Globus Medical (GMED) 10-Q 3 Aug 23 2023 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2023	Aug. 01, 2023
Document and Entity Information [Abstract]
Document Quarterly Report	true
Document Transition Report	false
Document Type	10-Q
Document Period End Date	Jun. 30, 2023
Entity Registrant Name	GLOBUS MEDICAL, INC.
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Title of 12(b) Security	Class A Common Stock, par value $.001 per share
Trading Symbol	GMED
Security Exchange Name	NYSE
Entity File Number	001-35621
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-3744954
Entity Address, Address Line One	2560 General Armistead Avenue
Entity Address, City or Town	Audubon
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19403-5214
City Area Code	610
Local Phone Number	930-1800
Amendment Flag	false
Entity Common Stock, Shares Outstanding		100,460,697
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001237831
Current Fiscal Year End Date	--12-31

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 306,452	$ 150,466
Short-term marketable securities	306,376	295,592
Accounts receivable, net of allowances of $6,245 and $4,724, respectively	240,184	213,247
Inventories	335,556	298,981
Prepaid expenses and other current assets	19,684	20,997
Income taxes receivable	1,758	4,061
Total current assets	1,210,010	983,344
Property and equipment, net of accumulated depreciation of $364,215 and $343,036, respectively	248,048	243,729
Long-term marketable securities	391,521	495,852
Intangible assets, net	54,901	63,574
Goodwill	198,932	197,471
Other assets	47,215	43,311
Deferred income taxes	61,838	48,845
Total assets	2,212,465	2,076,126
Current liabilities:
Accounts payable	33,811	36,101
Accrued expenses	89,606	94,705
Income taxes payable	1,758	990
Business acquisition liabilities	13,595	13,308
Deferred revenue	14,945	14,100
Payable to broker	1,505
Total current liabilities	155,220	159,204
Business acquisition liabilities, net of current portion	52,455	54,950
Deferred income taxes	5,299	1,779
Other liabilities	14,426	13,820
Total liabilities	227,400	229,753
Commitments and contingencies (Note 15)
Equity:
Additional paid-in capital	657,240	630,952
Accumulated other comprehensive income/(loss)	(19,067)	(24,630)
Retained earnings	1,346,792	1,239,951
Total equity	1,985,065	1,846,373
Total liabilities and equity	2,212,465	2,076,126
Common Class A [Member]
Equity:
Common stock	78	78
Common Class B [Member]
Equity:
Common stock	$ 22	$ 22

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parentheticals) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Accounts receivable, allowances	$ 6,245	$ 4,724
Property and equipment
Accumulated depreciation	$ 364,215	$ 343,036
Equity:
Common stock, shares authorized	775,000,000
Common Class A [Member]
Equity:
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	500,000,000	500,000,000
Common stock, shares issued	78,013,122	77,762,282
Common stock, shares outstanding	78,013,122	77,762,282
Common Class B [Member]
Equity:
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	275,000,000	275,000,000
Common stock, shares issued	22,430,097	22,430,097
Common stock, shares outstanding	22,430,097	22,430,097

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME [Abstract]
Net sales	$ 291,615	$ 263,648	$ 568,303	$ 494,197
Cost of goods sold	76,473	68,470	147,298	127,637
Gross profit	215,142	195,178	421,005	366,560
Operating expenses:
Research and development	21,347	17,395	42,429	34,807
Selling, general and administrative	120,069	106,718	242,485	207,466
Provision for litigation, net	(2,740)		(2,740)	2,341
Amortization of intangibles	4,547	4,393	9,148	8,905
Acquisition related costs	5,707	(1,104)	7,068	(1,180)
Total operating expenses	148,930	127,402	298,390	252,339
Operating income/(loss)	66,212	67,776	122,615	114,221
Other income/(expense), net
Interest income/(expense), net	8,294	2,476	14,791	5,019
Foreign currency transaction gain/(loss)	(548)	(1,107)	(336)	(1,498)
Other income/(expense)	716	1,395	793	1,696
Total other income/(expense), net	8,462	2,764	15,248	5,217
Income/(loss) before income taxes	74,674	70,540	137,863	119,438
Income tax provision	16,962	15,950	31,022	26,764
Net income/(loss)	57,712	54,590	106,841	92,674
Other comprehensive income/(loss), net of tax:
Unrealized gain/(loss) on marketable securities	40	(5,031)	4,338	(13,859)
Foreign currency translation gain/(loss)	315	(3,170)	1,225	(4,737)
Total other comprehensive income/(loss), net of tax	355	(8,201)	5,563	(18,596)
Comprehensive income/(loss)	$ 58,067	$ 46,389	$ 112,404	$ 74,078
Earnings per share:
Basic	$ 0.57	$ 0.54	$ 1.06	$ 0.92
Diluted	$ 0.57	$ 0.53	$ 1.05	$ 0.90
Weighted average shares outstanding:
Basic	100,373	100,671	100,326	101,136
Diluted	101,782	102,884	101,989	103,480

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF EQUITY - USD ($) shares in Thousands, $ in Thousands	Common Stock [Member] Common Class A [Member]	Common Stock [Member] Common Class B [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Income/(Loss) [Member]	Retained Earnings [Member]	Total
Shares, Outstanding, Beginning Balance at Dec. 31, 2021	79,114	22,430
Total equity, beginning of period at Dec. 31, 2021	$ 79	$ 22	$ 553,787	$ (6,772)	$ 1,194,272	$ 1,741,388
Stock-based compensation			8,353			8,353
Grant of restricted stock units			196			196
Exercise of stock options (shares)	184
Exercise of stock options			7,746			7,746
Comprehensive income/(loss)				(10,395)	38,084	27,689
Total equity, end of period at Mar. 31, 2022	$ 79	$ 22	570,082	(17,167)	1,232,356	1,785,372
Shares, Outstanding, Ending Balance at Mar. 31, 2022	79,298	22,430
Shares, Outstanding, Beginning Balance at Dec. 31, 2021	79,114	22,430
Total equity, beginning of period at Dec. 31, 2021	$ 79	$ 22	553,787	(6,772)	1,194,272	1,741,388
Comprehensive income/(loss)						74,078
Total equity, end of period at Jun. 30, 2022	$ 77	$ 22	581,907	(25,368)	1,142,455	1,699,093
Shares, Outstanding, Ending Balance at Jun. 30, 2022	77,037	22,430
Shares, Outstanding, Beginning Balance at Mar. 31, 2022	79,298	22,430
Total equity, beginning of period at Mar. 31, 2022	$ 79	$ 22	570,082	(17,167)	1,232,356	1,785,372
Stock-based compensation			8,020			8,020
Grant of restricted stock units			220			220
Exercise of stock options (shares)	90
Exercise of stock options			3,585			3,585
Comprehensive income/(loss)				(8,201)	54,590	46,389
Repurchase and retirement of common stock (shares)	(2,351)
Repurchase and retirement of common stock	$ (2)				(144,491)	(144,493)
Total equity, end of period at Jun. 30, 2022	$ 77	$ 22	581,907	(25,368)	1,142,455	1,699,093
Shares, Outstanding, Ending Balance at Jun. 30, 2022	77,037	22,430
Shares, Outstanding, Beginning Balance at Dec. 31, 2022	77,762	22,430
Total equity, beginning of period at Dec. 31, 2022	$ 78	$ 22	630,952	(24,630)	1,239,951	1,846,373
Stock-based compensation			9,032			9,032
Grant of restricted stock units			219			219
Exercise of stock options (shares)	143
Exercise of stock options			4,859			4,859
Comprehensive income/(loss)				5,208	49,129	54,337
Total equity, end of period at Mar. 31, 2023	$ 78	$ 22	645,062	(19,422)	1,289,080	1,914,820
Shares, Outstanding, Ending Balance at Mar. 31, 2023	77,905	22,430
Shares, Outstanding, Beginning Balance at Dec. 31, 2022	77,762	22,430
Total equity, beginning of period at Dec. 31, 2022	$ 78	$ 22	630,952	(24,630)	1,239,951	$ 1,846,373
Exercise of stock options (shares)						251
Comprehensive income/(loss)						$ 112,404
Total equity, end of period at Jun. 30, 2023	$ 78	$ 22	657,240	(19,067)	1,346,792	1,985,065
Shares, Outstanding, Ending Balance at Jun. 30, 2023	78,013	22,430
Shares, Outstanding, Beginning Balance at Mar. 31, 2023	77,905	22,430
Total equity, beginning of period at Mar. 31, 2023	$ 78	$ 22	645,062	(19,422)	1,289,080	1,914,820
Stock-based compensation			8,639			8,639
Grant of restricted stock units			340			340
Exercise of stock options (shares)	108
Exercise of stock options			3,199			3,199
Comprehensive income/(loss)				355	57,712	58,067
Total equity, end of period at Jun. 30, 2023	$ 78	$ 22	$ 657,240	$ (19,067)	$ 1,346,792	$ 1,985,065
Shares, Outstanding, Ending Balance at Jun. 30, 2023	78,013	22,430

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash flows from operating activities:
Net income	$ 106,841	$ 92,674
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	36,183	33,764
Amortization of premium (discount) on marketable securities	786	3,208
Write-down for excess and obsolete inventories, net	3,972	4,068
Stock-based compensation expense	17,542	15,989
Allowance for doubtful accounts	1,863	(528)
Change in fair value of business acquisition liabilities	3,280	(1,390)
Change in deferred income taxes	(11,160)	(7,939)
(Gain)/loss on disposal of assets, net	129	200
Payment of business acquisition related liabilities	(1,490)	(1,099)
(Increase)/decrease in:
Accounts receivable	(28,237)	(30,224)
Inventories	(38,658)	(31,421)
Prepaid expenses and other assets	(2,100)	1,268
Increase/(decrease) in:
Accounts payable	(2,769)	12,375
Accrued expenses and other liabilities	(888)	(7,408)
Income taxes payable/receivable	3,047	(1,964)
Net cash provided by/(used in) operating activities	88,341	81,573
Cash flows from investing activities:
Purchases of marketable securities	(81,381)	(179,096)
Maturities of marketable securities	159,328	170,572
Sales of marketable securities	21,788	66,655
Purchases of property and equipment	(33,859)	(43,724)
Acquisition of businesses, net of cash acquired and purchases of intangible and other assets	(2,662)	(1,175)
Net cash provided by/(used in) investing activities	63,214	13,232
Cash flows from financing activities:
Payment of business acquisition liabilities	(4,034)	(3,553)
Proceeds from exercise of stock options	8,058	11,331
Repurchase of common stock		(144,493)
Net cash provided by/(used in) financing activities	4,024	(136,715)
Effect of foreign exchange rates on cash	407	(387)
Net increase/(decrease) in cash and cash equivalents	155,986	(42,297)
Cash and cash equivalents at beginning of period	150,466	193,069
Cash and cash equivalents at end of period	306,452	150,772
Supplemental disclosures of cash flow information:
Income taxes paid	38,979	36,696
Purchases of property and equipment included in accounts payable and accrued expenses	$ 5,366	$ 5,019

BACKGROUND

BACKGROUND	6 Months Ended
	Jun. 30, 2023
BACKGROUND [Abstract]
Background	NOTE 1. BACKGROUND (a) The Company Globus Medical, Inc., together with its subsidiaries, is a medical device company that develops and commercializes healthcare solutions with a mission to improve the quality of life of patients with musculoskeletal disorders. We are primarily focused on implants that promote healing in patients with musculoskeletal disorders, including the use of a robotic guidance and navigation system and products to treat patients who have experienced orthopedic traumas. We are an engineering-driven company with a history of rapidly developing and commercializing advanced products and procedures to assist surgeons in effectively treating their patients and to address new treatment options. With over 230 products launched, we offer a comprehensive portfolio of innovative and differentiated technologies that address a variety of musculoskeletal pathologies, anatomies, and surgical approaches. We are headquartered in Audubon, Pennsylvania, and market and sell our products through our exclusive sales force in the United States, as well as within North, Central & South America, Europe, Asia, Africa and Australia. The sales force consists of direct sales representatives and distributor sales representatives employed by exclusive independent distributors. The terms the “Company,” “Globus,” “we,” “us” and “our” refer to Globus Medical, Inc. and, where applicable, our consolidated subsidiaries. (b) NuVasive Agreement and Plan of Merger On February 8, 2023, the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with NuVasive, Inc. (“NuVasive”) and Zebra Merger Sub Inc. (“Merger Sub”), a wholly owned subsidiary of the Company, pursuant to which Merger Sub will merge with and into NuVasive (the “Merger”), with NuVasive surviving as a wholly owned subsidiary of the Company. Under the Merger Agreement, at the effective time of the Merger, each share of common stock, par value $ 0.001 per share, of NuVasive issued and outstanding immediately prior to the effective time (other than certain excluded shares as described in the Merger Agreement) will be cancelled and converted into the right to receive 0.75 fully paid and non-assessable shares of Class A common stock of Globus Medical, $ 0.001 par value per share, and the right to receive cash in lieu of fractional shares. On April 27, 2023, the Merger and related transactions were approved by stockholders of the Company and NuVasive. The Company expects that the Merger will close in the third quarter of 2023, subject to the expiration or termination of the waiting period under the HSR Act and the satisfaction or waiver of the other customary closing conditions. As previously disclosed, in connection with the Merger, the Company and NuVasive filed notification and report forms (the “HSR Filing”) under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended (the “HSR Act”) with the U.S. Federal Trade Commission (the “FTC”) and on March 31, 2023, the Company, in consultation with NuVasive, voluntarily withdrew its HSR Filing. The Company refiled on April 3, 2023 in order to restart the initial waiting period under the HSR Act and to provide the FTC additional time to review the proposed transaction. On May 3, 2023, the Company and NuVasive each received a request for additional information and documentary materials (the “Second Request”) from the FTC in connection with the FTC’s review of the Merger. The effect of the Second Request is to extend the waiting period imposed by the HSR Act, unless that period is extended voluntarily by the parties or terminated sooner by the FTC. Both parties are continuing to work cooperatively with the FTC in its review. Completion of the Merger remains subject to the expiration or termination of the waiting period under the HSR Act and the satisfaction or waiver of the other closing conditions specified in the Merger Agreement. For more information about the Merger, please refer to our Current Reports on Form 8-K filed on February 9, 2023, April 3, 2023, April 17, 2023, April 28, 2023 and May 3, 2023.

