively.

The following table summarizes the Company’s stock option activity since December 31, 2022:


						Weighted
				Weighted		Average
				Average		Remaining		Aggregate
	Number of			Exercise		Contractual		Intrinsic
	Shares			Price		Term		Value
						(in years)
Outstanding as of December 31, 2022		5,931,742		$	5.91		6.14	$	2,245
Granted		3,554,528		$	2.51
Canceled / forfeited		(146,224	)	$	7.09
Outstanding as of December 31, 2023		9,340,046		$	4.60		6.66	$	10,267
Options exercisable as of December 31, 2023		3,999,380		$	4.57		4.08	$	4,681
Options vested or expected to vest as of December 31, 2023		8,488,262		$	4.66		6.44	$	9,227

The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the fair value of the Company’s Class A common stock for those stock options that have exercise prices lower than the fair value of the Company’s Class A common stock.

The total fair value of options vested during the years ended December 31, 2023 and 2022 was $3,117 and $2,082, respectively.

As of December 31, 2023, the total unrecognized stock compensation expense was $6,295 and was expected to be recognized over a weighted-average period of 2.35 years.

During the year ended December 31, 2021, a former executive repaid the remaining principal balance of certain partial recourse notes, which was treated as the exercise price for 195,278 shares of associated stock options. After such repayment, a total of 675,990 shares that had previously been used to secure all of the partial recourse notes taken by the executive were considered issued and outstanding. See Note 19, Related Party Transactions, for additional information.

Leases - Summary of Maturities of Lease Liabilities (Detail) $ in Thousands	Dec. 31, 2023 USD ($)
Lessee Disclosure [Abstract]
Operating leases, 2024	$ 9,799
Operating leases, 2025	8,823
Operating leases, 2026	7,542
Operating leases, 2027	13,275
Operating leases, 2028	3,570
Operating leases, Thereafter	15,108
Operating leases, Total lease payments	58,117
Operating leases, Less: interest	(7,966)
Operating leases, Total lease liabilities	50,151
Finance leases, 2024	1,278
Finance leases, 2025	1,278
Finance leases, 2026	737
Finance leases, Total lease payments	3,293
Finance leases, Less: interest	(324)
Finance leases, Total lease liabilities	$ 2,969

Long-Term Debt Obligations - Future payments of term loan (Detail) $ in Thousands	Dec. 31, 2023 USD ($)
2024	$ 5,625
2025	6,563
2026	54,375
Total	$ 66,563

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Share-Based Compensation - Summary of Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Number of Shares Outstanding	5,931,742
Number of Shares Granted	3,554,528	1,418,224
Number of Shares Canceled / forfeited	(146,224)
Number of Shares Outstanding	9,340,046	5,931,742
Number of Shares Options Exercisable	3,999,380
Number of Shares Options vested or expected to vest	8,488,262
Weighted Average Exercise Price Outstanding	$ 5.91
Weighted Average Exercise Price Granted	2.51
Weighted Average Exercise Price Cancelled / forfeited	7.09
Weighted Average Exercise Price Outstanding	4.6	$ 5.91
Weighted Average Exercise Price Options Exercisable	4.57
Weighted Average Exercise Price Options Vested or Expected to Vest	$ 4.66
Weighted Average Remaining Contractual Term (in years) Outstanding	6 years 7 months 28 days	6 years 1 month 20 days
Weighted Average Remaining Contractual Term (in years) Options Exercisable	4 years 29 days
Weighted Average Remaining Contractual Term (in years) Options Vested or Expected to Vest	6 years 5 months 8 days
Aggregate Intrinsic Value Outstanding	$ 10,267	$ 2,245
Aggregate Intrinsic Value Options Exercisable	4,681
Aggregate Intrinsic Value Options Vested or Expected to Vest	$ 9,227

Share-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Summary of Unvested Restricted Stock Units

The activity of restricted stock units is set forth below:


				Weighted
				Average
	Number			Grant Date
	of Shares			Fair Value
Unvested at December 31, 2022		1,381,500		$	7.62
Granted		3,192,372		$	2.47
Vested		(522,651	)	$	7.28
Canceled/Forfeited		(152,890	)	$	5.21
Unvested at December 31, 2023		3,898,331		$	3.54

