ClearPoint Neuro (CLPT) 10-Q 10 Nov 21 2021 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2021	Nov. 09, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2021
Current Fiscal Year End Date	--12-31
Entity File Number	001-34822
Entity Registrant Name	ClearPoint Neuro, Inc.
Entity Central Index Key	0001285550
Entity Tax Identification Number	58-2394628
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	120 S. Sierra Ave.
Entity Address, Address Line Two	Suite 100
Entity Address, City or Town	Solana Beach
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92075
City Area Code	(888)
Local Phone Number	287-9109
Title of 12(b) Security	Common Stock, $0.01 par value per share
Trading Symbol	CLPT
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Common stock shares outstanding		23,639,616

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 57,651	$ 20,099
Accounts receivable, net	2,559	1,881
Inventory, net	3,943	3,238
Prepaid expenses and other current assets	842	244
Total current assets	64,995	25,462
Property and equipment, net	450	319
Operating lease rights of use	2,365	2,736
Software license inventory	519	589
Licensing rights	287	353
Other assets	86	59
Total assets	68,702	29,518
Current liabilities:
Accounts payable	777	300
Accrued compensation	1,804	1,595
Other accrued liabilities	1,081	349
Operating lease liabilities, current portion	486	394
Deferred product and service revenue	440	562
Total current liabilities	4,588	3,200
Operating lease liabilities, net of current portion	2,071	2,446
Deferred product and service revenue, net of current portion	310	215
2020 senior secured convertible notes payable, net	17,613	21,280
Total liabilities	24,582	27,141
Stockholders’ equity:
Preferred stock, $0.01 par value; 25,000,000 shares authorized; none issued and outstanding at September 30, 2021 and December 31, 2020
Common stock, $0.01 par value; 200,000,000 shares authorized; 22,855,187 shares issued and outstanding at September 30, 2021; and 17,047,584 issued and outstanding at December 31, 2020	229	170
Additional paid-in capital	173,674	121,729
Accumulated deficit	(129,783)	(119,522)
Total stockholders’ equity	44,120	2,377
Total liabilities and stockholders’ equity	$ 68,702	$ 29,518

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, authorized	25,000,000	25,000,000
Preferred stock, outstanding	0	0
Preferred stock, issued	0	0
Common stock, par value (in dollars per share)	$ 0.01
Common stock, authorized	200,000,000	200,000,000
Common stock, issued	22,855,187	17,047,584
Common stock, outstanding	22,855,187	17,047,584

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues:
Total revenues	$ 4,574	$ 3,519	$ 12,017	$ 9,113
Cost of revenues	1,486	903	4,015	2,636
Gross profit	3,088	2,616	8,002	6,477
Research and development costs	2,630	1,143	6,251	2,774
Sales and marketing expenses	1,826	1,493	5,081	3,916
General and administrative expenses	2,436	1,252	6,062	3,742
Operating loss	(3,804)	(1,272)	(9,392)	(3,955)
Other income (expense):
Other (expense), net	62	(11)	(60)	(5)
Interest expense, net	(238)	(201)	(809)	(1,240)
Net loss	$ (3,980)	$ (1,484)	$ (10,261)	$ (5,200)
Net loss per share attributable to common stockholders:
Basic and diluted	$ (180)	$ (90)	$ (500)	$ (330)
Weighted average shares used in computing net loss per share:
Basic and diluted	22,522,460	15,724,401	20,545,080	15,556,231
Product [Member]
Revenues:
Total revenues	$ 3,338	$ 2,371	$ 8,863	$ 6,186
Service [Member]
Revenues:
Total revenues	$ 1,236	$ 1,148	$ 3,154	$ 2,927

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($)	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Total
Shares, Outstanding, Ending Balance	15,235,308
Beginning balance, value at Dec. 31, 2019	$ 152,000	$ 117,174,000	$ (112,740,000)	$ 4,586,000
Issuances of common stock:
Share-based compensation		228,000		228,000
Share-based compensation (in shares)	9,696
Net loss for the period			(2,055,000)	(2,055,000)
Ending balance, value at Mar. 31, 2020	155,000	117,399,000	(114,795,000)	2,759,000
Issuances of common stock:
Warrant exercises (cashless)	$ 3,000	(3,000)
Warrant exercises (cashless) (in shares)	262,145
Beginning balance, value at Dec. 31, 2019	$ 152,000	117,174,000	(112,740,000)	4,586,000
Issuances of common stock:
Public offering of common stock
Net loss for the period				(5,200,000)
Ending balance, value at Sep. 30, 2020	$ 159,000	117,930,000	(117,940,000)	149,000
Shares, Outstanding, Ending Balance	15,507,149
Beginning balance, value at Mar. 31, 2020	$ 155,000	117,399,000	(114,795,000)	2,759,000
Issuances of common stock:
Share-based compensation		241,000		241,000
Share-based compensation (in shares)	5,538
Net loss for the period			(1,661,000)	(1,661,000)
Ending balance, value at Jun. 30, 2020	$ 155,000	117,640,000	(116,456,000)	1,339,000
Shares, Outstanding, Ending Balance	15,512,687
Issuances of common stock:
Share-based compensation	$ 3,000	291,000		294,000
Share-based compensation (in shares)	248,637
Net loss for the period			(1,484,000)	(1,484,000)
Ending balance, value at Sep. 30, 2020	159,000	117,930,000	(117,940,000)	149,000
Issuances of common stock:
Warrant exercises (cashless)	$ 1,000	(1,000)
Warrant exercises (cashless) (in shares)	120,080
Shares, Outstanding, Ending Balance	15,881,404
Shares, Outstanding, Ending Balance	17,047,584
Beginning balance, value at Dec. 31, 2020	$ 170,000	121,729,000	(119,522,000)	2,377,000
Adoption of ASU 2020-06		(3,107,000)		(3,107,000)
Issuances of common stock:
Public offering of common stock	$ 21,000	46,764,000		46,785,000
Public offering of common stock (in shares)	2,127,660
Share-based compensation	$ 1,000	319,000		320,000
Share-based compensation (in shares)	20,709
Warrant and option exercises (cash and cashless)	$ 15,000	130,000		145,000
Warrant and option exercises (cash and cashless) (in shares)	1,482,327
Net loss for the period			(2,538,000)	(2,538,000)
Ending balance, value at Mar. 31, 2021	207,000	165,835,000	(122,060,000)	43,982,000
Beginning balance, value at Dec. 31, 2020	$ 170,000	121,729,000	(119,522,000)	2,377,000
Adoption of ASU 2020-06				(3,100,000)
Issuances of common stock:
Public offering of common stock				(46,785,000)
Net loss for the period				(10,261,000)
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation	(29,764)
Ending balance, value at Sep. 30, 2021	$ 229,000	173,674,000	(129,783,000)	44,120,000
Shares, Outstanding, Ending Balance	20,678,280
Beginning balance, value at Mar. 31, 2021	$ 207,000	165,835,000	(122,060,000)	43,982,000
Issuances of common stock:
Share-based compensation		247,000		247,000
Share-based compensation (in shares)	26,435
Warrant and option exercises (cash and cashless)	$ 3,000	346,000		349,000
Warrant and option exercises (cash and cashless) (in shares)	361,486
Net loss for the period			(3,743,000)	(3,743,000)
Conversion of 2020 senior secured convertible note	$ 13	7,118		7,131
Conversion of 2020 senior secured convertible note (in shares)	1,256,143
Ending balance, value at Jun. 30, 2021	$ 223,000	173,546,000	(125,803,000)	47,966,000
Shares, Outstanding, Ending Balance	22,322,344
Issuances of common stock:
Share-based compensation	$ 1,000	585,000		586,000
Share-based compensation (in shares)	126,805
Warrant and option exercises (cash and cashless)	$ 5,000	85,000		90,000
Warrant and option exercises (cash and cashless) (in shares)	435,802
Net loss for the period			(3,980,000)	(3,980,000)
Payments for taxes related to net share settlement of equity awards		(542,000)		(542,000)
Ending balance, value at Sep. 30, 2021	$ 229,000	$ 173,674,000	$ (129,783,000)	$ 44,120,000
Shares, Outstanding, Ending Balance	22,855,187