SUMMARY OF SIGNIFICANT ACCOUNTI

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	6 Months Ended
	Jun. 30, 2023
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES [Abstract]
Summary Of Significant Accounting Policies	NOTE 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (a) Basis of Presentation The accompanying interim unaudited condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial statements and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, certain information and footnote disclosures normally included in complete financial statements prepared in accordance with U.S. GAAP have been condensed or omitted pursuant to the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”). As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the consolidated financial statements and accompanying footnotes included in our Annual Report on Form 10-K for the year ended December 31, 2022. In the opinion of management, these condensed consolidated financial statements include all adjustments necessary, which are of a normal and recurring nature, for the fair presentation of our financial position as of June 30, 2023, and results of operations for the three and six months ended June 30, 2023. The results of operations for any interim period may not be indicative of results for the full year. (b) Principles of Consolidation The accompanying unaudited condensed consolidated financial statements include the accounts of Globus and its majority-owned or controlled subsidiaries. All intercompany balances and transactions are eliminated in consolidation. (c) Use of Estimates The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We base our estimates, in part, on historical experience that management believes to be reasonable under the circumstances. Actual results could differ from those estimates. Estimates and assumptions are periodically reviewed and the effects of revisions are reflected in the condensed consolidated financial statements in the period they are determined to be necessary. Significant areas that require estimates include revenue recognition, intangible assets, business acquisition liabilities, allowance for doubtful accounts, stock-based compensation, reserves for excess and obsolete inventory, useful lives of assets, the outcome of litigation, recoverability of intangible assets and income taxes. We are subject to risks and uncertainties due to changes in the healthcare environment, regulatory oversight, competition, and legislation that may cause actual results to differ from estimated results. (d) Revenue Recognition Revenue is recognized upon transfer of control of promised products or services to customers in an amount that reflects the consideration we expect to receive in exchange for those products or services. Sales and other taxes we collect concurrent with revenue-producing activities are excluded from revenue. For purposes of disclosure, we disaggregate our revenue into two categories, Musculoskeletal Solutions and Enabling Technologies. Our Musculoskeletal Solutions products consist primarily of the implantable devices, disposables, and unique instruments used in an expansive range of spine, orthopedic trauma, hip, knee and extremity procedures. The majority of our Musculoskeletal Solutions contracts have a single performance obligation and revenue is recognized at a point in time. Our Enabling Technologies products are advanced hardware and software systems, and related technologies that are designed to enhance a surgeon’s capabilities and streamline surgical procedures by making them less invasive, more accurate, and more reproducible to improve patient care. The majority of our Enabling Technologies product contracts contain multiple performance obligations, including maintenance and support, and revenue is recognized as we fulfill each performance obligation. When contracts have multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our policy is to classify shipping and handling costs billed to customers as sales and the related expenses as cost of goods sold. Nature of Products and Services A significant portion of our Musculoskeletal Solutions product revenue is generated from consigned inventory maintained at hospitals or with sales representatives. Revenue from the sale of consigned musculoskeletal products is recognized when we transfer control, which occurs at the time the product is used or implanted. For all other Musculoskeletal Solutions product transactions, we recognize revenue when we transfer title to the goods, provided there are no remaining performance obligations that can affect the customer’s final acceptance of the sale. Revenue from the sale of Enabling Technologies products is generally recognized when control transfers to the customer which occurs at the time the product is shipped or delivered. Any revenue related to the provision of maintenance and support is recognized as we satisfy the performance obligation. We use an observable price to determine the stand-alone selling price for each separate performance obligation. Contract Balances Timing of revenue recognition may differ from the timing of invoicing to customers. We record a receivable when revenue is recognized prior to invoicing, or deferred revenue when revenue is recognized subsequent to invoicing. Deferred revenue is comprised mainly of unearned revenue related to the sales of certain Enabling Technologies products, which includes maintenance and support services. Maintenance and support services are generally invoiced annually, at the beginning of each contract period, and revenue is recognized ratably over the maintenance period. For the three and six months ended June 30, 2023, there was an immaterial amount of revenue recognized from previously deferred revenue. (e) Cash and Cash Equivalents The Company considers all short-term, highly liquid investments with original maturities of 90 days or less at acquisition date to be cash equivalents. Cash equivalents, which consist of money market accounts, commercial paper, government securities, and corporate debt securities are stated at fair value. (f) Marketable Securities Our marketable securities include municipal bonds, corporate debt securities, commercial paper, asset-backed securities, and securities of government, federal agency, and other sovereign obligations and are classified as available-for-sale as of June 30, 2023. S hort-term and long-term marketable securities are recorded at fair value on our condensed consolidated balance sheets. Any change in fair value of our available-for-sale securities, that do not result in recognition or reversal of an allowance for credit loss or write-down, are recorded, net of taxes, as a component of accumulated other comprehensive income or loss on our condensed consolidated balance sheets. Premiums and discounts are recognized over the life of the related security as an adjustment to yield using the straight-line method. Realized gains or losses from the sale of marketable securities are determined on a specific identification basis. Realized gains and losses, interest income and the amortization/accretion of premiums/discounts are included as a component of other income/(expense), net, on our condensed consolidated statements of operations and comprehensive income. Interest receivable is recorded as a component of prepaid expenses and other current assets on our condensed consolidated balance sheets. We invest in securities that meet or exceed standards as defined in our investment policy. Our policy also limits the amount of credit exposure to any one issue, issuer or type of security. We review declines in the fair value of our securities to determine whether they are resulting from expected credit losses or other factors. If the assessment indicates a credit loss exists, we recognize any measured impairment as an allowance for credit loss in our condensed consolidated statements of operations. Any other impairments not recorded through allowance for credit losses is recognized in our other comprehensive income. (g) Fair Value Measurements Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis Fair value is defined as the 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 the liability in an orderly transaction between market participants on the measurement date. Additionally, a fair value hierarchy was established that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets and liabilities and the lowest priority to unobservable inputs. The level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. Our assets and liabilities measured at fair value on a recurring basis are classified and disclosed in one of the following three categories: Level 1—quoted prices (unadjusted) in active markets for identical assets and liabilities; Level 2—observable inputs other than quoted prices in active markets for identical assets and liabilities; and Level 3—unobservable inputs in which there is little or no market data available, which require the reporting entity to use significant unobservable inputs or valuation techniques. Assets and Liabilities That Are Measured at Fair Value on a Nonrecurring Basis The purchase price of business acquisitions is primarily allocated to the tangible and identifiable intangible assets acquired and liabilities assumed based on their estimated fair values on the acquisition date, with the excess recorded as goodwill. We utilize Level 3 inputs in the determination of the initial fair value. Contingent consideration represents contingent milestone, performance and revenue-sharing payment obligations related to acquisitions and is measured at fair value, based on significant inputs that are not observable in the market, which represents a Level 3 measurement within the fair value hierarchy. The valuation of contingent consideration uses assumptions we believe would be made by a market participant. We assess these assumptions on an ongoing basis as additional data impacting the assumptions is obtained. The fair value of contingent consideration is recorded in business acquisition liabilities on our condensed consolidated balance sheets, and changes in the fair value of contingent consideration are recognized in acquisition related costs in the condensed consolidated statements of operations and comprehensive income. The fair value of contingent restricted stock unit (“RSU”) grants are recorded as additional paid-in capital in the consolidated balance sheet on the day of the grant due to the remote likelihood of forfeiture. (h) Inventories Inventories are stated at the lower of cost or net realizable value. Cost is determined on a first-in, first-out basis. The majority of our inventory is finished goods and we utilize both in-house manufacturing and third-party suppliers to produce our products. We periodically evaluate the carrying value of our inventories in relation to estimated forecasts of product demand, which takes into consideration the life cycle of product releases. When quantities on hand exceed estimated sales forecasts, we record a write-down for such excess inventories. Once inventory has been written down, it creates a new cost basis for inventory that is not subsequently written up. (i) Goodwill and Intangible Assets Goodwill represents the excess of purchase price over the fair values of the identifiable assets acquired less the liabilities assumed in the acquisition of a business. Goodwill is tested for impairment at least annually or whenever events or circumstances indicate that a carrying amount may not be recoverable. Goodwill is tested for impairment at the reporting unit level by comparing the reporting unit’s carrying amount to the estimated fair value of the reporting unit. Fair values are estimated using an income and discounted cash flow approach. We perform our annual impairment test of goodwill in the fourth quarter of each year. We consider qualitative indicators of the fair value of a reporting unit when it is unlikely that a reporting unit has impaired goodwill. Intangible assets consist of purchased in-process research and development (“IPR&D”), developed technology, supplier network, patents, customer relationships, re-acquired rights, and non-compete agreements. Intangible assets with finite useful lives are amortized over the period of estimated benefit using the straight-line method and estimated useful lives ranging from 1 to 21 years. Intangible assets with finite useful lives are tested whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable. If an impairment is indicated, we measure the amount of the impairment loss as the amount by which the carrying amount exceeds the fair value of the asset. Fair value is generally determined using a discounted future cash flow analysis. IPR&D has an indefinite life and is not amortized until completion of the project at which time the IPR&D becomes an amortizable asset. Intangible assets with indefinite useful lives are tested for impairment annually or whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable. If the related project is not completed in a timely manner, we may have an impairment related to the IPR&D, calculated as the excess of the asset’s carrying value over its fair value. During the three and six months ended June 30, 2023, there were no impairments in goodwill, finite-lived intangible assets, and IPR&D. (j) Stock -Based Compensation The cost of employee and non-employee director awards is measured at the grant date fair value of the award and is recognized as expense over the requisite service period, which is generally the vesting period of the equity award. Compensation expense for awards includes the impact of forfeiture in the period when they occur. We estimate the fair value of stock options utilizing the Black-Scholes option-pricing model. Inputs to the Black-Scholes model include our stock price, expected volatility, expected term, risk-free interest rate and expected dividends. Expected volatility is based on the historical volatility of the Company’s common stock over the most recent period commensurate with the estimated expected term of the Company’s stock options offering period which is derived from historical experience. The risk-free interest rate assumption is based on observed interest rates of U.S. Treasury securities appropriate for the expected terms of the stock options. The dividend yield assumption is based on the history and expectation of no dividend payouts. The fair value of restricted stock units is estimated on the day of grant based on the closing price of the Company’s common stock. (k) Recently Issued Accounting Pronouncements None applicable. (l) Recently Adopted Accounting Pronouncements On March 12, 2020, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standard Update (“ASU”) No. 2020-04, Facilitation of the Effects of Reference Rate Reform on Financial Reporting , which provides optional expedients and exceptions for applying generally accepted accounting principles to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another reference rate expected to be discontinued. The ASU became effective for all entities as of March 12, 2020, and applied through December 31, 2022. On December 21, 2022, the FASB issued ASU 2022-06, Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848, which extends the period of time entities can utilize the reference rate reform relief guidance under ASU 2020-04 from December 31, 2022 to December 31, 2024. This standard did not have a material impact on our financial position, results of operations and disclosures.