Schedule of Fair Value of Stock Options Granted to Employees and Directors

The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods are as follows, presented on a weighted-average basis:


	Year Ended
	December 31,
	2023			2022

Risk-free interest rate		4.00	%		1.92	%
Expected term (in years)		6.25			6.25
Expected volatility		51.00	%		50.66	%
Expected dividend yield		0.0	%		0.0	%
Underlying stock price	$	2.47		$	7.87

Summary of Stock Option Activity

The following table summarizes the Company’s stock option activity since December 31, 2022:


						Weighted
				Weighted		Average
				Average		Remaining		Aggregate
	Number of			Exercise		Contractual		Intrinsic
	Shares			Price		Term		Value
						(in years)
Outstanding as of December 31, 2022		5,931,742		$	5.91		6.14	$	2,245
Granted		3,554,528		$	2.51
Canceled / forfeited		(146,224	)	$	7.09
Outstanding as of December 31, 2023		9,340,046		$	4.60		6.66	$	10,267
Options exercisable as of December 31, 2023		3,999,380		$	4.57		4.08	$	4,681
Options vested or expected to vest as of December 31, 2023		8,488,262		$	4.66		6.44	$	9,227

Significant Accounting Policies

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Significant Accounting Policies

Use of Estimates

Principles of Consolidation

Foreign Currency

Segment Reporting

Cash and Cash Equivalents

Restricted Cash

The Company had restricted cash of $498 and $812 as of December 31, 2023 and 2022, respectively. Restricted cash represents employee deposits in connection with the Company’s health benefit plan.

Accounts Receivable, Net

Inventories

Property and Equipment, Net


Leasehold improvements		Lesser of the life of the lease or the economic life of the asset
Building		30 years
Furniture and computers		3 - 5 years
Equipment		5 - 10 years

Goodwill

Intangible Assets Subject to Amortization


Trade names and trademarks		1-12 years
Developed technology		6-12 years
Customer relationships		10 years
Non-compete agreements		5 years

Impairment of Long-Lived Assets

Revenue Recognition

Product Revenue

Reserves for Variable Consideration

Product Returns

Rebates and Allowances

GPO Fees

Other Revenue Policies

Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue.

Disaggregation of Revenue

The following table sets forth revenue by product category:


	Year Ended December 31,
	2023		2022		2021
Advanced Wound Care	$	405,514	$	422,231	$	430,237
Surgical and Sports Medicine		27,626		28,662		37,122
Total revenue	$	433,140	$	450,893	$	467,359

For all periods presented, net revenue generated outside the United States represented less than 1% of total net revenue.

License and manufacturing agreement

Stock-Based Compensation

Advertising

Research and Development Costs

Valuation of Contingent Purchase Earnout

Income Taxes

Fair Value of Financial Instruments

•

Level 1—Quoted prices in active markets for identical assets or liabilities.

•

Earnings per Share (EPS)

Recently Adopted Accounting Pronouncements

Recently Issued Accounting Pronouncements Not Yet Adopted

Significant Accounting Policies - Schedule of Revenue by Product Category (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Total revenue	$ 433,140	$ 450,893	$ 467,359
Advanced Wound Care
Total revenue	405,514	422,231	430,237
Surgical & Sports Medicine
Total revenue	$ 27,626	$ 28,662	$ 37,122

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

+ Details

Accounts receivable, net (Tables)

12 Months Ended

Dec. 31, 2023

Receivables [Abstract]

Schedule of accounts receivable

Accounts receivable consisted of the following:


	December 31,
	2023			2022
Accounts receivable	$	88,859		$	95,812
Less - allowance for credit losses		(6,860	)		(6,362	)
	$	81,999		$	89,450

Schedule of allowance for doubtful accounts

The Company’s allowance for credit losses is comprised of the following:


Balance as of December 31, 2021	$	5,153
Additions		1,781
Write-offs		(572	)
Balance as of December 31, 2022	$	6,362
Cumulative-effect adjustment from adoption of ASU 2016-13, net of tax (Note 2)		615
Additions		1,297
Write-offs		(1,414	)
Balance as of December 31, 2023	$	6,860