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net loss	$ (10,261)	$ (5,200)
Adjustments to reconcile net loss to net cash flows from operating activities:
Allowance for doubtful accounts	170	13
Depreciation and amortization	113	170
Share-based compensation	1,153	762
Payment-in-kind interest	285
Amortization of debt issuance costs and original issue discounts	73	856
Amortization of lease rights of use, net of accretion in lease liabilities	400	75
Increase (decrease) in cash resulting from changes in:
Accounts receivable	(848)	(373)
Inventory, net	(682)	(323)
Prepaid expenses and other current assets	(599)	(136)
Other assets	(28)	59
Accounts payable and accrued expenses	1,418	60
Accrued interest		(960)
Lease liabilities	(312)	(71)
Deferred revenue	(27)	(338)
Net cash flows from operating activities	(9,145)	(5,406)
Cash flows from investing activities:
Purchases of property and equipment	(130)
Acquisition of licensing rights		(441)
Net cash flows from investing activities	(130)	(441)
Cash flows from financing activities:
Proceeds from issuance of 2020 senior secured convertible notes, net of financing costs and discount		16,758
Proceeds from issuance of Paycheck Protection Program loan		896
Proceeds from public offering of common stock, net of offering costs	46,785
Proceeds from stock option and warrant exercises	584
Payments for taxes related to net share settlement of equity awards	(542)
Repayment of notes payable		(2,838)
Net cash flows from financing activities	46,827	14,816
Net change in cash and cash equivalents	37,552	8,969
Cash and cash equivalents, beginning of period	20,099	5,696
Cash and cash equivalents, end of period	57,651	14,665
Cash paid for:
Income taxes
Interest	$ 495	$ 1,399

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows (Unaudited) (Parenthetical) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Statement of Cash Flows [Abstract]
Net transfers of reusable components from loaned systems	$ 30	$ 40
Reduction of additional paid-in capital	3,100
Conversion of debt	7,500
Accrued interest included in the conversion of debt	$ 40
Shares issued upon conversion of debt	1,256,143
Amortization of debt discount	$ 200

Description of the Business and

Description of the Business and Financial Condition	9 Months Ended
	Sep. 30, 2021
Description Of Business And Financial Condition
Description of the Business and Financial Condition	1. Description of the Business and Financial Condition ClearPoint Neuro, Inc. (the “Company”) is a medical device company focused on the development and commercialization of technology that enables physicians to see inside the brain using direct, intra-procedural magnetic resonance imaging (“MRI”) guidance while performing minimally invasive surgical procedures. The Company’s ClearPoint system, an integrated system comprised of capital equipment and disposable products, is designed to allow minimally invasive procedures in the brain to be performed in an MRI suite. The Company received 510(k) clearance from the U.S. Food and Drug Administration (“FDA”) in 2010 to market the ClearPoint system in the United States for general neurological interventional procedures. COVID-19 In March 2020, the World Health Organization characterized the spread of a novel strain of coronavirus (“COVID-19”) as a global pandemic, and the President of the United States later proclaimed that the COVID-19 outbreak in the United States constituted a national emergency. Extraordinary actions were taken by federal, state and local governmental authorities to combat the spread of COVID-19, including issuances of “stay-at-home” directives and similar mandates that substantially restricted daily activities and for many businesses curtailed or ceased normal operations. These measures led to reduced economic activity, including the postponement or cancellation of elective surgical procedures, which historically have represented approximately 80% of the number of surgical procedures using the Company’s ClearPoint system. Although economic activity is returning to a normalized level, the Delta variant of COVID-19 continues to spread in the United States and across the globe. The ultimate impact of the Delta variant, and other new strains that may develop, cannot be predicted at this time, and could depend on numerous factors, including vaccination rates among the population, the effectiveness of COVID-19 vaccines against the Delta and other variants and the response by governmental bodies and regulators, which could include vaccine mandates. Furthermore, global supply chain disruptions, labor shortages, which may affect our ability to retain and attract new talent, and inflationary conditions caused by the COVID-19 pandemic could have a material adverse effect on the Company’s business. The rapid development and fluidity of the situation preclude any prediction as to the ultimate impact COVID-19 will have on the Company’s business, financial condition, results of operation and cash flows, which will depend largely on future developments directly or indirectly relating to the duration and scope of the COVID-19 outbreak in the United States and globally. Liquidity The Company has incurred net losses since its inception, which has resulted in a cumulative deficit at September 30, 2021 of approximately $ 130 9.1 7.8 In January 2020, the Company entered into a Securities Purchase Agreement (the “SPA”) with two investors (each, a “2020 Convertible Noteholder,” and together, the “2020 Convertible Noteholders”) under which the Company issued an aggregate principal amount of $ 17.5 five 16.8 3.7 The SPA also gave the Company the right, but not the obligation, to request one of the 2020 Convertible Noteholders to purchase an additional $5.0 million in principal amount of a note (the “Second Closing Note”, and, together with the First Closing Note, the “2020 Secured Notes”). 7.5 See Note 5 for additional information with respect to the 2020 Secured Notes. In April 2020, the Company received $ 0.9 As discussed in Note 7, on February 23, 2021, the Company completed a public offering of 2,127,660 46.8 Based on the foregoing, in management’s opinion, cash and cash equivalent balances at September 30, 2021, are sufficient to support the Company’s operations and meet its obligations for at least the next twelve months.