ASSET ACQUISITIONS AND BUSINESS

ASSET ACQUISITIONS AND BUSINESS COMBINATIONS	6 Months Ended
	Jun. 30, 2023
ASSET ACQUISITIONS AND BUSINESS COMBINATIONS [Abstract]
Asset Acquisitions And Business Combinations	NOTE 3. ASSET ACQUISITIONS AND BUSINESS COMBINATIONS Asset Acquisitions During the fourth quarter of 2021, the Company acquired substantially all the assets of Capstone Surgical Technologies, LLC, which engages in the business of advanced drill and robotic surgery platforms. The purchase price consisted of $ 24.5 million of cash paid at closing, subject to net working capital and other post-closing adjustments, if applicable. The transaction also provides for additional consideration contingent upon the developed products obtaining approval from the U.S. Food and Drug Administration (the “FDA”) of up to $ 15.0 million, and additional consideration contingent upon the achievement of certain performance obligations of up to $ 10.0 million. Contingent consideration is not recorded in an asset acquisition until the milestone is met. Also during the fourth quarter of 2021, the Company acquired substantially all the assets of a company that engages in the development of technology for use in robotic surgery platforms which was not considered material to the consolidated financial statements during the periods presented. The purchase price consisted of $ 10.0 million of cash paid at closing and also provides for additional consideration contingent upon the achievement of certain performance obligations of $ 5.0 million. Contingent consideration is not recorded in an asset acquisition until the milestone is met. The Company accounted for both of these transactions as asset acquisitions as substantially all of the fair value of the assets acquired in each transaction was concentrated in a single identified asset, in-process research and development (“IPR&D”) of the acquired technology, thus satisfying the requirements of the screen test in ASU 2017-1. At the date of the acquisitions, the Company determined that the development of the projects underway had not yet reached technological feasibility and that the research in process had no alternative future use. Accordingly, the acquired IPR&D of $ 34.3 million was charged to research and development expense in the condensed consolidated statements of operations and comprehensive income for the year ended 2021. Business Combinations During the first quarter of 2023, the Company completed one acquisition that was not considered material to the condensed consolidated financial statements and has been included in our financial statements from the date of acquisition. The purchase price consisted of approximately $ 1.4 million of cash. The Company recorded identifiable assets of $ 0.4 million of instruments and $ 1.0 million of inventory. During the fourth quarter of 2022, the Company acquired the membership interests of Harvest Biologics LLC, which engages in the business of selling systems that produce autologous biologics. The purchase price consisted of approximately $ 30.0 million of cash paid at closing, plus $ 1.4 million of preliminary post-closing adjustments. The Company recorded identifiable net assets, based on their estimated fair values, for inventory of $ 3.2 million, goodwill of $ 15.3 million, customer relationships and other intangibles of $ 10.5 million with a weighted average useful life of 20 years, and developed technology of $ 2.4 million with a weighted average useful life of 8 years. The Company will finalize the purchase price allocation of the assets and liabilities acquired within one year from the date of acquisition. During the second quarter of 2022, the Company completed one acquisition that was not considered material to the overall condensed consolidated financial statements during the periods presented. This acquisition has been included in the condensed consolidated financial statements from the date of acquisition. The purchase price consisted of approximately $ 0.2 million of cash paid at closing and $ 4.4 million of contingent consideration payments, resulting in goodwill of $ 4.6 million based on the estimated fair values. The contingent payments for this acquisition are based upon achieving various performance milestones over a period of 10 years and are payable in a combination of cash and RSUs. During 2021, the Company completed three acquisitions that were not considered material, individually or collectively, to the condensed consolidated financial statements during the periods presented. Two acquisitions were completed in the third quarter, while the third acquisition was completed in the fourth quarter. These acquisitions have been included in the condensed consolidated financial statements from the date of acquisition. The purchase price of the acquisition in the fourth quarter consisted of approximately $ 0.3 million of cash paid at closing and $ 13.0 million of contingent consideration payments, resulting in goodwill of $ 13.3 million based on the estimated fair values. The combined purchase price of the two acquisitions in the third quarter consisted of approximately $ 12.6 million of contingent consideration payments. The Company recorded other intangible assets of $ 1.6 million, with a weighted average useful life of 3.8 years, and goodwill of $ 11.0 million based on their estimated fair values. The contingent payments for all three acquisitions are based upon achieving various performance obligations over a period of 10 years and are payable in a combination of cash and RSUs.

NET SALES

NET SALES	6 Months Ended
	Jun. 30, 2023
NET SALES [Abstract]
Net Sales	NOTE 4. NET SALES The following table represents net sales by product category: Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Musculoskeletal Solutions $ 256,855 $ 234,242 $ 508,462 $ 451,644 Enabling Technologies 34,760 29,406 59,841 42,553 Total net sales $ 291,615 $ 263,648 $ 568,303 $ 494,197

MARKETABLE SECURITIES

MARKETABLE SECURITIES	6 Months Ended
	Jun. 30, 2023
MARKETABLE SECURITIES [Abstract]
Marketable Securities	NOTE 5. MARKETABLE SECURITIES The composition of our short-term and long-term marketable securities was as follows: JJ June 30, 2023 (In thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Short-term: Municipal bonds $ 79,668 $ — $ ( 848 ) $ 78,820 Corporate debt securities 188,355 2 ( 3,495 ) 184,862 Commercial paper 7,139 — ( 1 ) 7,138 Asset-backed securities 4,200 — ( 98 ) 4,102 Government, federal agency, and other sovereign obligations 31,891 — ( 437 ) 31,454 Total short-term marketable securities $ 311,253 $ 2 $ ( 4,879 ) $ 306,376 Long-term: Municipal bonds $ 45,260 $ — $ ( 1,178 ) $ 44,082 Corporate debt securities 193,642 10 ( 4,541 ) 189,111 Asset-backed securities 111,344 — ( 2,381 ) 108,963 Government, federal agency, and other sovereign obligations 50,584 — ( 1,219 ) 49,365 Total long-term marketable securities $ 400,830 $ 10 $ ( 9,319 ) $ 391,521 December 31, 2022 (In thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Short-term: Municipal bonds $ 83,279 $ 9 $ ( 1,680 ) $ 81,608 Corporate debt securities 187,174 2 ( 3,438 ) 183,738 Commercial paper 5,583 — ( 1 ) 5,582 Asset-backed securities 4,200 — ( 181 ) 4,019 Government, federal agency, and other sovereign obligations 21,102 1 ( 458 ) 20,645 Total short-term marketable securities $ 301,338 $ 12 $ ( 5,758 ) $ 295,592 Long-term: Municipal bonds $ 61,986 $ 44 $ ( 1,549 ) $ 60,481 Corporate debt securities 268,524 72 ( 8,947 ) 259,649 Asset-backed securities 120,929 217 ( 2,795 ) 118,351 Government, federal agency, and other sovereign obligations 58,453 18 ( 1,100 ) 57,371 Total long-term marketable securities $ 509,892 $ 351 $ ( 14,391 ) $ 495,852 The short-term marketable securities have effective maturity dates of less than one year and the long-term marketable securities have effective maturity dates ranging from one to three years as of June 30, 2023 and December 31, 2022, respectively. Purchases of marketable securities include amounts payable to brokers of $ 1.5 million as of June 30, 2023.

FAIR VALUE MEASUREMENTS

FAIR VALUE MEASUREMENTS	6 Months Ended
	Jun. 30, 2023
FAIR VALUE MEASUREMENTS [Abstract]
Fair Value Measurements	NOTE 6. FAIR VALUE MEASUREMENTS Assets and liabilities measured at fair value on a recurring basis included the following: (In thousands) Balance at June 30, 2023 Level 1 Level 2 Level 3 Assets: Cash equivalents $ 134,407 $ 14,875 $ 119,532 $ — Municipal bonds 122,902 — 122,902 — Corporate debt securities 373,973 — 373,973 — Commercial paper 7,138 — 7,138 — Asset-backed securities 113,065 — 113,065 — Government, federal agency, and other sovereign obligations 80,819 — 80,819 — Liabilities: Business acquisition liabilities 65,352 — — 65,352 (In thousands) Balance at December 31, 2022 Level 1 Level 2 Level 3 Assets: Cash equivalents $ 17,655 $ 17,655 $ — $ — Municipal bonds 142,089 — 142,089 — Corporate debt securities 443,387 — 443,387 — Commercial paper 5,582 — 5,582 — Asset-backed securities 122,370 — 122,369 — Government, federal agency, and other sovereign obligations 78,016 — 78,016 — Liabilities: Business acquisition liabilities 68,258 — — 68,258 Our marketable securities and certain cash equivalents are classified as Level 2 within the fair value hierarchy, as we measure their fair value using market prices for similar instruments and inputs such as actual trade data, benchmark yields, broker/dealer quotes and other similar data obtained from quoted market prices or independent pricing vendors. Assets and Liabilities That Are Measured at Fair Value on a Nonrecurring Basis Fair value of the revenue-based business acquisition liabilities was determined using a discounted cash flow model and an option pricing methodology. The significant inputs of such models are not observable in the market, such as certain financial metric growth rates, volatility and discount rates, market price risk adjustment, projections associated with the applicable milestone, the interest rate, and the related probabilities and payment structure in the contingent consideration arrangement. The following are the significant unobservable inputs used in the two valuation techniques: Unobservable input Range Weighted Average* Revenue risk premium 2.3 % - 4.7 % 2.7 % Revenue volatility 14.0 % - 15.8 % 14.8 % Discount rate 6.1 % - 8.5 % 6.6 % Projected year of payment 2023 - 2032 * The weighted average rates were calculated based on the relative fair value of each business acquisition liability. The change in the carrying value of the business acquisition liabilities during the three and six months ended June 30, 2023 and 2022, respectively included the following: Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Beginning balance $ 64,882 $ 68,036 $ 68,258 $ 70,525 Purchase price contingent consideration — 4,414 — 4,414 Contingent cash payments ( 2,832 ) ( 2,193 ) ( 5,524 ) ( 4,607 ) Contingent RSU grants ( 340 ) ( 220 ) ( 559 ) ( 416 ) Changes in fair value of business acquisition liabilities 3,726 ( 1,126 ) 3,280 ( 1,390 ) Contractual payable reclassification ( 84 ) ( 597 ) ( 103 ) ( 212 ) Ending balance $ 65,352 $ 68,314 $ 65,352 $ 68,314 Changes in the fair value of business acquisition liabilities are driven by changes in market conditions and the achievement of certain performance conditions.

INVENTORIES

INVENTORIES	6 Months Ended
	Jun. 30, 2023
INVENTORIES [Abstract]
Inventories	NOTE 7. INVENTORIES Inventories included the following: June 30, December 31, (In thousands) 2023 2022 Raw materials $ 74,965 $ 60,324 Work in process 23,579 18,699 Finished goods 237,012 219,958 Total inventories $ 335,556 $ 298,981 During the three months ended June 30, 2023 and 2022, net adjustments to cost of sales related to excess and obsolete inventory were $ 1.9 million and $ 2.3 million, respectively. The net adjustments for the three months ended June 30, 2023 and 2022 reflect a combination of additional expense for excess and obsolete related provisions ($ 3.4 million and $ 5.2 million, respectively) offset by sales and disposals ($ 1.5 million and $ 2.9 million, respectively) of inventory for which an excess and obsolete provision was provided previously through expense recognized in prior periods. During the six months ended June 30, 2023 and 2022, net adjustments to cost of sales related to excess and obsolete inventory were $ 4.0 million and $ 4.1 million, respectively. The net adjustments for the six months ended June 30, 2023 and 2022 reflect a combination of additional expense for excess and obsolete related provisions ($ 6.9 million and $ 8.6 million, respectively) offset by sales and disposals ($ 2.9 million and $ 4.5 million, respectively) of inventory for which an excess and obsolete provision was provided previously through expense recognized in prior periods.

PROPERTY AND EQUIPMENT

PROPERTY AND EQUIPMENT	6 Months Ended
	Jun. 30, 2023
PROPERTY AND EQUIPMENT [Abstract]
Property And Equipment	NOTE 8. PROPERTY AND EQUIPMENT Property and equipment included the following: Useful June 30, December 31, (In thousands) Life 2023 2022 Land — $ 8,286 $ 8,277 Buildings and improvements 31.5 55,801 51,510 Equipment 5 - 15 152,897 148,803 Instruments 5 331,356 312,055 Modules and cases 5 49,480 48,023 Other property and equipment 3 - 5 14,443 18,097 612,263 586,765 Less: accumulated depreciation ( 364,215 ) ( 343,036 ) Total $ 248,048 $ 243,729 Instruments are hand-held devices used by surgeons to install implants during surgery. Modules and cases are used to store and transport the instruments and implants. Depreciation expense related to property and equipment was as follows: Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Depreciation $ 13,528 $ 12,535 $ 27,035 $ 24,860

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS	6 Months Ended
	Jun. 30, 2023
GOODWILL AND INTANGIBLE ASSETS [Abstract]
Goodwill And Intangible Assets	NOTE 9. GOODWILL AND INTANGIBLE ASSETS The change in the carrying amount of goodwill during the twelve months ended December 31, 2022 and the six months ended June 30, 2023, respectively included the following: (In thousands) December 31, 2021 $ 179,708 Additions and adjustments 18,799 Foreign exchange ( 1,036 ) December 31, 2022 197,471 Additions and adjustments 1,123 Foreign exchange 338 June 30, 2023 $ 198,932 Intangible assets as of June 30, 2023 included the following: June 30, 2023 (In thousands) Weighted Average Amortization Period (in years) Gross Carrying Amount Accumulated Amortization Intangible Assets, net Supplier network 10.0 $ 4,000 $ ( 3,467 ) $ 533 Customer relationships & other intangibles 8.8 60,323 ( 43,450 ) 16,873 Developed technology 8.0 75,923 ( 43,306 ) 32,617 Patents 16.1 9,058 ( 4,180 ) 4,878 Total intangible assets $ 149,304 $ ( 94,403 ) $ 54,901 Intangible assets as of December 31, 2022 included the following: December 31, 2022 (In thousands) Weighted Average Amortization Period (in years) Gross Carrying Amount Accumulated Amortization Intangible Assets, net Supplier network 10.0 $ 4,000 $ ( 3,267 ) $ 733 Customer relationships & other intangibles 8.7 62,324 ( 41,651 ) 20,673 Developed technology 8.0 75,087 ( 37,984 ) 37,103 Patents 16.1 8,885 ( 3,820 ) 5,065 Total intangible assets $ 150,296 $ ( 86,722 ) $ 63,574 The following table summarizes amortization of intangible assets for future periods as of June 30, 2023 : (In thousands) Annual Amortization Remaining 2023 $ 7,673 2024 14,050 2025 9,764 2026 6,320 2027 5,231 Thereafter 11,863 Total $ 54,901