Prepaid Expenses and Other Current Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Subscriptions	$ 5,866	$ 4,211
Prepaid licensing fee (Note 18)	2,368
Conferences and marketing expenses	945	106
Deposits	872	635
Insurance	85	54
Other	318	80
Prepaid Expense	$ 10,454	$ 5,086

Leases - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended		60 Months Ended
	Aug. 11, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2027	Sep. 30, 2023	Jun. 30, 2023	Apr. 30, 2023	Aug. 31, 2021
Variable lease expenses		$ 5,595	$ 5,082
Right-of-use asset		40,118	$ 43,192
Right-of-use asset		2,975
Loss on lease termination		(559)
Lease liability		50,151
Lease liability		$ 2,969
Property and equipment [Member]
Right-of-use asset								$ 4,943
275 Dan Road SPE LLC [Member]
Purchase of building under the lease amount	$ 6,013
Percentage of amount required to pay for the accrued but unpaid lease obligations associated with building	50.00%
Dan Road Leases [Member] \| Scenario Forecast [Member]
Variable lease expenses				$ 8,060
Contract Manufacturing Organization [Member]
Right-of-use asset						$ 2,106
Lease liability						$ 2,106
Medical Garments [Member] \| Liability [Member]
Lease liability					$ 2,701
Medical Garments [Member] \| Property and equipment [Member]
Right-of-use asset							$ 750
Fleet Lease
Lessee, operating lease, term of contract		367 days
Maximum
Lessee, operating lease, renewal term		10 years
Minimum
Lessee, operating lease, renewal term		5 years

Restructuring

12 Months Ended

Dec. 31, 2023

Restructuring and Related Activities [Abstract]

Restructuring

11. Restructuring

In order to reduce the Company’s cost structure and improve operating efficiency, the Company consolidates its manufacturing operations in various locations into Massachusetts facilities.

On October 21, 2020, the Company committed to a plan to restructure the workforce and operations in its La Jolla, California facilities. The restructuring involved 65 employees and was substantially completed as of December 31, 2021, with certain facility and storage activities continuing through 2024. On March 9, 2022, the Company committed to a plan to restructure the workforce and operations in its Birmingham, Alabama facilities. The restructuring involved approximately 25 employees and was substantially completed as of December 31, 2022, with minimal expenses incurred in 2023.

On February 3, 2023, the Company committed to a plan to restructure its workforce to increase productivity and enhance profitability. The reduction in force reduced the Company’s headcount by 71 employees, or approximately 7% of all employees. The Company incurred total employee-related charges of $1,609 in connection with the restructuring, primarily consisting of severance payments. It was substantially completed as of March 31, 2023.

On October 27, 2023, the Company committed to a plan to restructure its workforce to increase productivity and enhance profitability. The reduction in force reduced the Company’s headcount by 49 employees, or approximately 5% of all employees. The Company incurred a total charge of $1,820 in the fourth quarter of 2023, primarily consisting of severance payments.

As a result of the restructuring activities, the Company incurred pre-tax charges of $3,796, $2,268 and $4,704 in the years ended December 31, 2023, 2022, and 2021, respectively. These charges were included in selling, general and administrative expenses in the consolidated statements of operations and comprehensive income. The liability related to the restructuring activities was $904 and $1,192 as of December 31, 2023 and 2022, respectively, and was included in accrued expenses and other current liabilities in the consolidated balance sheets. The following table provides a rollforward of the restructuring liability.


	Employee			Other			Total
Liability balance as of December 31, 2020		618			—			618
Expenses		3,513			1,191			4,704
Cash distributions		(1,614	)		(540	)		(2,154	)
Liability balance as of December 31, 2021		2,517			651			3,168
Expenses		1,557			711			2,268
Cash distributions		(3,064	)		(1,180	)		(4,244	)
Liability balance as of December 31, 2022		1,010			182			1,192
Expenses		3,429			367			3,796
Cash distributions and other adjustments		(3,535	)		(549	)		(4,084	)
Liability balance as of December 31, 2023	$	904		$	—		$	904

Fair Value Measurement of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Summary of Fair Value of Earnout liability


	Earnout liability
Balance as of December 31, 2020	$	3,985
Change in fair value		(3,985	)
Balance as of December 31, 2021		—
Change in fair value		—
Balance as of June 30, 2022	$	—