Basis of Presentation and Summa

Basis of Presentation and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation and Summary of Significant Accounting Policies	2. Basis of Presentation and Summary of Significant Accounting Policies Basis of Presentation and Use of Estimates In the opinion of management, the accompanying unaudited condensed consolidated financial statements have been prepared on a basis consistent with the Company’s December 31, 2020 audited consolidated financial statements, and include all adjustments, consisting of only normal recurring adjustments, necessary to fairly state the information set forth therein. These condensed consolidated financial statements have been prepared in accordance with SEC rules for interim financial information, and, therefore, omit certain information and footnote disclosures necessary to present such statements in accordance with generally accepted accounting principles in the U.S. (“GAAP”). The preparation of these condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue, expenses and the related disclosures at the date of the financial statements and during the reporting period. Actual results could materially differ from these estimates. These condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s 2020 Form 10-K. The accompanying condensed consolidated balance sheet as of December 31, 2020 has been derived from the audited consolidated financial statements at that date but does not include all information and footnotes required by GAAP for a complete set of financial statements. The results of operations for the three and nine months ended September 30, 2021 may not be indicative of the results to be expected for the entire year or any future periods. Inventory Inventory is carried at the lower of cost (first-in, first-out method) or net realizable value. Items in inventory relate predominantly to the Company’s ClearPoint system. Software license inventory related to ClearPoint systems undergoing on-site customer evaluation is included in inventory in the accompanying condensed consolidated balance sheets. All other software license inventory is classified as a non-current asset. The Company periodically reviews its inventory for obsolete items and provides a reserve upon identification of potentially obsolete items. Intangible Assets The Company is a party to certain license agreements that provide rights to the Company for the development and commercialization of products. Under the terms of those license agreements, the Company made payments to the licensors upon execution of the license agreements for access to the underlying technologies and will make future payments based on the achievement of regulatory and commercialization milestones as defined in the license agreements. In conformity with Accounting Standards Codification Section 350, “Intangibles – Goodwill and Other,” the Company amortizes its investment in the license rights described above over an expected useful life of five years. In addition, the Company periodically evaluates the recoverability of its investment in the license rights and records an impairment charge in the event such evaluation indicates that the Company’s investment is not likely to be recovered. Revenue Recognition The Company’s revenue is comprised primarily of: (1) product revenue resulting from the sale of functional neurosurgery, navigation, therapy, and biologics and drug delivery disposable products; (2) product revenue resulting from the sale of ClearPoint capital equipment and software; (3) revenue resulting from the service, installation, training and shipping related to ClearPoint capital equipment and software; and (4) consultation and clinical case support revenue in connection with customer-sponsored clinical trials. The Company recognizes revenue when control of the Company’s products and services is transferred to its customers in an amount that reflects the consideration the Company expects to receive from its customers in exchange for those products and services, in a process that involves identifying the contract with a customer, determining the performance obligations in the contract, determining the contract price, allocating the contract price to the distinct performance obligations in the contract, and recognizing revenue when the performance obligations have been satisfied. A performance obligation is considered distinct from other obligations in a contract when it provides a benefit to the customer either on its own or together with other resources that are readily available to the customer and is separately identified in the contract. When a contract calls for the satisfaction of multiple performance obligations for a single contract price, the Company allocates the contract price among the performance obligations based on the relative stand-alone prices for each such performance obligation customarily charged by the Company. The Company considers a performance obligation satisfied once it has transferred control of a good or service to the customer, meaning the customer has the ability to use and obtain the benefit of the good or service. The Company recognizes revenue for satisfied performance obligations only when it determines there are no uncertainties regarding payment terms or transfer of control. Lines of Business; Timing of Revenue Recognition · Functional neurosurgery navigation product, biologics and drug delivery systems product, and therapy product sales: · Capital equipment and software sales o Capital equipment and software sales preceded by evaluation periods: o Capital equipment and software sales not preceded by evaluation periods: For both types of capital equipment and software sales described above, the Company’s determination of the point in time at which to recognize revenue represents that point at which the customer has legal title, physical possession, and the risks and rewards of ownership, and the Company has a present right to payment. · Functional neurosurgery navigation and therapy services: Minimum Maximum · Biologics and drug delivery services: o Consultation Services: o Clinical Service Access Fees: o Clinical Service Procedure-Based Fees: · Capital equipment-related services: o Equipment service: one three o Installation, training and shipping: The Company operates in one Payment terms under contracts with customers generally are in a range of 30-60 days The Company’s terms and conditions do not provide for a right of return unless for: (a) product defects; or (b) other conditions subject to the Company’s approval. See Note 3 for additional information regarding revenue recognition. Net Loss Per Share The Company computes net loss per share using the weighted-average number of common shares outstanding during the period. Basic and diluted net loss per share are the same because the conversion, exercise or issuance of all potential common stock equivalents, which comprise the entire amount of the Company’s outstanding common stock options and warrants, as described in Note 7, and the potential conversion of the First and Second Closing Notes, as described in Note 5, would be anti-dilutive, due to the reporting of a net loss for each of the periods in the accompanying condensed consolidated statements of operations. Concentration Risks and Other Risks and Uncertainties Accounts Receivable Customer Sales Financial instruments that potentially subject the Company to significant concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. The Company holds substantially all its cash and cash equivalents on deposit with financial institutions in the U.S. insured by the Federal Deposit Insurance Corporation. At September 30, 2021, the Company had approximately $ 52 At September 30, 2021, there were no customers whose accounts receivable balance exceeded 10% of accounts receivable at that date. At December 31, 2020, one customer accounted for 11 One customer, a related party as discussed in Note 3, accounted for 18 15 19 18 Prior to granting credit, the Company performs credit evaluations of its customers’ financial condition, and generally does not require collateral from its customers. The Company will provide an allowance for doubtful accounts when collections become doubtful. The allowance for doubtful accounts at September 30, 2021 and December 31, 2020 was $ 0.2 0.06 The Company is subject to risks common to emerging companies in the medical device industry, including, but not limited to: new technological innovations; acceptance and competitiveness of its products; dependence on key personnel; dependence on key suppliers; dependence on third-party collaboration, license and joint development partners; changes in general economic conditions and interest rates; protection of proprietary technology; compliance with changing government regulations; uncertainty of widespread market acceptance of products; access to credit for capital purchases by customers; and product liability claims. Certain components used in manufacturing have relatively few alternative sources of supply and establishing additional or replacement suppliers for such components cannot be accomplished quickly. The inability of any of these suppliers to fulfill the Company’s supply requirements may negatively impact future operating results. Adoption of New Accounting Standard Effective January 1, 2021, the Company adopted, on a modified retrospective method of transition, the provisions of Accounting Standards Update No. 2020-06, “Debt – Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40) – Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity” (the “ASU”). The ASU is effective for public companies, other than smaller reporting companies as defined by the SEC, for fiscal years beginning after December 15, 2021, and for smaller reporting companies, which is the Company’s current classification, for fiscal years beginning after December 31, 2023. However, the ASU permits early adoption, no earlier than for fiscal years beginning after December 31, 2020, and the Company elected such early adoption. The ASU amends prior authoritative literature to reduce the number of accounting models for, among others, convertible debt instruments for which the embedded conversion features of such instruments had previously been required to be separated from the host contract. The Company determined that the conversion feature embedded in the Second Closing Note (see Note 5) was within the scope of the ASU. Accordingly, the discount originally recorded in connection with the issuance of the Second Closing Note and a corresponding amount recorded in additional paid-in capital, each in the amount of approximately $ 3.1 Reclassifications The accompanying consolidated statements of operations for the three and nine months ended September 30, 2021 contain: (a) certain items formerly classified as service revenue that that have been reclassified to product revenue; (b) certain items formerly classified as general and administrative expenses, research and development expenses, and sales and marketing expenses that have been reclassified to cost of revenue; and (c) an item formerly classified as interest expense that has been reclassified as other expense. The accompanying condensed consolidated statements of operations for the three and nine months ended September 30, 2020 have been conformed to the 2021 presentation.