ACCRUED EXPENSES

ACCRUED EXPENSES	6 Months Ended
	Jun. 30, 2023
ACCRUED EXPENSES [Abstract]
Accrued Expenses	NOTE 10. ACCRUED EXPENSES Accrued expenses as of June 30, 2023 and December 31, 2022, respectively included the following: June 30, December 31, (In thousands) 2023 2022 Compensation and other employee-related costs $ 46,730 $ 53,352 Legal and other settlements and expenses 6,279 5,564 Accrued non-income taxes 10,248 10,029 Royalties 4,331 4,375 Rebates 11,203 10,501 Other 10,815 10,884 Total accrued expenses $ 89,606 $ 94,705

DEBT

DEBT	6 Months Ended
	Jun. 30, 2023
DEBT [Abstract]
Debt	NOTE 11. DEBT Line of Credit In August 2020, we entered into a credit agreement with Citizens Bank, N.A. (the “Credit Agreement”) that provided a revolving credit facility permitting borrowings up to $ 125.0 million (as amended, the “Revolving Credit Facility”). The Revolving Credit Facility included up to a $ 25.0 million sub limit for letters of credit. Revolving loans under the Credit Agreement bore interest, at the Company’s option, at either a base rate or the Bloomberg Short-Term Bank Yield Index Rate (the “Daily BSBY Rate”) (as defined in the Revolving Credit Facility), plus, in each case, an applicable margin, as determined in accordance with the provisions of the Credit Agreement. The base rate was the highest of: the rate of interest announced publicly by Citizens Bank, N.A. from time to time as its “prime rate”; the federal funds effective rate plus 1/2 of 1 %; and the Daily BSBY Rate plus 1 %. The applicable margin was subject to adjustment as provided in the Credit Agreement. The Credit Agreement contained financial and other customary covenants, including a maximum leverage ratio. As of June 30, 2023, we had no t borrowed under the Revolving Credit Facility. The Revolving Credit Facility expired on August 2, 2023 .

EQUITY

EQUITY	6 Months Ended
	Jun. 30, 2023
EQUITY [Abstract]
Equity	NOTE 12. EQUITY Share Repurchases On March 11, 2020, the Company announced a share repurchase program, which authorized the Company to repurchase up to $ 200.0 million of the Company’s Class A common stock (“Class A Common”). On March 4, 2022, the share repurchase program was expanded by authorizing the Company to repurchase an additional $ 200.0 million of the Company’s Class A Common. The repurchase program has no time limit and may be suspended for periods or discontinued at any time. The Company did no t repurchase any Class A Common during the three and six months ended June 30, 2023. As of June 30, 2023, the Company has remaining authorization to repurchase a total of $ 150.8 million of Class A common stock. The timing and actual number of shares repurchased will depend on various factors including price, corporate and regulatory requirements, debt covenant requirements, alternative investment opportunities and other market conditions. F unding of share repurchases is expected to come from operating cash flows and excess cash. Shares repurchased by the Company are accounted for under the constructive retirement method, in which the shares repurchased, are immediately retired, as there is no plan to reissue the shares. The Company made an accounting policy election to charge the excess of repurchase price over par value entirely to retained earnings. Common Stock Our amended and restated Certificate of Incorporation provides for a total of 775,000,000 authorized shares of common stock. Of the authorized number of shares of common stock, 500,000,000 shares are designated as Class A Common, and 275,000,000 shares are designated as Class B common stock (“Class B Common”). The holders of Class A Common are entitled to one vote for each share of Class A Common held. Each share of our Class B Common is convertible at any time at the option of the holder into one share of our Class A Common. In addition, each share of our Class B Common will convert automatically into one share of our Class A Common upon any transfer, whether or not for value, except for permitted transfers. For more details relating to the conversion of our Class B Common please see “Exhibit 4.2, Description of Securities of the Registrant” filed with our Annual Report on Form 10-K on February 21, 2023. The holders of Class B Common are entitled to 10 votes for each share of Class B Common held. The holders of Class A Common and Class B Common vote together as one class of common stock. Except for voting rights, the Class A Common and Class B Common have the same rights and privileges. Accumulated Other Comprehensive Income (Loss) The tables below present the changes in each component of accumulated other comprehensive income/(loss), including current period other comprehensive income/(loss) and reclassifications out of accumulated other comprehensive income/(loss) for the six months ended June 30, 2023 and 2022, respectively: (In thousands) Unrealized loss on marketable securities, net of tax Foreign currency translation adjustments Accumulated other comprehensive loss Accumulated other comprehensive income/(loss), net of tax, at December 31, 2022 $ ( 15,093 ) $ ( 9,537 ) $ ( 24,630 ) Other comprehensive income/(loss) before reclassifications 5,657 1,225 6,882 Amounts reclassified from accumulated other comprehensive income/(loss), net of tax ( 1,319 ) — ( 1,319 ) Other comprehensive income/(loss), net of tax 4,338 1,225 5,563 Accumulated other comprehensive income/(loss), net of tax, at June 30, 2023 $ ( 10,755 ) $ ( 8,312 ) $ ( 19,067 ) (In thousands) Unrealized loss on marketable securities, net of tax Foreign currency translation adjustments Accumulated other comprehensive loss Accumulated other comprehensive income/(loss), net of tax, at December 31, 2021 $ ( 1,053 ) $ ( 5,719 ) $ ( 6,772 ) Other comprehensive income/(loss) before reclassifications ( 18,204 ) ( 4,737 ) ( 22,941 ) Amounts reclassified from accumulated other comprehensive income/(loss), net of tax 4,345 — 4,345 Other comprehensive income/(loss), net of tax ( 13,859 ) ( 4,737 ) ( 18,596 ) Accumulated other comprehensive income/(loss), net of tax, at June 30, 2022 $ ( 14,912 ) $ ( 10,456 ) $ ( 25,368 ) Amounts reclassified from accumulated other comprehensive loss, net of tax, related to unrealized gains/losses on marketable securities were released to other income, net in our condensed consolidated statements of operations and comprehensive income. Earnings Per Common Share The Company computes basic earnings per share using the weighted-average number of common shares outstanding during the period. Diluted earnings per share assumes the conversion, exercise or issuance of all potential common stock equivalents, unless the effect of inclusion would be anti-dilutive. For purposes of this calculation, common stock equivalents include the Company’s stock options and unvested RSUs. The contingently issuable shares are included in basic net income per share as of the date that all necessary conditions have been satisfied and are included in the denominator for dilutive calculation for the entire period if such shares would be issuable as of the end of the reporting period assuming the end of the reporting period was the end of the contingency period. The following table sets forth the computation of basic and diluted earnings per share: Three Months Ended Six Months Ended June 30, June 30, (In thousands, except per share amounts) 2023 2022 2023 2022 Numerator: Net income/(loss) 57,712 $ 54,590 $ 106,841 $ 92,674 Denominator for basic and diluted net income per share: Weighted average shares outstanding for basic 100,373 100,671 100,326 101,136 Dilutive stock options and RSUs 1,409 2,213 1,663 2,344 Weighted average shares outstanding for diluted 101,782 102,884 101,989 103,480 Earnings per share: Basic 0.57 $ 0.54 $ 1.06 $ 0.92 Diluted 0.57 $ 0.53 $ 1.05 $ 0.90 Anti-dilutive stock options and RSUs excluded from the calculation 5,768 3,419 5,576 3,397

STOCK-BASED AWARDS

STOCK-BASED AWARDS	6 Months Ended
	Jun. 30, 2023
STOCK-BASED AWARDS [Abstract]
Stock-Based Awards	NOTE 13. STOCK-BASED AWARDS We have two stock plans: our 2012 Equity Incentive Plan (the “2012 Plan”) and our 2021 Equity Incentive Plan (the “2021 Plan”), together with the 2012 Plan, the “Plans”. The 2021 Plan is the only active stock plan. The purpose of the 2012 Plan was, and of the 2021 Plan is, to provide incentive to employees, directors, and consultants of Globus. The Plans are administered by the Board of Directors of Globus (the “Board”) or its delegates. The number, type of option, exercise price, and vesting terms are determined by the Board or its delegates in accordance with the terms of the Plans. The options granted expire on a date specified by the Board, which is ten years from the grant date. Options granted to employees vest in varying installments over a four-year period. The 2012 Plan was approved by our Board in March 2012, and by our stockholders in June 2012. The 2012 Plan terminated as to new awards pursuant to its terms in 2022. Following effectiveness of the 2021 Plan, we have not issued any additional awards under the 2012 Plan; however, awards previously granted under the 2012 Plan remain outstanding and are administered by our Board under the terms and conditions of the 2012 Plan. Under the 2012 Plan, the aggregate number of shares of Class A Common that were able to be issued subject to options and other awards is equal to the sum of (i) 3,076,923 shares, (ii) any shares available for issuance under the 2008 Equity Incentive Plan as of March 13, 2012, (iii) any shares underlying awards outstanding under the 2008 Plan as of March 13, 2012 that, on or after that date, are forfeited, terminated, expired or lapse for any reason, or are settled for cash without delivery of shares and (iv) starting January 1, 2013, an annual increase in the number of shares available under the 2012 Plan equal to up to 3 % of the number of shares of our common and preferred stock outstanding at the end of the previous year, as determined by our Board. The number of shares that were able to be issued or transferred pursuant to incentive stock options under the 2012 Plan was limited to 10,769,230 shares. The shares of Class A Common covered by the 2012 Plan included authorized but unissued shares, treasury shares or shares of common stock purchased on the open market. The 2021 Plan was approved by our Board in March 2021, and by our stockholders in June 2021. Under the 2021 Plan, as amended to date, the aggregate number of shares of Class A Common that are able to be issued subject to options and other awards is equal to the sum of (i) 8,000,000 shares, (ii) any shares available for issuance under the 2012 Plan as of June 3, 2021 and (iii) any shares underlying awards outstanding under the 2012 Plan or 2021 Plan as of June 3, 2021 that, on or after that date, are forfeited, terminated, expired or lapse for any reason, or are settled for cash without delivery of shares. The number of shares that may be issued or transferred pursuant to incentive stock options under the 2021 Plan is limited to 8,000,000 shares. The shares of Class A Common covered by the 2021 Plan include authorized but unissued shares, treasury shares or shares of common stock purchased on the open market. As of June 30, 2023, pursuant to the 2021 Plan, there were 9,745,676 shares of Class A Common reserved and 5,451,650 shares of Class A Common available for future grants. Stock Options Stock option activity during the six months ended June 30, 2023 is summarized as follows: Option Shares (thousands) Weighted average exercise price Weighted average remaining contractual life (years) Aggregate intrinsic value (thousands) Outstanding at December 31, 2022 10,338 $ 51.86 Granted 1,400 60.00 Exercised ( 251 ) 32.72 Forfeited ( 227 ) 63.86 Outstanding at June 30, 2023 11,260 $ 53.05 6.8 $ 104,480 Exercisable at June 30, 2023 6,501 $ 47.42 5.5 $ 87,249 Expected to vest at June 30, 2023 4,759 $ 60.75 8.4 $ 17,231 The total intrinsic value of stock options exercised was $ 2.8 million and $ 2.7 million during the three months ended June 30, 2023, and 2022, respectively. The total intrinsic value of stock options exercised was $ 8.1 million and $ 7.4 million during the six months ended June 30, 2023, and 2022, respectively. The fair value of the options was estimated on the date of the grant using a Black-Scholes option pricing model with the following assumptions: Six Months Ended June 30, 2023 2022 Risk-free interest rate 3.45 % - 4.10 % 1.46 % - 3.36 % Expected term (years) 4.7 4.7 - 4.8 Expected volatility 35.0 % - 38.0 % 34.0 % - 35.0 % Expected dividend yield —% —% The weighted average grant date fair value of stock options granted during the three ended June 30, 2023, and 2022 was $ 21.61 and $ 23.93 per share, respectively. The weighted average grant date fair value of stock options granted during the six months ended June 30, 2023, and 2022 was $ 22.21 and $ 21.05 per share, respectively. Restricted Stock Units Restricted stock unit activity during the three and six months ended June 30, 2023 is summarized as follows: Restricted Stock Units (thousands) Weighted average grant date fair value per share Weighted average remaining contractual life (years) Outstanding at December 31, 2022 60 $ 67.40 Granted 10 58.90 Vested — — Forfeited — — Outstanding at June 30, 2023 70 $ 66.24 7.3 Stock-Based Compensation Compensation expense related to stock options granted to employees and non-employees under the Plans was as follows: Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Stock-based compensation expense $ 8,589 $ 7,837 $ 17,542 $ 15,989 Net stock-based compensation capitalized into inventory 50 184 128 384 Total stock-based compensation cost $ 8,639 $ 8,021 $ 17,670 $ 16,373 As of June 30, 2023, there was $ 85.3 million of unrecognized compensation expense related to unvested employee stock options that vest over a weighted average period of three years .