Revenue Recognition

Revenue Recognition	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Revenue Recognition	3. Revenue Recognition Revenue by Service Line Three Months Ended September 30, (in thousands) 2021 2020 Functional neurosurgery navigation and therapy Disposable products $ 2,004 $ 1,840 Services 150 — Subtotal – functional neurosurgery navigation and 2,154 1,840 Biologics and drug delivery Disposable products 1,137 420 Services 920 1,055 Subtotal – biologics and drug delivery 2,057 1,475 Capital equipment and software Systems and software products 197 111 Services 166 93 Subtotal – capital equipment and software 363 204 Total revenue $ 4,574 $ 3,519 Nine Months Ended September 30, (in thousands) 2021 2020 Functional neurosurgery navigation and therapy Disposable products $ 5,782 $ 4,652 Services 150 — Subtotal – functional neurosurgery navigation and 5,932 4,652 Biologics and drug delivery Disposable products 2,501 1,000 Services 2,605 2,671 Subtotal – biologics and drug delivery 5,106 3,671 Capital equipment and software Systems and software products 580 534 Services 399 256 Subtotal – capital equipment and software 979 790 Total revenue $ 12,017 $ 9,113 Contract Balances · Contract assets · Contract liabilities – During the three and nine months ended September 30, 2021, the Company recognized capital equipment and software-related service revenue of approximately $ 0.1 0.3 In 2019, the Company entered into a Development Services Agreement with a customer under which the Company was entitled to bill the customer for an upfront payment of $ 0.13 0.02 0.05 Investor Unbilled Revenues Commencing in 2019, the Company was a party to a Letter of Intent and a related Statement of Work (together with the Letter of Intent, the “Project Documents”) with a customer who is a stockholder and a noteholder (see Note 5), and an officer of whom is a member of the Company’s Board of Directors, to commence a product development project. Under the terms of the Project Documents, the Company was entitled to bill the customer for: (a) an upfront, nonrefundable payment of $ 0.5 0.5 0.25 0.7 2.1 0.1 0.1 The Company offers an upgraded version of its software at no additional charge to customers purchasing a three-year systems service agreement. The transaction prices of the software and the service agreement are determined through an allocation of the service agreement price based on the standalone prices of the software and the service agreements customarily charged by the Company. The transaction price of the software is recognized as revenue upon its installation and comprised less than $ 0.1 0.1 Remaining Performance Obligations The Company’s contracts with customers for functional neurosurgery and therapy product sales are predominantly of terms less than one year. Accordingly, the transaction prices of remaining performance obligations related to such contracts at September 30, 2021 are not material. Revenue with respect to remaining performance obligations related to capital equipment and software-related service agreements with original terms in excess of one year and the upfront payments discussed under the heading “Contract Balances” above amounted to approximately $ 0.8 Company expects to recognize this revenue within the next three years. Revenue with respect to remaining performance obligations related to contracts with the Company’s biologic and drug delivery customers, other than those contracts discussed under the heading “Contract Balances,” predominantly is contingent upon such customers’ performance of clinical trials on which the Company’s performance obligations are predicated.

Inventory

Inventory	9 Months Ended
	Sep. 30, 2021
Inventory Disclosure [Abstract]
Inventory	4. Inventory Inventory consists of the following as of: Inventory - Schedule of Inventory, Current (in thousands) September 30, December 31, Raw materials and work in process $ 2,314 $ 1,485 Software licenses 210 193 Finished goods 1,419 1,560 Inventory, net, included in current assets 3,943 3,238 Software licenses – non-current 519 589 Total $ 4,462 $ 3,827

Notes Payable

Notes Payable	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Notes Payable	5. Notes Payable As a result of the transactions described below, an aggregate principal amount of $ 17.5 At the option of the holders at any time prior to maturity, $10 million in principal amount of the 2020 Secured Convertible Notes, which are held by a customer who is a stockholder and has a representative on the Company’s Board of Directors, are convertible to the Company’s common stock at a conversion price of $6.00, and $7.5 million in principal amount of the 2020 Secured Convertible Notes are convertible at a price of $10.14, subject in both cases to adjustments as set forth in the SPA and the note agreements. On January 29, 2020 (the “Closing Date”), the Company completed a financing transaction (the “2020 Financing Transaction”) with the 2020 Convertible Noteholders, whereby the Company issued an aggregate principal amount of $ 17.5 fifth bear interest at a rate equal to the sum of (i) the greater of (a) the three (3)-month London Interbank Offered Rate (“LIBOR”) and (b) two percent (2%), plus (ii) a margin of 2% on the outstanding balance of the First Closing Notes, payable quarterly on the first business day of each calendar quarter. The First Closing Notes may be converted at a price of $6.00 per share, subject to certain adjustments set forth in the SPA, and may not be pre-paid without the consent of the noteholder, provided that the Company must offer to pre-pay such other noteholder on the same terms and conditions. In May 2021, one of 2020 Convertible Noteholders (the “Converting Noteholder”) converted the entire $ 7.5 0.04 1,256,143 At the Closing Date, the SPA gave the Company the right, but not the obligation, to request at any time on or prior to January 11, 2022, that one of the 2020 Convertible Noteholders purchase an additional $5.0 million in aggregate principal amount of Second Closing Note and an additional $10.0 million in aggregate principal amount of Third Closing Note (as defined in the SPA; together, with the Second Closing Note, the “Additional Convertible Notes”), provided that such 2020 Convertible Noteholder has the right, but not the obligation, to purchase such notes. The Additional Convertible Notes would also mature on the fifth anniversary of the Closing Date. On December 29, 2020, the Company and the 2020 Convertible Noteholders entered into the Amendment to the SPA, the terms of which, among other provisions, provided for: (a) an increase in the principal amount of the Second Closing Note to $7.5 million; (b) a revision of the interest rate to be borne by the Second Closing Note to consist of: (i) cash interest of 2% per annum, payable quarterly; and (ii) payment-in-kind interest of 5% per annum, accruable quarterly as an addition to the unpaid principal balance of the Second Closing Note; and (c) an increase in the conversion price of the Second Closing Notes to $10.14 per share, subject to certain adjustments set forth in the SPA. The aggregate carrying amounts of the First Closing Notes in the accompanying September 30, 2021 and December 31, 2020 condensed consolidated balance sheets are presented net of financing costs, comprised of commissions and legal expenses, having an unamortized balance of $ 0.2 0.4 0.2 0.2 The carrying amount of the Second Closing Note in the accompanying December 31, 2020 consolidated balance sheet is presented net of a discount, amounting to approximately $ 3.1 14.34 Under the terms of the SPA, as amended, the Company retains the right, but not the obligation, to request the 2020 Convertible Noteholder to purchase the Third Closing Note, and the 2020 Convertible Noteholder has the right, but not the obligation, to purchase such note. As of September 30, 2021, the Company had not made such a request. The 2020 Secured Notes are secured by all the assets of the Company. An executive officer of one of the 2020 Convertible Noteholders is a member of the Company’s Board of Directors. Pursuant to the terms of the SPA and a Board Observer Agreement entered into by the other 2020 Convertible Noteholder and the Company, the other 2020 Convertible Noteholder appointed a representative to attend and observe meetings of the Company’s Board of Directors. On February 25, 2021, such 2020 Convertible Noteholder terminated the Board Observer Agreement, thus precluding its representative from attending future meetings of the Company’s Board of Directors. 2010 Junior Secured Notes Payable On January 27, 2020, as a condition to completion of the 2020 Financing Transaction, the Company entered into the Fourth Omnibus Amendment to the 2010 Secured Notes, whereby the 2010 Secured Notes were subordinated to the Company’s obligations under the terms of the 2020 Secured Notes and the Additional Convertible Notes, as applicable. During the first fiscal quarter of 2020, the Company repaid in full the aggregate outstanding principal amount of the 2010 Secured Notes, amounting to approximately $ 2.8 0.9 Scheduled Notes Payable Maturities Scheduled principal payments as of September 30, 2021 with respect to notes payable are summarized as follows: Notes Payable - Schedule of Notes Payable Maturities Year ending December 31, (in thousands) 2025 $ 17,788 Total scheduled principal payments 17,788 Less: Unamortized financing costs (175 ) Total $ 17,613

Leases

Leases	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Leases	6. Leases The Company leases office space in Irvine, California that houses office space and a manufacturing facility under a non-cancellable operating lease. The lease term commenced on October 1, 2018 September 2023 five December 15, 2020 December 31, 2026 five The lease cost, included in general and administrative expense, was $ 0.1 0.03 0.4 0.1

Stockholders_ Equity

Stockholders’ Equity	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Stockholders’ Equity	7. Stockholders’ Equity 2021 Public Offering Public Offering On February 23, 2021, the Company completed a public offering of 2,127,660 1,850,140 23.50 277,520 22.09 Net proceeds from the offering totaled approximately $ 46.8 The underwriting agreement contains representations, warranties, agreements and indemnification obligations by the Company that are customary for this type of transaction. Issuance of Common Stock in Lieu of Cash Payments Under the terms of the Amended and Restated Non-Employee Director Compensation Plan, each compensated non-employee member of the Company’s Board of Directors may elect to receive all or part of his or her director fees in shares of the Company’s common stock. Effective from June 25, 2021, director fees, whether paid in cash or in shares of common stock, are payable quarterly on the first business day following the end of the quarter. The number of shares of common stock issued to directors is determined by dividing the product of: (i) (a) the fees otherwise payable to each director in cash, times (b) the percentage of fees the director elected to receive in shares of common stock, by (ii) the volume weighted average price per share of common stock over the last five trading days of the quarter. The following is information regarding the number of shares issued to directors as payment for director fees in lieu of cash for the three and nine months ended September 30, 2021 and 2020: Three Months Ended September 30, 2021 2020 — 6,141 Nine Months Ended September 30, 2021 2020 3,829 25,704 Stock Incentive Plans The Company has various share-based compensation plans and share-based compensatory contracts (collectively, the “Plans”) under which it has granted share-based awards, such as stock grants, and incentive and non-qualified stock options, to employees, directors, consultants and advisors. Awards may be subject to a vesting schedule as set forth in individual award agreements. From October 2017 until June 2020, the Company granted share-based awards under the Company’s Second Amended and Restated 2013 Incentive Compensation Plan (the “Second Amended Plan”). On June 2, 2020, the Company’s stockholders approved the Company’s Third Amended and Restated 2013 Incentive Compensation Plan (the “Third Amended Plan” and, together with the Second Amended Plan, the “2013 Plan”), under which 1.0 2,956,250 834,060 1,378,400 743,790 Stock option activity under all of the Company’s Plans and share-based compensatory contracts during the nine months ended September 30, 2021 is summarized below: Stockholders’ Equity - Schedule of Stock Option Activity Option Weighted-average Intrinsic (1) (in thousands) Outstanding at January 1, 2021 1,806,092 $ 7.12 $ 20,760 Granted 121,703 18.12 Exercised (557,184 ) 2.69 Expired / terminated (18,500 ) 20.46 Outstanding at September 30, 2021 1,352,111 $ 9.75 $ 15,328 (1) Intrinsic value is calculated as the estimated fair value of the Company’s stock at the end of the related period less the option exercise price of in-the-money options. As of September 30, 2021, there was unrecognized compensation expense of approximately $ 4.8 2.3 ESPP On June 3, 2021, the Company’s stockholders adopted and approved the ClearPoint Neuro, Inc. Employee Stock Purchase Plan (the “ESPP”), which allows eligible employees to acquire shares of the Company’s common stock through payroll deductions at a discount to market price. A total of 400,000 Warrants Warrants to purchase shares of the Company's common stock were issued in connection with financing transactions in 2015, 2016, and 2017, and are generally for terms of five years. These warrants contain net exercise provisions giving the holder the option of acquiring a number of shares having a value equal to the difference between the exercise price and the current stock price, in lieu of paying the exercise price to acquire the full number of stated shares. All of the warrants outstanding at September, 30, 2021 will terminate by the year end 2023. Common stock warrant activity for the nine months ended September 30, 2021 was as follows: Stockholders’ Equity - Schedule of Common Stock Warrant Activity Warrant Weighted-average Intrinsic (1) (in thousands) Outstanding at January 1, 2021 3,082,987 $ 3.82 $ 37,379 Exercised (2,023,190 ) 3.31 Terminated (390,390 ) 7.78 Outstanding at September 30, 2021 669,407 $ 2.97 $ 9,895 (1) Intrinsic value is calculated as the estimated fair value of the Company’s stock at the end of the related period less the option exercise price of in-the-money options.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	8. Subsequent Events Subsequent Events On November 3, 2021, the holder of the Second Closing Note (see Note 5) converted the entire $ 7.8 0.05 773,446