INCOME TAXES

INCOME TAXES	6 Months Ended
	Jun. 30, 2023
INCOME TAXES [Abstract]
Income Taxes	NOTE 14. INCOME TAXES In computing our income tax provision, we make certain estimates and judgments, such as estimated annual taxable income or loss, annual effective tax rate, the nature and timing of permanent and temporary differences between taxable income for financial reporting and tax reporting, and the recoverability of deferred tax assets. Our estimates and assumptions may change as new events occur, additional information is obtained, or as the tax environment changes. Should facts and circumstances change during a quarter causing a material change to the estimated effective income tax rate, a cumulative adjustment is recorded. The following table provides a summary of our effective tax rate for the three and six months ended June 30, 2023 and 2022, respectively: Three Months Ended Six Months Ended June 30, June 30, 2023 2022 2023 2022 Effective income tax rate 22.7 % 22.6 % 22.5 % 22.4 %

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	6 Months Ended
	Jun. 30, 2023
COMMITMENTS AND CONTINGENCIES [Abstract]
Commitments And Contingencies	NOTE 15. COMMITMENTS AND CONTINGENCIES We are involved in a number of proceedings, legal actions, and claims arising in the ordinary course of business. Such matters are subject to many uncertainties, and the outcomes of these matters are not within our control and may not be known for prolonged periods of time. In some actions, the claimants seek damages, as well as other relief, including injunctions prohibiting us from engaging in certain activities, which, if granted, could require significant expenditures and/or result in lost revenues. We record a liability in the condensed consolidated financial statements for these actions when a loss is considered probable and the amount can be reasonably estimated. If the reasonable estimate of a probable loss is a range, and no amount in the range is a better estimate than any other, the minimum amount of the range is accrued. If a loss is reasonably possible, but not known or probable, and can be reasonably estimated, the estimated loss or range of loss is disclosed. In most cases, significant judgment is required to estimate the amount and timing of a loss to be recorded. While it is not possible to predict the outcome for most of the matters discussed, we believe it is possible that costs associated with them could have a material adverse impact on our consolidated earnings, financial position or cash flows. Moskowitz Family LLC Litigation On November 20, 2019, Moskowitz Family LLC filed suit against us in the U.S. District Court for the Western District of Texas for patent infringement. Moskowitz, a non-practicing entity, alleges that Globus willfully infringes one or more claims of six patents by making, using, offering for sale or selling the COALITION ® , COALITION MIS ® , COALITION AGX ® , CORBEL ® , MONUMENT ® , MAGNIFY ® -S, HEDRON IA TM , HEDRON IC ® , INDEPENDENCE ® , INDEPENDENCE MIS ® , INDEPENDENCE MIS AGX ® , FORTIFY ® and XPAND ® families, SABLE ® , RISE ® , RISE ® INTRALIF, RISE ® -L, ELSA ® , ELSA ® ATP, ALTERA ® , ARIEL ® , CALIBER ® and CALIBER ® -L products. Moskowitz seeks monetary damages and injunctive relief. On July 2, 2020, this suit was transferred from the U.S. District Court for the Western District of Texas to the U.S. District Court for the Eastern District of Pennsylvania. The outcome of this litigation cannot be determined, nor can we estimate a range of potential loss, therefore, we have no t recorded a liability related to this litigation as of June 30, 2023 .

SEGMENT AND GEOGRAPHIC INFORMAT

SEGMENT AND GEOGRAPHIC INFORMATION	6 Months Ended
	Jun. 30, 2023
SEGMENT AND GEOGRAPHIC INFORMATION [Abstract]
Segment And Geographic Information	NOTE 16. SEGMENT AND GEOGRAPHIC INFORMATION Operating segments are defined as components of an enterprise for which separate financial information is available and evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. We manage our business globally within one operating segment, and segment information is consistent with how the chief operating decision makers review the business, make investing and resource allocation decisions and assess operating performance. The following table represents total net sales by geographic area, based on the location of the customer: Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 United States $ 245,490 $ 225,280 $ 479,609 $ 421,683 International 46,125 38,368 88,694 72,514 Total net sales $ 291,615 $ 263,648 $ 568,303 $ 494,197

SUMMARY OF SIGNIFICANT ACCOUN_2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policy)	6 Months Ended
	Jun. 30, 2023
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES [Abstract]
Basis of Presentation	Basis of Presentation The accompanying interim unaudited condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial statements and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, certain information and footnote disclosures normally included in complete financial statements prepared in accordance with U.S. GAAP have been condensed or omitted pursuant to the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”). As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the consolidated financial statements and accompanying footnotes included in our Annual Report on Form 10-K for the year ended December 31, 2022. In the opinion of management, these condensed consolidated financial statements include all adjustments necessary, which are of a normal and recurring nature, for the fair presentation of our financial position as of June 30, 2023, and results of operations for the three and six months ended June 30, 2023. The results of operations for any interim period may not be indicative of results for the full year.
Principles of Consolidation	Principles of Consolidation The accompanying unaudited condensed consolidated financial statements include the accounts of Globus and its majority-owned or controlled subsidiaries. All intercompany balances and transactions are eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We base our estimates, in part, on historical experience that management believes to be reasonable under the circumstances. Actual results could differ from those estimates. Estimates and assumptions are periodically reviewed and the effects of revisions are reflected in the condensed consolidated financial statements in the period they are determined to be necessary. Significant areas that require estimates include revenue recognition, intangible assets, business acquisition liabilities, allowance for doubtful accounts, stock-based compensation, reserves for excess and obsolete inventory, useful lives of assets, the outcome of litigation, recoverability of intangible assets and income taxes. We are subject to risks and uncertainties due to changes in the healthcare environment, regulatory oversight, competition, and legislation that may cause actual results to differ from estimated results.
Revenue Recognition	Revenue Recognition Revenue is recognized upon transfer of control of promised products or services to customers in an amount that reflects the consideration we expect to receive in exchange for those products or services. Sales and other taxes we collect concurrent with revenue-producing activities are excluded from revenue. For purposes of disclosure, we disaggregate our revenue into two categories, Musculoskeletal Solutions and Enabling Technologies. Our Musculoskeletal Solutions products consist primarily of the implantable devices, disposables, and unique instruments used in an expansive range of spine, orthopedic trauma, hip, knee and extremity procedures. The majority of our Musculoskeletal Solutions contracts have a single performance obligation and revenue is recognized at a point in time. Our Enabling Technologies products are advanced hardware and software systems, and related technologies that are designed to enhance a surgeon’s capabilities and streamline surgical procedures by making them less invasive, more accurate, and more reproducible to improve patient care. The majority of our Enabling Technologies product contracts contain multiple performance obligations, including maintenance and support, and revenue is recognized as we fulfill each performance obligation. When contracts have multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our policy is to classify shipping and handling costs billed to customers as sales and the related expenses as cost of goods sold. Nature of Products and Services A significant portion of our Musculoskeletal Solutions product revenue is generated from consigned inventory maintained at hospitals or with sales representatives. Revenue from the sale of consigned musculoskeletal products is recognized when we transfer control, which occurs at the time the product is used or implanted. For all other Musculoskeletal Solutions product transactions, we recognize revenue when we transfer title to the goods, provided there are no remaining performance obligations that can affect the customer’s final acceptance of the sale. Revenue from the sale of Enabling Technologies products is generally recognized when control transfers to the customer which occurs at the time the product is shipped or delivered. Any revenue related to the provision of maintenance and support is recognized as we satisfy the performance obligation. We use an observable price to determine the stand-alone selling price for each separate performance obligation. Contract Balances Timing of revenue recognition may differ from the timing of invoicing to customers. We record a receivable when revenue is recognized prior to invoicing, or deferred revenue when revenue is recognized subsequent to invoicing. Deferred revenue is comprised mainly of unearned revenue related to the sales of certain Enabling Technologies products, which includes maintenance and support services. Maintenance and support services are generally invoiced annually, at the beginning of each contract period, and revenue is recognized ratably over the maintenance period. For the three and six months ended June 30, 2023, there was an immaterial amount of revenue recognized from previously deferred revenue.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all short-term, highly liquid investments with original maturities of 90 days or less at acquisition date to be cash equivalents. Cash equivalents, which consist of money market accounts, commercial paper, government securities, and corporate debt securities are stated at fair value.
Marketable Securities	Marketable Securities Our marketable securities include municipal bonds, corporate debt securities, commercial paper, asset-backed securities, and securities of government, federal agency, and other sovereign obligations and are classified as available-for-sale as of June 30, 2023. S hort-term and long-term marketable securities are recorded at fair value on our condensed consolidated balance sheets. Any change in fair value of our available-for-sale securities, that do not result in recognition or reversal of an allowance for credit loss or write-down, are recorded, net of taxes, as a component of accumulated other comprehensive income or loss on our condensed consolidated balance sheets. Premiums and discounts are recognized over the life of the related security as an adjustment to yield using the straight-line method. Realized gains or losses from the sale of marketable securities are determined on a specific identification basis. Realized gains and losses, interest income and the amortization/accretion of premiums/discounts are included as a component of other income/(expense), net, on our condensed consolidated statements of operations and comprehensive income. Interest receivable is recorded as a component of prepaid expenses and other current assets on our condensed consolidated balance sheets. We invest in securities that meet or exceed standards as defined in our investment policy. Our policy also limits the amount of credit exposure to any one issue, issuer or type of security. We review declines in the fair value of our securities to determine whether they are resulting from expected credit losses or other factors. If the assessment indicates a credit loss exists, we recognize any measured impairment as an allowance for credit loss in our condensed consolidated statements of operations. Any other impairments not recorded through allowance for credit losses is recognized in our other comprehensive income.
Fair Value Measurements	Fair Value Measurements Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis Fair value is defined as the 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 the liability in an orderly transaction between market participants on the measurement date. Additionally, a fair value hierarchy was established that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets and liabilities and the lowest priority to unobservable inputs. The level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. Our assets and liabilities measured at fair value on a recurring basis are classified and disclosed in one of the following three categories: Level 1—quoted prices (unadjusted) in active markets for identical assets and liabilities; Level 2—observable inputs other than quoted prices in active markets for identical assets and liabilities; and Level 3—unobservable inputs in which there is little or no market data available, which require the reporting entity to use significant unobservable inputs or valuation techniques. Assets and Liabilities That Are Measured at Fair Value on a Nonrecurring Basis The purchase price of business acquisitions is primarily allocated to the tangible and identifiable intangible assets acquired and liabilities assumed based on their estimated fair values on the acquisition date, with the excess recorded as goodwill. We utilize Level 3 inputs in the determination of the initial fair value. Contingent consideration represents contingent milestone, performance and revenue-sharing payment obligations related to acquisitions and is measured at fair value, based on significant inputs that are not observable in the market, which represents a Level 3 measurement within the fair value hierarchy. The valuation of contingent consideration uses assumptions we believe would be made by a market participant. We assess these assumptions on an ongoing basis as additional data impacting the assumptions is obtained. The fair value of contingent consideration is recorded in business acquisition liabilities on our condensed consolidated balance sheets, and changes in the fair value of contingent consideration are recognized in acquisition related costs in the condensed consolidated statements of operations and comprehensive income. The fair value of contingent restricted stock unit (“RSU”) grants are recorded as additional paid-in capital in the consolidated balance sheet on the day of the grant due to the remote likelihood of forfeiture.
Inventories	Inventories Inventories are stated at the lower of cost or net realizable value. Cost is determined on a first-in, first-out basis. The majority of our inventory is finished goods and we utilize both in-house manufacturing and third-party suppliers to produce our products. We periodically evaluate the carrying value of our inventories in relation to estimated forecasts of product demand, which takes into consideration the life cycle of product releases. When quantities on hand exceed estimated sales forecasts, we record a write-down for such excess inventories. Once inventory has been written down, it creates a new cost basis for inventory that is not subsequently written up.
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill represents the excess of purchase price over the fair values of the identifiable assets acquired less the liabilities assumed in the acquisition of a business. Goodwill is tested for impairment at least annually or whenever events or circumstances indicate that a carrying amount may not be recoverable. Goodwill is tested for impairment at the reporting unit level by comparing the reporting unit’s carrying amount to the estimated fair value of the reporting unit. Fair values are estimated using an income and discounted cash flow approach. We perform our annual impairment test of goodwill in the fourth quarter of each year. We consider qualitative indicators of the fair value of a reporting unit when it is unlikely that a reporting unit has impaired goodwill. Intangible assets consist of purchased in-process research and development (“IPR&D”), developed technology, supplier network, patents, customer relationships, re-acquired rights, and non-compete agreements. Intangible assets with finite useful lives are amortized over the period of estimated benefit using the straight-line method and estimated useful lives ranging from 1 to 21 years. Intangible assets with finite useful lives are tested whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable. If an impairment is indicated, we measure the amount of the impairment loss as the amount by which the carrying amount exceeds the fair value of the asset. Fair value is generally determined using a discounted future cash flow analysis. IPR&D has an indefinite life and is not amortized until completion of the project at which time the IPR&D becomes an amortizable asset. Intangible assets with indefinite useful lives are tested for impairment annually or whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable. If the related project is not completed in a timely manner, we may have an impairment related to the IPR&D, calculated as the excess of the asset’s carrying value over its fair value. During the three and six months ended June 30, 2023, there were no impairments in goodwill, finite-lived intangible assets, and IPR&D.
Stock-Based Compensation	Stock -Based Compensation The cost of employee and non-employee director awards is measured at the grant date fair value of the award and is recognized as expense over the requisite service period, which is generally the vesting period of the equity award. Compensation expense for awards includes the impact of forfeiture in the period when they occur. We estimate the fair value of stock options utilizing the Black-Scholes option-pricing model. Inputs to the Black-Scholes model include our stock price, expected volatility, expected term, risk-free interest rate and expected dividends. Expected volatility is based on the historical volatility of the Company’s common stock over the most recent period commensurate with the estimated expected term of the Company’s stock options offering period which is derived from historical experience. The risk-free interest rate assumption is based on observed interest rates of U.S. Treasury securities appropriate for the expected terms of the stock options. The dividend yield assumption is based on the history and expectation of no dividend payouts. The fair value of restricted stock units is estimated on the day of grant based on the closing price of the Company’s common stock.
Recently Issued Accounting Pronouncements & Recently Adopted Accounting Pronouncements	(k) Recently Issued Accounting Pronouncements None applicable. (l) Recently Adopted Accounting Pronouncements On March 12, 2020, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standard Update (“ASU”) No. 2020-04, Facilitation of the Effects of Reference Rate Reform on Financial Reporting , which provides optional expedients and exceptions for applying generally accepted accounting principles to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another reference rate expected to be discontinued. The ASU became effective for all entities as of March 12, 2020, and applied through December 31, 2022. On December 21, 2022, the FASB issued ASU 2022-06, Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848, which extends the period of time entities can utilize the reference rate reform relief guidance under ASU 2020-04 from December 31, 2022 to December 31, 2024. This standard did not have a material impact on our financial position, results of operations and disclosures.