Basis of Presentation and Sum_2

Basis of Presentation and Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation and Use of Estimates	Basis of Presentation and Use of Estimates In the opinion of management, the accompanying unaudited condensed consolidated financial statements have been prepared on a basis consistent with the Company’s December 31, 2020 audited consolidated financial statements, and include all adjustments, consisting of only normal recurring adjustments, necessary to fairly state the information set forth therein. These condensed consolidated financial statements have been prepared in accordance with SEC rules for interim financial information, and, therefore, omit certain information and footnote disclosures necessary to present such statements in accordance with generally accepted accounting principles in the U.S. (“GAAP”). The preparation of these condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue, expenses and the related disclosures at the date of the financial statements and during the reporting period. Actual results could materially differ from these estimates. These condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s 2020 Form 10-K. The accompanying condensed consolidated balance sheet as of December 31, 2020 has been derived from the audited consolidated financial statements at that date but does not include all information and footnotes required by GAAP for a complete set of financial statements. The results of operations for the three and nine months ended September 30, 2021 may not be indicative of the results to be expected for the entire year or any future periods.
Inventory	Inventory Inventory is carried at the lower of cost (first-in, first-out method) or net realizable value. Items in inventory relate predominantly to the Company’s ClearPoint system. Software license inventory related to ClearPoint systems undergoing on-site customer evaluation is included in inventory in the accompanying condensed consolidated balance sheets. All other software license inventory is classified as a non-current asset. The Company periodically reviews its inventory for obsolete items and provides a reserve upon identification of potentially obsolete items.
Intangible Assets	Intangible Assets The Company is a party to certain license agreements that provide rights to the Company for the development and commercialization of products. Under the terms of those license agreements, the Company made payments to the licensors upon execution of the license agreements for access to the underlying technologies and will make future payments based on the achievement of regulatory and commercialization milestones as defined in the license agreements. In conformity with Accounting Standards Codification Section 350, “Intangibles – Goodwill and Other,” the Company amortizes its investment in the license rights described above over an expected useful life of five years. In addition, the Company periodically evaluates the recoverability of its investment in the license rights and records an impairment charge in the event such evaluation indicates that the Company’s investment is not likely to be recovered.
Revenue Recognition	Revenue Recognition The Company’s revenue is comprised primarily of: (1) product revenue resulting from the sale of functional neurosurgery, navigation, therapy, and biologics and drug delivery disposable products; (2) product revenue resulting from the sale of ClearPoint capital equipment and software; (3) revenue resulting from the service, installation, training and shipping related to ClearPoint capital equipment and software; and (4) consultation and clinical case support revenue in connection with customer-sponsored clinical trials. The Company recognizes revenue when control of the Company’s products and services is transferred to its customers in an amount that reflects the consideration the Company expects to receive from its customers in exchange for those products and services, in a process that involves identifying the contract with a customer, determining the performance obligations in the contract, determining the contract price, allocating the contract price to the distinct performance obligations in the contract, and recognizing revenue when the performance obligations have been satisfied. A performance obligation is considered distinct from other obligations in a contract when it provides a benefit to the customer either on its own or together with other resources that are readily available to the customer and is separately identified in the contract. When a contract calls for the satisfaction of multiple performance obligations for a single contract price, the Company allocates the contract price among the performance obligations based on the relative stand-alone prices for each such performance obligation customarily charged by the Company. The Company considers a performance obligation satisfied once it has transferred control of a good or service to the customer, meaning the customer has the ability to use and obtain the benefit of the good or service. The Company recognizes revenue for satisfied performance obligations only when it determines there are no uncertainties regarding payment terms or transfer of control. Lines of Business; Timing of Revenue Recognition · Functional neurosurgery navigation product, biologics and drug delivery systems product, and therapy product sales: · Capital equipment and software sales o Capital equipment and software sales preceded by evaluation periods: o Capital equipment and software sales not preceded by evaluation periods: For both types of capital equipment and software sales described above, the Company’s determination of the point in time at which to recognize revenue represents that point at which the customer has legal title, physical possession, and the risks and rewards of ownership, and the Company has a present right to payment. · Functional neurosurgery navigation and therapy services: Minimum Maximum · Biologics and drug delivery services: o Consultation Services: o Clinical Service Access Fees: o Clinical Service Procedure-Based Fees: · Capital equipment-related services: o Equipment service: one three o Installation, training and shipping: The Company operates in one Payment terms under contracts with customers generally are in a range of 30-60 days The Company’s terms and conditions do not provide for a right of return unless for: (a) product defects; or (b) other conditions subject to the Company’s approval. See Note 3 for additional information regarding revenue recognition.
Net Loss Per Share	Net Loss Per Share The Company computes net loss per share using the weighted-average number of common shares outstanding during the period. Basic and diluted net loss per share are the same because the conversion, exercise or issuance of all potential common stock equivalents, which comprise the entire amount of the Company’s outstanding common stock options and warrants, as described in Note 7, and the potential conversion of the First and Second Closing Notes, as described in Note 5, would be anti-dilutive, due to the reporting of a net loss for each of the periods in the accompanying condensed consolidated statements of operations.
Concentration Risks and Other Risks and Uncertainties	Concentration Risks and Other Risks and Uncertainties Accounts Receivable Customer Sales Financial instruments that potentially subject the Company to significant concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. The Company holds substantially all its cash and cash equivalents on deposit with financial institutions in the U.S. insured by the Federal Deposit Insurance Corporation. At September 30, 2021, the Company had approximately $ 52 At September 30, 2021, there were no customers whose accounts receivable balance exceeded 10% of accounts receivable at that date. At December 31, 2020, one customer accounted for 11 One customer, a related party as discussed in Note 3, accounted for 18 15 19 18 Prior to granting credit, the Company performs credit evaluations of its customers’ financial condition, and generally does not require collateral from its customers. The Company will provide an allowance for doubtful accounts when collections become doubtful. The allowance for doubtful accounts at September 30, 2021 and December 31, 2020 was $ 0.2 0.06 The Company is subject to risks common to emerging companies in the medical device industry, including, but not limited to: new technological innovations; acceptance and competitiveness of its products; dependence on key personnel; dependence on key suppliers; dependence on third-party collaboration, license and joint development partners; changes in general economic conditions and interest rates; protection of proprietary technology; compliance with changing government regulations; uncertainty of widespread market acceptance of products; access to credit for capital purchases by customers; and product liability claims. Certain components used in manufacturing have relatively few alternative sources of supply and establishing additional or replacement suppliers for such components cannot be accomplished quickly. The inability of any of these suppliers to fulfill the Company’s supply requirements may negatively impact future operating results.
Adoption of New Accounting Standard	Adoption of New Accounting Standard Effective January 1, 2021, the Company adopted, on a modified retrospective method of transition, the provisions of Accounting Standards Update No. 2020-06, “Debt – Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40) – Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity” (the “ASU”). The ASU is effective for public companies, other than smaller reporting companies as defined by the SEC, for fiscal years beginning after December 15, 2021, and for smaller reporting companies, which is the Company’s current classification, for fiscal years beginning after December 31, 2023. However, the ASU permits early adoption, no earlier than for fiscal years beginning after December 31, 2020, and the Company elected such early adoption. The ASU amends prior authoritative literature to reduce the number of accounting models for, among others, convertible debt instruments for which the embedded conversion features of such instruments had previously been required to be separated from the host contract. The Company determined that the conversion feature embedded in the Second Closing Note (see Note 5) was within the scope of the ASU. Accordingly, the discount originally recorded in connection with the issuance of the Second Closing Note and a corresponding amount recorded in additional paid-in capital, each in the amount of approximately $ 3.1
Reclassifications	Reclassifications The accompanying consolidated statements of operations for the three and nine months ended September 30, 2021 contain: (a) certain items formerly classified as service revenue that that have been reclassified to product revenue; (b) certain items formerly classified as general and administrative expenses, research and development expenses, and sales and marketing expenses that have been reclassified to cost of revenue; and (c) an item formerly classified as interest expense that has been reclassified as other expense. The accompanying condensed consolidated statements of operations for the three and nine months ended September 30, 2020 have been conformed to the 2021 presentation.

Revenue Recognition (Tables)

Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Revenue from External Customers by Products and Services [Table Text Block]	Three Months Ended September 30, (in thousands) 2021 2020 Functional neurosurgery navigation and therapy Disposable products $ 2,004 $ 1,840 Services 150 — Subtotal – functional neurosurgery navigation and 2,154 1,840 Biologics and drug delivery Disposable products 1,137 420 Services 920 1,055 Subtotal – biologics and drug delivery 2,057 1,475 Capital equipment and software Systems and software products 197 111 Services 166 93 Subtotal – capital equipment and software 363 204 Total revenue $ 4,574 $ 3,519 Nine Months Ended September 30, (in thousands) 2021 2020 Functional neurosurgery navigation and therapy Disposable products $ 5,782 $ 4,652 Services 150 — Subtotal – functional neurosurgery navigation and 5,932 4,652 Biologics and drug delivery Disposable products 2,501 1,000 Services 2,605 2,671 Subtotal – biologics and drug delivery 5,106 3,671 Capital equipment and software Systems and software products 580 534 Services 399 256 Subtotal – capital equipment and software 979 790 Total revenue $ 12,017 $ 9,113

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2021
Inventory Disclosure [Abstract]
Inventory - Schedule of Inventory, Current	Inventory consists of the following as of: Inventory - Schedule of Inventory, Current (in thousands) September 30, December 31, Raw materials and work in process $ 2,314 $ 1,485 Software licenses 210 193 Finished goods 1,419 1,560 Inventory, net, included in current assets 3,943 3,238 Software licenses – non-current 519 589 Total $ 4,462 $ 3,827

Notes Payable (Tables)

Notes Payable (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Notes Payable - Schedule of Notes Payable Maturities	Scheduled principal payments as of September 30, 2021 with respect to notes payable are summarized as follows: Notes Payable - Schedule of Notes Payable Maturities Year ending December 31, (in thousands) 2025 $ 17,788 Total scheduled principal payments 17,788 Less: Unamortized financing costs (175 ) Total $ 17,613

Stockholders_ Equity (Tables)

Stockholders’ Equity (Tables)	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Stockholders' Equity - Schedule of Share-Based Compensation for Directors Fees	Three Months Ended September 30, 2021 2020 — 6,141 Nine Months Ended September 30, 2021 2020 3,829 25,704
Stockholders’ Equity - Schedule of Stock Option Activity	Stock option activity under all of the Company’s Plans and share-based compensatory contracts during the nine months ended September 30, 2021 is summarized below: Stockholders’ Equity - Schedule of Stock Option Activity Option Weighted-average Intrinsic (1) (in thousands) Outstanding at January 1, 2021 1,806,092 $ 7.12 $ 20,760 Granted 121,703 18.12 Exercised (557,184 ) 2.69 Expired / terminated (18,500 ) 20.46 Outstanding at September 30, 2021 1,352,111 $ 9.75 $ 15,328 (1) Intrinsic value is calculated as the estimated fair value of the Company’s stock at the end of the related period less the option exercise price of in-the-money options.
Stockholders’ Equity - Schedule of Common Stock Warrant Activity	Common stock warrant activity for the nine months ended September 30, 2021 was as follows: Stockholders’ Equity - Schedule of Common Stock Warrant Activity Warrant Weighted-average Intrinsic (1) (in thousands) Outstanding at January 1, 2021 3,082,987 $ 3.82 $ 37,379 Exercised (2,023,190 ) 3.31 Terminated (390,390 ) 7.78 Outstanding at September 30, 2021 669,407 $ 2.97 $ 9,895 (1) Intrinsic value is calculated as the estimated fair value of the Company’s stock at the end of the related period less the option exercise price of in-the-money options.

Description of the Business a_2

Description of the Business and Financial Condition (Details Narrative) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended		12 Months Ended
	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Cumulative net loss		$ 129,783		$ 119,522
Net cash used in operations		9,145	$ 5,406	7,800
Secured convertible notes		17,613		21,280
Proceeds from issuance of Paycheck Protection Program loan			$ 896	900
Sale of stock, number of shares issued		2,127,660
Proceeds from issuance of stock		$ 46,800
The 2010 Secured Notes [Member]
Repayment of secured notes	$ 3,700
Security Purchase Agreement | The "2020 Convertible Noteholders"
Secured convertible notes		$ 17,500		$ 17,500
Term of debt				5 years
Proceeds from Debt, Net of Issuance Costs				$ 16,800
Security Purchase Agreement | The "2020 Secured Notes"
Secured convertible notes				$ 7,500
Sale of stock, additional information				The SPA also gave the Company the right, but not the obligation, to request one of the 2020 Convertible Noteholders to purchase an additional $5.0 million in principal amount of a note (the “Second Closing Note”, and, together with the First Closing Note, the “2020 Secured Notes”).