NET SALES (Tables)

NET SALES (Tables)	6 Months Ended
	Jun. 30, 2023
NET SALES [Abstract]
Schedule of Net Sales by Product Category	Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Musculoskeletal Solutions $ 256,855 $ 234,242 $ 508,462 $ 451,644 Enabling Technologies 34,760 29,406 59,841 42,553 Total net sales $ 291,615 $ 263,648 $ 568,303 $ 494,197

MARKETABLE SECURITIES (Tables)

MARKETABLE SECURITIES (Tables)	6 Months Ended
	Jun. 30, 2023
MARKETABLE SECURITIES [Abstract]
Composition of Marketable Securities	The composition of our short-term and long-term marketable securities was as follows: JJ June 30, 2023 (In thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Short-term: Municipal bonds $ 79,668 $ — $ ( 848 ) $ 78,820 Corporate debt securities 188,355 2 ( 3,495 ) 184,862 Commercial paper 7,139 — ( 1 ) 7,138 Asset-backed securities 4,200 — ( 98 ) 4,102 Government, federal agency, and other sovereign obligations 31,891 — ( 437 ) 31,454 Total short-term marketable securities $ 311,253 $ 2 $ ( 4,879 ) $ 306,376 Long-term: Municipal bonds $ 45,260 $ — $ ( 1,178 ) $ 44,082 Corporate debt securities 193,642 10 ( 4,541 ) 189,111 Asset-backed securities 111,344 — ( 2,381 ) 108,963 Government, federal agency, and other sovereign obligations 50,584 — ( 1,219 ) 49,365 Total long-term marketable securities $ 400,830 $ 10 $ ( 9,319 ) $ 391,521 December 31, 2022 (In thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Short-term: Municipal bonds $ 83,279 $ 9 $ ( 1,680 ) $ 81,608 Corporate debt securities 187,174 2 ( 3,438 ) 183,738 Commercial paper 5,583 — ( 1 ) 5,582 Asset-backed securities 4,200 — ( 181 ) 4,019 Government, federal agency, and other sovereign obligations 21,102 1 ( 458 ) 20,645 Total short-term marketable securities $ 301,338 $ 12 $ ( 5,758 ) $ 295,592 Long-term: Municipal bonds $ 61,986 $ 44 $ ( 1,549 ) $ 60,481 Corporate debt securities 268,524 72 ( 8,947 ) 259,649 Asset-backed securities 120,929 217 ( 2,795 ) 118,351 Government, federal agency, and other sovereign obligations 58,453 18 ( 1,100 ) 57,371 Total long-term marketable securities $ 509,892 $ 351 $ ( 14,391 ) $ 495,852

FAIR VALUE MEASUREMENTS (Tables

FAIR VALUE MEASUREMENTS (Tables)	6 Months Ended
	Jun. 30, 2023
FAIR VALUE MEASUREMENTS [Abstract]
Fair Value of Assets and Liabilities Measured on Recurring Basis	(In thousands) Balance at June 30, 2023 Level 1 Level 2 Level 3 Assets: Cash equivalents $ 134,407 $ 14,875 $ 119,532 $ — Municipal bonds 122,902 — 122,902 — Corporate debt securities 373,973 — 373,973 — Commercial paper 7,138 — 7,138 — Asset-backed securities 113,065 — 113,065 — Government, federal agency, and other sovereign obligations 80,819 — 80,819 — Liabilities: Business acquisition liabilities 65,352 — — 65,352 (In thousands) Balance at December 31, 2022 Level 1 Level 2 Level 3 Assets: Cash equivalents $ 17,655 $ 17,655 $ — $ — Municipal bonds 142,089 — 142,089 — Corporate debt securities 443,387 — 443,387 — Commercial paper 5,582 — 5,582 — Asset-backed securities 122,370 — 122,369 — Government, federal agency, and other sovereign obligations 78,016 — 78,016 — Liabilities: Business acquisition liabilities 68,258 — — 68,258
Significant Unobservable Inputs in Valuation Techniques	Unobservable input Range Weighted Average* Revenue risk premium 2.3 % - 4.7 % 2.7 % Revenue volatility 14.0 % - 15.8 % 14.8 % Discount rate 6.1 % - 8.5 % 6.6 % Projected year of payment 2023 - 2032 * The weighted average rates were calculated based on the relative fair value of each business acquisition liability.
Changes in Carrying Value of Business Acquisition Liabilities	Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Beginning balance $ 64,882 $ 68,036 $ 68,258 $ 70,525 Purchase price contingent consideration — 4,414 — 4,414 Contingent cash payments ( 2,832 ) ( 2,193 ) ( 5,524 ) ( 4,607 ) Contingent RSU grants ( 340 ) ( 220 ) ( 559 ) ( 416 ) Changes in fair value of business acquisition liabilities 3,726 ( 1,126 ) 3,280 ( 1,390 ) Contractual payable reclassification ( 84 ) ( 597 ) ( 103 ) ( 212 ) Ending balance $ 65,352 $ 68,314 $ 65,352 $ 68,314

INVENTORIES (Tables)

INVENTORIES (Tables)	6 Months Ended
	Jun. 30, 2023
INVENTORIES [Abstract]
Schedule of Inventory	June 30, December 31, (In thousands) 2023 2022 Raw materials $ 74,965 $ 60,324 Work in process 23,579 18,699 Finished goods 237,012 219,958 Total inventories $ 335,556 $ 298,981

PROPERTY AND EQUIPMENT (Tables)

PROPERTY AND EQUIPMENT (Tables)	6 Months Ended
	Jun. 30, 2023
PROPERTY AND EQUIPMENT [Abstract]
Schedule of Property and Equipment	Useful June 30, December 31, (In thousands) Life 2023 2022 Land — $ 8,286 $ 8,277 Buildings and improvements 31.5 55,801 51,510 Equipment 5 - 15 152,897 148,803 Instruments 5 331,356 312,055 Modules and cases 5 49,480 48,023 Other property and equipment 3 - 5 14,443 18,097 612,263 586,765 Less: accumulated depreciation ( 364,215 ) ( 343,036 ) Total $ 248,048 $ 243,729
Schedule of Depreciation Related to Property and Equipment	Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Depreciation $ 13,528 $ 12,535 $ 27,035 $ 24,860

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS (Tables)	6 Months Ended
	Jun. 30, 2023
GOODWILL AND INTANGIBLE ASSETS [Abstract]
Summary of Goodwill	(In thousands) December 31, 2021 $ 179,708 Additions and adjustments 18,799 Foreign exchange ( 1,036 ) December 31, 2022 197,471 Additions and adjustments 1,123 Foreign exchange 338 June 30, 2023 $ 198,932
Summary of Intangible Assets	June 30, 2023 (In thousands) Weighted Average Amortization Period (in years) Gross Carrying Amount Accumulated Amortization Intangible Assets, net Supplier network 10.0 $ 4,000 $ ( 3,467 ) $ 533 Customer relationships & other intangibles 8.8 60,323 ( 43,450 ) 16,873 Developed technology 8.0 75,923 ( 43,306 ) 32,617 Patents 16.1 9,058 ( 4,180 ) 4,878 Total intangible assets $ 149,304 $ ( 94,403 ) $ 54,901 Intangible assets as of December 31, 2022 included the following: December 31, 2022 (In thousands) Weighted Average Amortization Period (in years) Gross Carrying Amount Accumulated Amortization Intangible Assets, net Supplier network 10.0 $ 4,000 $ ( 3,267 ) $ 733 Customer relationships & other intangibles 8.7 62,324 ( 41,651 ) 20,673 Developed technology 8.0 75,087 ( 37,984 ) 37,103 Patents 16.1 8,885 ( 3,820 ) 5,065 Total intangible assets $ 150,296 $ ( 86,722 ) $ 63,574
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	The following table summarizes amortization of intangible assets for future periods as of June 30, 2023 : (In thousands) Annual Amortization Remaining 2023 $ 7,673 2024 14,050 2025 9,764 2026 6,320 2027 5,231 Thereafter 11,863 Total $ 54,901

ACCRUED EXPENSES (Tables)

ACCRUED EXPENSES (Tables)	6 Months Ended
	Jun. 30, 2023
ACCRUED EXPENSES [Abstract]
Schedule of Accrued Expenses	June 30, December 31, (In thousands) 2023 2022 Compensation and other employee-related costs $ 46,730 $ 53,352 Legal and other settlements and expenses 6,279 5,564 Accrued non-income taxes 10,248 10,029 Royalties 4,331 4,375 Rebates 11,203 10,501 Other 10,815 10,884 Total accrued expenses $ 89,606 $ 94,705

EQUITY (Tables)

EQUITY (Tables)	6 Months Ended
	Jun. 30, 2023
EQUITY [Abstract]
Accumulated Other Comprehensive Income (Loss)	(In thousands) Unrealized loss on marketable securities, net of tax Foreign currency translation adjustments Accumulated other comprehensive loss Accumulated other comprehensive income/(loss), net of tax, at December 31, 2022 $ ( 15,093 ) $ ( 9,537 ) $ ( 24,630 ) Other comprehensive income/(loss) before reclassifications 5,657 1,225 6,882 Amounts reclassified from accumulated other comprehensive income/(loss), net of tax ( 1,319 ) — ( 1,319 ) Other comprehensive income/(loss), net of tax 4,338 1,225 5,563 Accumulated other comprehensive income/(loss), net of tax, at June 30, 2023 $ ( 10,755 ) $ ( 8,312 ) $ ( 19,067 ) (In thousands) Unrealized loss on marketable securities, net of tax Foreign currency translation adjustments Accumulated other comprehensive loss Accumulated other comprehensive income/(loss), net of tax, at December 31, 2021 $ ( 1,053 ) $ ( 5,719 ) $ ( 6,772 ) Other comprehensive income/(loss) before reclassifications ( 18,204 ) ( 4,737 ) ( 22,941 ) Amounts reclassified from accumulated other comprehensive income/(loss), net of tax 4,345 — 4,345 Other comprehensive income/(loss), net of tax ( 13,859 ) ( 4,737 ) ( 18,596 ) Accumulated other comprehensive income/(loss), net of tax, at June 30, 2022 $ ( 14,912 ) $ ( 10,456 ) $ ( 25,368 )
Schedule of Computation of Basic and Diluted Earnings	Three Months Ended Six Months Ended June 30, June 30, (In thousands, except per share amounts) 2023 2022 2023 2022 Numerator: Net income/(loss) 57,712 $ 54,590 $ 106,841 $ 92,674 Denominator for basic and diluted net income per share: Weighted average shares outstanding for basic 100,373 100,671 100,326 101,136 Dilutive stock options and RSUs 1,409 2,213 1,663 2,344 Weighted average shares outstanding for diluted 101,782 102,884 101,989 103,480 Earnings per share: Basic 0.57 $ 0.54 $ 1.06 $ 0.92 Diluted 0.57 $ 0.53 $ 1.05 $ 0.90 Anti-dilutive stock options and RSUs excluded from the calculation 5,768 3,419 5,576 3,397

STOCK-BASED AWARDS (Tables)

STOCK-BASED AWARDS (Tables)	6 Months Ended
	Jun. 30, 2023
STOCK-BASED AWARDS [Abstract]
Summary of Stock Option Activity	Stock option activity during the six months ended June 30, 2023 is summarized as follows: Option Shares (thousands) Weighted average exercise price Weighted average remaining contractual life (years) Aggregate intrinsic value (thousands) Outstanding at December 31, 2022 10,338 $ 51.86 Granted 1,400 60.00 Exercised ( 251 ) 32.72 Forfeited ( 227 ) 63.86 Outstanding at June 30, 2023 11,260 $ 53.05 6.8 $ 104,480 Exercisable at June 30, 2023 6,501 $ 47.42 5.5 $ 87,249 Expected to vest at June 30, 2023 4,759 $ 60.75 8.4 $ 17,231
Fair Value of Options Using Black Scholes Option Pricing Model	The fair value of the options was estimated on the date of the grant using a Black-Scholes option pricing model with the following assumptions: Six Months Ended June 30, 2023 2022 Risk-free interest rate 3.45 % - 4.10 % 1.46 % - 3.36 % Expected term (years) 4.7 4.7 - 4.8 Expected volatility 35.0 % - 38.0 % 34.0 % - 35.0 % Expected dividend yield —% —%
Summary of Restricted Stock Unit Activity	Restricted Stock Units (thousands) Weighted average grant date fair value per share Weighted average remaining contractual life (years) Outstanding at December 31, 2022 60 $ 67.40 Granted 10 58.90 Vested — — Forfeited — — Outstanding at June 30, 2023 70 $ 66.24 7.3
Stock-based Compensation Schedule	Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 Stock-based compensation expense $ 8,589 $ 7,837 $ 17,542 $ 15,989 Net stock-based compensation capitalized into inventory 50 184 128 384 Total stock-based compensation cost $ 8,639 $ 8,021 $ 17,670 $ 16,373

INCOME TAXES (Tables)

INCOME TAXES (Tables)	6 Months Ended
	Jun. 30, 2023
INCOME TAXES [Abstract]
Summary of Effective Tax Rate	Three Months Ended Six Months Ended June 30, June 30, 2023 2022 2023 2022 Effective income tax rate 22.7 % 22.6 % 22.5 % 22.4 %

SEGMENT AND GEOGRAPHIC INFORM_2

SEGMENT AND GEOGRAPHIC INFORMATION (Tables)	6 Months Ended
	Jun. 30, 2023
SEGMENT AND GEOGRAPHIC INFORMATION [Abstract]
Schedule of Total Sales by Geographical Area	Three Months Ended Six Months Ended June 30, June 30, (In thousands) 2023 2022 2023 2022 United States $ 245,490 $ 225,280 $ 479,609 $ 421,683 International 46,125 38,368 88,694 72,514 Total net sales $ 291,615 $ 263,648 $ 568,303 $ 494,197

BACKGROUND (Narrative) (Details

BACKGROUND (Narrative) (Details)		6 Months Ended
	Feb. 08, 2023 $ / shares shares	Jun. 30, 2023 item $ / shares shares	Dec. 31, 2022 $ / shares
Minimum [Member]
Number of products launched | item		230
NuVasive [Member] | Merger Agreement [Member]
Common stock, par value	$ 0.001
Common Class A [Member]
Common stock, par value		$ 0.001	$ 0.001
Conversion ratio of common stock | shares		1
Common Class A [Member] | Merger Agreement [Member]
Common stock, par value	$ 0.001
Conversion ratio of common stock | shares	0.75

SUMMARY OF SIGNIFICANT ACCOUN_3

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Narrative) (Details)	3 Months Ended	6 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2023 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Goodwill impairment	$ 0	$ 0
Impairment of finite-lived intangible assets	0	0
Impairment of intangible assets	$ 0	$ 0
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives	1 year	1 year
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives	21 years	21 years

ASSET ACQUISITIONS AND BUSINE_2

ASSET ACQUISITIONS AND BUSINESS COMBINATIONS (Narrative) (Details) $ in Thousands	3 Months Ended						6 Months Ended		12 Months Ended
	Jun. 30, 2023 USD ($)	Mar. 31, 2023 USD ($) item	Dec. 31, 2022 USD ($)	Jun. 30, 2022 USD ($) item	Dec. 31, 2021 USD ($)	Sep. 30, 2021 USD ($) item	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Dec. 31, 2021 USD ($) item
Business Acquisition [Line Items]
Research and development	$ 21,347			$ 17,395			$ 42,429	$ 34,807
Contingent consideration liability	65,352		$ 68,258				65,352
Goodwill	$ 198,932		$ 197,471		$ 179,708		$ 198,932		$ 179,708
Customer Relationships & Other Intangibles [Member]
Business Acquisition [Line Items]
Weighted average amortization period	8 years 9 months 18 days		8 years 8 months 12 days				8 years 9 months 18 days
Developed Technology [Member]
Business Acquisition [Line Items]
Weighted average amortization period	8 years		8 years				8 years
Capstone Surgical Technologies, LLC [Member]
Business Acquisition [Line Items]
Asset Acquisition, Consideration Transferred					24,500
Synoste Acquisition [Member]
Business Acquisition [Line Items]
Research and development									$ 34,300
Development Of Technology, Robotic Surgery Platforms [Member]
Business Acquisition [Line Items]
Purchase price of assets					10,000
Additional contingent consideration					5,000
Approval Of FDA [Member] | Capstone Surgical Technologies, LLC [Member]
Business Acquisition [Line Items]
Asset Acquisition, Consideration Transferred					15,000
Achievement Of Certain Performance Obligation [Member] | Capstone Surgical Technologies, LLC [Member]
Business Acquisition [Line Items]
Additional contingent consideration					10,000
Harvest Biologics, LLC [Member]
Business Acquisition [Line Items]
Purchase price, preliminary post-closing adjustments			$ 1,400
Inventory acquired			3,200
Business combination, consideration transferred			30,000
Goodwill			15,300
Harvest Biologics, LLC [Member] | Customer Relationships & Other Intangibles [Member]
Business Acquisition [Line Items]
Intangible assets acquired			$ 10,500
Weighted average amortization period			20 years
Harvest Biologics, LLC [Member] | Developed Technology [Member]
Business Acquisition [Line Items]
Intangible assets acquired			$ 2,400
Series of Individually Immaterial Business Acquisitions [Member]
Business Acquisition [Line Items]
Number of acquisitions | item		1		1		2			3
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Intangible Assets, Other than Goodwill						$ 1,600
Identifiable Assets		$ 400
Inventory acquired		1,000
Weighted average amortization period						3 years 9 months 18 days
Payments to Acquire Businesses, Gross		$ 1,400			300
Business combination, consideration transferred				$ 200
Contingent consideration liability					13,000				$ 13,000
Contingent payments, performance period				10 years
Goodwill				$ 4,600	$ 13,300	$ 11,000		$ 4,600	$ 13,300
Contingent consideration payment				$ 4,400		$ 12,600
Business Acquisitions, Contractual Holdback Obligation Payable Period									10 years

NET SALES (Schedule of Net Sale

NET SALES (Schedule of Net Sales by Product Category) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Net sales	$ 291,615	$ 263,648	$ 568,303	$ 494,197
Musculoskeletal Solutions [Member]
Disaggregation of Revenue [Line Items]
Net sales	256,855	234,242	508,462	451,644
Enabling Technologies [Member]
Disaggregation of Revenue [Line Items]
Net sales	$ 34,760	$ 29,406	$ 59,841	$ 42,553

MARKETABLE SECURITIES (Narrativ

MARKETABLE SECURITIES (Narrative) (Details) - USD ($) $ in Millions	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Payable to brokers	$ 1.5
Short-term Investments [Member] | Maximum [Member]
Debt Securities, Available-for-sale [Line Items]
Contractual Maturity	1 year	1 year
Long-term Investments [Member] | Minimum [Member]
Debt Securities, Available-for-sale [Line Items]
Contractual Maturity	1 year	1 year
Long-term Investments [Member] | Maximum [Member]
Debt Securities, Available-for-sale [Line Items]
Contractual Maturity	3 years	3 years

MARKETABLE SECURITIES (Composit

MARKETABLE SECURITIES (Composition of Marketable Securities) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Amortized Cost, Short-term	$ 311,253	$ 301,338
Gross Unrealized Gains, Short-term	2	12
Gross Unrealized Losses, Short-term	(4,879)	(5,758)
Fair Value, Short-term	306,376	295,592
Amortized Cost, Long-term	400,830	509,892
Gross Unrealized Gains, Long-term	10	351
Gross Unrealized Losses, Long-term	(9,319)	(14,391)
Fair Value, Long-term	391,521	495,852
Municipal Bonds [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost, Short-term	79,668	83,279
Gross Unrealized Gains, Short-term		9
Gross Unrealized Losses, Short-term	(848)	(1,680)
Fair Value, Short-term	78,820	81,608
Amortized Cost, Long-term	45,260	61,986
Gross Unrealized Gains, Long-term		44
Gross Unrealized Losses, Long-term	(1,178)	(1,549)
Fair Value, Long-term	44,082	60,481
Corporate Debt Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost, Short-term	188,355	187,174
Gross Unrealized Gains, Short-term	2	2
Gross Unrealized Losses, Short-term	(3,495)	(3,438)
Fair Value, Short-term	184,862	183,738
Amortized Cost, Long-term	193,642	268,524
Gross Unrealized Gains, Long-term	10	72
Gross Unrealized Losses, Long-term	(4,541)	(8,947)
Fair Value, Long-term	189,111	259,649
Commercial Paper [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost, Short-term	7,139	5,583
Gross Unrealized Losses, Short-term	(1)	(1)
Fair Value, Short-term	7,138	5,582
Asset-backed Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost, Short-term	4,200	4,200
Gross Unrealized Losses, Short-term	(98)	(181)
Fair Value, Short-term	4,102	4,019
Amortized Cost, Long-term	111,344	120,929
Gross Unrealized Gains, Long-term		217
Gross Unrealized Losses, Long-term	(2,381)	(2,795)
Fair Value, Long-term	108,963	118,351
Government, Federal Agency, And Other Sovereign Obligations [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost, Short-term	31,891	21,102
Gross Unrealized Gains, Short-term		1
Gross Unrealized Losses, Short-term	(437)	(458)
Fair Value, Short-term	31,454	20,645
Amortized Cost, Long-term	50,584	58,453
Gross Unrealized Gains, Long-term		18
Gross Unrealized Losses, Long-term	(1,219)	(1,100)
Fair Value, Long-term	$ 49,365	$ 57,371

FAIR VALUE MEASUREMENTS (Fair V

FAIR VALUE MEASUREMENTS (Fair Value of Assets and Liabilities Measured on Recurring Basis) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022	Jun. 30, 2022	Mar. 31, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	$ 134,407		$ 17,655
Business acquisition liabilities	65,352		68,258
Municipal Bonds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	122,902		142,089
Corporate Debt Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	373,973		443,387
Commercial Paper [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	7,138		5,582
Asset-backed Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	113,065		122,370
Government, Federal Agency, And Other Sovereign Obligations [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	80,819		78,016
Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	14,875		17,655
Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	119,532
Fair Value, Inputs, Level 2 [Member] | Municipal Bonds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	122,902		142,089
Fair Value, Inputs, Level 2 [Member] | Corporate Debt Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	373,973		443,387
Fair Value, Inputs, Level 2 [Member] | Commercial Paper [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	7,138		5,582
Fair Value, Inputs, Level 2 [Member] | Asset-backed Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	113,065		122,369
Fair Value, Inputs, Level 2 [Member] | Government, Federal Agency, And Other Sovereign Obligations [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	80,819		78,016
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities	$ 65,352	$ 64,882	$ 68,258	$ 68,314	$ 68,036	$ 70,525

FAIR VALUE MEASUREMENTS (Signif

FAIR VALUE MEASUREMENTS (Significant Unobservable Inputs in Valuation Techniques) (Details) - Fair Value, Inputs, Level 3 [Member]	6 Months Ended
	Jun. 30, 2023
Revenue Risk Premium [Member] | Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.047
Revenue Risk Premium [Member] | Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.023
Revenue Risk Premium [Member] | Weighted Average [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.027	[1]
Revenue Volatility [Member] | Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.158
Revenue Volatility [Member] | Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.140
Revenue Volatility [Member] | Weighted Average [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.148	[1]
Discount Rate [Member] | Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.085
Discount Rate [Member] | Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.061
Discount Rate [Member] | Weighted Average [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities, measurement input	0.066	[1]
Probability Of Payment [Member] | Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Projected year of payment	2032
Probability Of Payment [Member] | Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Projected year of payment	2023
[1] The weighted average rates were calculated based on the relative fair value of each business acquisition liability.

FAIR VALUE MEASUREMENTS (Change

FAIR VALUE MEASUREMENTS (Changes in Carrying Value of Business Acquisition Liabilities) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value measurement, beginning balance			$ 68,258
Fair value measurement, ending balance	$ 65,352		65,352
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value measurement, beginning balance	64,882	$ 68,036	68,258	$ 70,525
Purchase price contingent consideration		4,414		4,414
Contingent cash payments	(2,832)	(2,193)	(5,524)	(4,607)
Contingent RSU grants	(340)	(220)	(559)	(416)
Changes in fair value of business acquisition liabilities	3,726	(1,126)	3,280	(1,390)
Contractual payable reclassification	(84)	(597)	(103)	(212)
Fair value measurement, ending balance	$ 65,352	$ 68,314	$ 65,352	$ 68,314

INVENTORIES (Narrative) (Detail

INVENTORIES (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
INVENTORIES [Abstract]
Net adjustment to cost of sales related to excess and obsolete inventory	$ 1.9	$ 2.3	$ 4	$ 4.1
Excess and obsolete related provisions	3.4	5.2	6.9	8.6
Inventory sales and disposals related provisions	$ 1.5	$ 2.9	$ 2.9	$ 4.5

INVENTORIES (Schedule of Invent

INVENTORIES (Schedule of Inventory) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
INVENTORIES [Abstract]
Raw materials	$ 74,965	$ 60,324
Work in process	23,579	18,699
Finished goods	237,012	219,958
Total inventories	$ 335,556	$ 298,981

PROPERTY AND EQUIPMENT (Schedul

PROPERTY AND EQUIPMENT (Schedule of Property and Equipment) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Property and equipment	$ 612,263	$ 586,765
Less: accumulated depreciation	(364,215)	(343,036)
Total	248,048	243,729
Land [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	8,286	8,277
Building And Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 55,801	51,510
Useful Life	31 years 6 months
Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 152,897	148,803
Instruments [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 331,356	312,055
Useful Life	5 years
Modules And Cases [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 49,480	48,023
Useful Life	5 years
Other Property And Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 14,443	$ 18,097
Maximum [Member] | Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	15 years
Maximum [Member] | Other Property And Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	5 years
Minimum [Member] | Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	5 years
Minimum [Member] | Other Property And Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	3 years

PROPERTY AND EQUIPMENT (Sched_2

PROPERTY AND EQUIPMENT (Schedule of Depreciation Related to Property and Equipment) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
PROPERTY AND EQUIPMENT [Abstract]
Depreciation	$ 13,528	$ 12,535	$ 27,035	$ 24,860

GOODWILL AND INTANGIBLE ASSET_2

GOODWILL AND INTANGIBLE ASSETS (Summary of Goodwill) (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
GOODWILL AND INTANGIBLE ASSETS [Abstract]
Goodwill, Beginning Balance	$ 197,471	$ 179,708
Additions and adjustments	1,123	18,799
Foreign exchange	338	(1,036)
Goodwill, Ending Balance	$ 198,932	$ 197,471

GOODWILL AND INTANGIBLE ASSET_3

GOODWILL AND INTANGIBLE ASSETS (Summary of Intangible Assets) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 149,304	$ 150,296
Accumulated amortization	(94,403)	(86,722)
Intangible Assets, net	$ 54,901	$ 63,574
Supplier Network [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	10 years	10 years
Gross Carrying Amount	$ 4,000	$ 4,000
Accumulated amortization	(3,467)	(3,267)
Intangible Assets, net	$ 533	$ 733
Customer Relationships & Other Intangibles [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	8 years 9 months 18 days	8 years 8 months 12 days
Gross Carrying Amount	$ 60,323	$ 62,324
Accumulated amortization	(43,450)	(41,651)
Intangible Assets, net	$ 16,873	$ 20,673
Developed Technology [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	8 years	8 years
Gross Carrying Amount	$ 75,923	$ 75,087
Accumulated amortization	(43,306)	(37,984)
Intangible Assets, net	$ 32,617	$ 37,103
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	16 years 1 month 6 days	16 years 1 month 6 days
Gross Carrying Amount	$ 9,058	$ 8,885
Accumulated amortization	(4,180)	(3,820)
Intangible Assets, net	$ 4,878	$ 5,065

GOODWILL AND INTANGIBLE ASSET_4

GOODWILL AND INTANGIBLE ASSETS (Schedule of Finite-Lived Intangible Assets, Future Amortization Expense) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
GOODWILL AND INTANGIBLE ASSETS [Abstract]
Remaining 2023	$ 7,673
2024	14,050
2025	9,764
2026	6,320
2027	5,231
Thereafter	11,863
Intangible Assets, net	$ 54,901	$ 63,574

ACCRUED EXPENSES (Schedule of A

ACCRUED EXPENSES (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
ACCRUED EXPENSES [Abstract]
Compensation and other employee-related costs	$ 46,730	$ 53,352
Legal and other settlements and expenses	6,279	5,564
Accrued non-income taxes	10,248	10,029
Royalties	4,331	4,375
Rebates	11,203	10,501
Other	10,815	10,884
Total accrued expenses	$ 89,606	$ 94,705

DEBT (Narrative) (Details)

DEBT (Narrative) (Details) - USD ($)	1 Months Ended	6 Months Ended
	Aug. 31, 2021	Jun. 30, 2023	Aug. 31, 2020
Citizens Bank [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity			$ 125,000,000
Line of credit facility, expiration date		Aug. 02, 2023
Line of credit, borrowed amount		$ 0
Daily BSBY Rate [Member] | Citizens Bank [Member]
Debt Instrument [Line Items]
Credit facility, basis spread on variable rate	1%
Federal Funds Effective Rate [Member]
Debt Instrument [Line Items]
Credit facility, basis spread on variable rate	0.50%
Letter of Credit [Member] | Citizens Bank [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity			$ 25,000,000

EQUITY (Narrative) (Details)

EQUITY (Narrative) (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($) item / shares item shares	Dec. 31, 2022 shares	Mar. 04, 2022 USD ($)	Mar. 11, 2020 USD ($)
Class of Stock [Line Items]
Stock repurchase plan, authorized amount | $				$ 200
Stock repurchase plan, remaining authorized amount | $	$ 150.8
Common stock, shares authorized	775,000,000
Common Class A [Member]
Class of Stock [Line Items]
Additional stock repurchase plan, authorized amount | $			$ 200
Total number of shares repurchased	0
Common stock, shares authorized	500,000,000	500,000,000
Number of votes per share | item / shares	1
Shares converted from other class	1
Common Class B [Member]
Class of Stock [Line Items]
Common stock, shares authorized	275,000,000	275,000,000
Number of votes per share | item	10

EQUITY (Schedule of Shares Repu

EQUITY (Schedule of Shares Repurchased) (Details) $ in Millions	Jun. 30, 2023 USD ($)
EQUITY [Abstract]
Approximate dollar value of shares that may yet be purchased under the plan	$ 150.8

EQUITY (Accumulated Other Compr

EQUITY (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period	$ 1,914,820	$ 1,785,372	$ 1,846,373	$ 1,741,388
Total other comprehensive income/(loss), net of tax	355	(8,201)	5,563	(18,596)
Total equity, end of period	1,985,065	1,699,093	1,985,065	1,699,093
Accumulated Other Comprehensive Income/(Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period	(19,422)	(17,167)	(24,630)	(6,772)
Other comprehensive (loss)/income before reclassifications			6,882	(22,941)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax			(1,319)	4,345
Total other comprehensive income/(loss), net of tax			5,563	(18,596)
Total equity, end of period	(19,067)	(25,368)	(19,067)	(25,368)
Unrealized Loss On Marketable Securities, Net Of Tax [Member] | Accumulated Other Comprehensive Income/(Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period			(15,093)	(1,053)
Other comprehensive (loss)/income before reclassifications			5,657	(18,204)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax			(1,319)	4,345
Total other comprehensive income/(loss), net of tax			4,338	(13,859)
Total equity, end of period	(10,755)	(14,912)	(10,755)	(14,912)
Foreign Currency Translation Adjustments [Member] | Accumulated Other Comprehensive Income/(Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period			(9,537)	(5,719)
Other comprehensive (loss)/income before reclassifications			1,225	(4,737)
Total other comprehensive income/(loss), net of tax			1,225	(4,737)
Total equity, end of period	$ (8,312)	$ (10,456)	$ (8,312)	$ (10,456)

EQUITY (Schedule of Computation

EQUITY (Schedule of Computation of Basic and Diluted Earnings) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
EQUITY [Abstract]
Net income/(loss)	$ 57,712	$ 54,590	$ 106,841	$ 92,674
Weighted average shares outstanding for basic	100,373	100,671	100,326	101,136
Dilutive stock options and RSUs	1,409	2,213	1,663	2,344
Weighted average shares outstanding for diluted	101,782	102,884	101,989	103,480
Basic	$ 0.57	$ 0.54	$ 1.06	$ 0.92
Diluted	$ 0.57	$ 0.53	$ 1.05	$ 0.90
Anti-dilutive stock options and RSUs excluded from the calculation	5,768	3,419	5,576	3,397

STOCK-BASED AWARDS (Narrative)

STOCK-BASED AWARDS (Narrative) (Details) $ / shares in Units, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023 USD ($) ShareBasedCompensationPlan $ / shares shares	Jun. 30, 2022 USD ($) $ / shares	Jun. 30, 2023 USD ($) ShareBasedCompensationPlan $ / shares shares	Jun. 30, 2022 USD ($) $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of stock plans | ShareBasedCompensationPlan	2		2
Intrinsic value of stock options exercised | $	$ 2.8	$ 2.7	$ 8.1	$ 7.4
Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			4 years
Unrecognized compensation expense, unvested stock options | $	$ 85.3		$ 85.3
Weighted average period of recognition, unvested stock options			3 years
Maximum contractual term			10 years
Weighted average grant date fair value per share | $ / shares	$ 21.61	$ 23.93	$ 22.21	$ 21.05
2012 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Base number of shares that may be issuable under stock plan	3,076,923		3,076,923
2012 Plan [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized	10,769,230		10,769,230
Annual percentage limit for incremental shares that may be issued	3%		3%
2021 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Base number of shares that may be issuable under stock plan	8,000,000		8,000,000
Class A reserved under the 2012 Equity Incentive Plan	9,745,676		9,745,676
Class A number of shares available for grant under the 2012 Equity Incentive Plan	5,451,650		5,451,650
2021 Plan [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Base number of shares that may be issuable under stock plan	8,000,000		8,000,000

STOCK-BASED AWARDS (Summary of

STOCK-BASED AWARDS (Summary of Stock Option Activity) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	6 Months Ended
	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Option shares outstanding beginning balance	10,338
Option shares granted	1,400
Option shares exercised	(251)
Option shares forfeited	(227)
Option shares outstanding ending balance	11,260
Option shares exercisable	6,501
Option shares expected to vest	4,759
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price
Weighted average exercise price per share outstanding beginning balance	$ 51.86
Weighted average exercise price per share granted	60
Weighted average exercise price per share exercised	32.72
Weighted average exercise price per share forfeited	63.86
Weighted average exercise price per share outstanding ending balance	53.05
Weighted average exercise price per share exercisable	47.42
Weighted average exercise price per share expected to vest	$ 60.75
Weighted average remaining contractual life outstanding	6 years 9 months 18 days
Weighted average remaining contractual life exercisable	5 years 6 months
Weighted average remaining contractual life expected to vest	8 years 4 months 24 days
Aggregate intrinsic value outstanding	$ 104,480
Aggregate intrinsic value exercisable	87,249
Aggregate intrinsic value expected to vest	$ 17,231

STOCK-BASED AWARDS (Fair Value

STOCK-BASED AWARDS (Fair Value of Options Using Black Scholes Option Pricing Model) (Details)	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	3.45%	1.46%
Risk-free interest rate, maximum	4.10%	3.36%
Expected term (years)	4 years 8 months 12 days
Expected volatility, minimum	35%	34%
Expected volatility, maximum	38%	35%
Expected dividend yield
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (years)		4 years 9 months 18 days
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (years)		4 years 8 months 12 days

STOCK-BASED AWARDS (Summary o_2

STOCK-BASED AWARDS (Summary of Restricted Stock Unit Activity) (Details) - Restricted Stock Units (RSUs) [Member] shares in Thousands	6 Months Ended
	Jun. 30, 2023 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding, Beginning Balance | shares	60
Granted | shares	10
Outstanding, Ending Balance | shares	70
Weighted average grant date fair value per share, Beginning Balance | $ / shares	$ 67.40
Weighted average grant date fair value per share, Granted | $ / shares	58.90
Weighted average grant date fair value per share, Ending Balance | $ / shares	$ 66.24
Weighted average remaining contractual life (years)	7 years 3 months 18 days

STOCK-BASED AWARDS (Stock-based

STOCK-BASED AWARDS (Stock-based Compensation Schedule) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
STOCK-BASED AWARDS [Abstract]
Stock-based compensation expense	$ 8,589	$ 7,837	$ 17,542	$ 15,989
Net stock-based compensation capitalized into inventory	50	184	128	384
Total stock-based compensation cost	$ 8,639	$ 8,021	$ 17,670	$ 16,373

INCOME TAXES (Summary of Effect

INCOME TAXES (Summary of Effective Tax Rate) (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
INCOME TAXES [Abstract]
Effective income tax rate	22.70%	22.60%	22.50%	22.40%

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Narrative) (Details)	Jun. 30, 2023 USD ($)
Moskowitz Family LLC Litigation [Member]
Estimated Litigation Liability	$ 0

SEGMENT AND GEOGRAPHIC INFORM_3

SEGMENT AND GEOGRAPHIC INFORMATION (Narrative) (Details)	6 Months Ended
	Jun. 30, 2023 segment
SEGMENT AND GEOGRAPHIC INFORMATION [Abstract]
Number of operating segments	1

SEGMENT AND GEOGRAPHIC INFORM_4

SEGMENT AND GEOGRAPHIC INFORMATION (Schedule of Total Sales by Geographical Area) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Revenues from External Customers and Long-Lived Assets [Line Items]
Total net sales	$ 291,615	$ 263,648	$ 568,303	$ 494,197
United States [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total net sales	245,490	225,280	479,609	421,683
International [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total net sales	$ 46,125	$ 38,368	$ 88,694	$ 72,514

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2023
Insider Trading Arrangements [Line Items]
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