Basis of Presentation and Sum_3

Basis of Presentation and Summary of Significant Accounting Policies (Details Narrative) $ in Thousands	3 Months Ended			9 Months Ended		12 Months Ended
	Sep. 30, 2021USD ($)	Mar. 31, 2021USD ($)	Sep. 30, 2020	Sep. 30, 2021USD ($)Number	Sep. 30, 2020	Dec. 31, 2020USD ($)
Product Information [Line Items]
Operating segments | Number				1
Payment terms under contracts with customers				a range of 30-60 days
Bank balances in excess of insured limits, approximate	$ 52,000			$ 52,000
Allowance for doubtful accounts	$ 200			200		$ 60
Adoption of ASU 2020-06		$ 3,107		$ 3,100
Accounts Receivable | Customer
Product Information [Line Items]
Concentration risk, percentage						11.00%
Sales | Customer
Product Information [Line Items]
Concentration risk, percentage	18.00%		15.00%	19.00%	18.00%
Minimum
Product Information [Line Items]
Term of service agreements (in years)				1 year
Maximum
Product Information [Line Items]
Term of service agreements (in years)				3 years

Revenue Recognition - Schedule

Revenue Recognition - Schedule of Revenue Recognition (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Line Items]
Total revenues	$ 4,574	$ 3,519	$ 12,017	$ 9,113
Functional Neurosurgery Navigation and Therapy - Disposable Products
Disaggregation of Revenue [Line Items]
Total revenues	2,004	1,840	5,782	4,652
Functional Neurosurgery Navigation and Therapy - Services
Disaggregation of Revenue [Line Items]
Total revenues	150		150
Functional Neurosurgery Navigation and Therapy
Disaggregation of Revenue [Line Items]
Total revenues	2,154	1,840	5,932	4,652
Biologics and Drug Delivery - Disposable Products
Disaggregation of Revenue [Line Items]
Total revenues	1,137	420	2,501	1,000
Biologics and Drug Delivery - Services
Disaggregation of Revenue [Line Items]
Total revenues	920	1,055	2,605	2,671
Biologics and Drug Delivery
Disaggregation of Revenue [Line Items]
Total revenues	2,057	1,475	5,106	3,671
Capital Equipment and Software - Systems and Software Products
Disaggregation of Revenue [Line Items]
Total revenues	197	111	580	534
Capital Equipment and Software - Services
Disaggregation of Revenue [Line Items]
Total revenues	166	93	399	256
Capital Equipment and Software
Disaggregation of Revenue [Line Items]
Total revenues	$ 363	$ 204	$ 979	$ 790

Revenue Recognition (Details Na

Revenue Recognition (Details Narrative) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 30, 2020	Dec. 31, 2019	Dec. 31, 2020
Disaggregation of Revenue [Line Items]
Total revenues	$ 4,574	$ 3,519	$ 12,017	$ 9,113
Unbilled accounts receivable, approximate	100		100				$ 100
Development Services Agreement
Disaggregation of Revenue [Line Items]
Upfront payment commitment						$ 130
Deferred revenue	20		20				50
Letter of Intent | Investor
Disaggregation of Revenue [Line Items]
Total revenues	700		2,100			500
Deferred revenue							100
Reduction of service fees receivable					$ 250
Accounts receivable	100		100				$ 100
Letter of Intent | Investor | Unbilled Revenues
Disaggregation of Revenue [Line Items]
Upfront payment commitment						$ 500
Capital Equipment Related Service Revenue
Disaggregation of Revenue [Line Items]
Total revenues	100		300
Remaining Performance Obligations Capital Equipment-Related Service Revenue
Disaggregation of Revenue [Line Items]
Remaining performance obligations	$ 800		$ 800
Period for recognition of revenue			Company expects to recognize this revenue within the next three years.

Inventory - Schedule of Invento

Inventory - Schedule of Inventory, Current (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials and work in process	$ 2,314	$ 1,485
Software licenses	210	193
Finished goods	1,419	1,560
Inventory, net, included in current assets	3,943	3,238
Software licenses – non-current	519	589
Total	$ 4,462	$ 3,827

Notes Payable - Schedule of Not

Notes Payable - Schedule of Notes Payable Maturities (Details) $ in Thousands	Sep. 30, 2021USD ($)
Debt Disclosure [Abstract]
2025	$ 17,788
Total scheduled principal payments	17,788
Less: Unamortized financing costs	(175)
Total	$ 17,613

Notes Payable (Details Narrativ

Notes Payable (Details Narrative) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	9 Months Ended	12 Months Ended
	Mar. 31, 2020	Sep. 30, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Secured convertible notes		$ 17,613	$ 21,280
Conversion of debt		7,500
Accrued interest included in the conversion of debt		$ 40
Shares issued upon conversion of debt		1,256,143
2010 Junior Secured Notes Payable
Debt Instrument [Line Items]
Repayment of secured debt	$ 2,800
Payments for accrued interest	$ 900
Security Purchase Agreement | The "2020 Convertible Noteholders"
Debt Instrument [Line Items]
Secured convertible notes		$ 17,500	$ 17,500
Terms of debt conversion		At the option of the holders at any time prior to maturity, $10 million in principal amount of the 2020 Secured Convertible Notes, which are held by a customer who is a stockholder and has a representative on the Company’s Board of Directors, are convertible to the Company’s common stock at a conversion price of $6.00, and $7.5 million in principal amount of the 2020 Secured Convertible Notes are convertible at a price of $10.14, subject in both cases to adjustments as set forth in the SPA and the note agreements.	The First Closing Notes may be converted at a price of $6.00 per share, subject to certain adjustments set forth in the SPA, and may not be pre-paid without the consent of the noteholder, provided that the Company must offer to pre-pay such other noteholder on the same terms and conditions.
Term of secured notes			5 years
Interest rate terms			bear interest at a rate equal to the sum of (i) the greater of (a) the three (3)-month London Interbank Offered Rate (“LIBOR”) and (b) two percent (2%), plus (ii) a margin of 2% on the outstanding balance of the First Closing Notes, payable quarterly on the first business day of each calendar quarter.
Additional rights, description			the SPA gave the Company the right, but not the obligation, to request at any time on or prior to January 11, 2022, that one of the 2020 Convertible Noteholders purchase an additional $5.0 million in aggregate principal amount of Second Closing Note and an additional $10.0 million in aggregate principal amount of Third Closing Note (as defined in the SPA; together, with the Second Closing Note, the “Additional Convertible Notes”), provided that such 2020 Convertible Noteholder has the right, but not the obligation, to purchase such notes. The Additional Convertible Notes would also mature on the fifth anniversary of the Closing Date.
Security Purchase Agreement | First Closing Notes
Debt Instrument [Line Items]
Secured convertible notes		$ 200	$ 400
Conversion of debt		7,500
Accrued interest included in the conversion of debt		$ 40
Shares issued upon conversion of debt		1,256,143
Commitment fee			200
Reversal of commitment fee			200
Security Purchase Agreement | Second Closing Note
Debt Instrument [Line Items]
Secured convertible notes			$ 3,100
Closing price per share			$ 14.34
Security Purchase Agreement Amended | The "2020 Convertible Noteholders"
Debt Instrument [Line Items]
Secured convertible notes, terms and conditions			the Company and the 2020 Convertible Noteholders entered into the Amendment to the SPA, the terms of which, among other provisions, provided for: (a) an increase in the principal amount of the Second Closing Note to $7.5 million; (b) a revision of the interest rate to be borne by the Second Closing Note to consist of: (i) cash interest of 2% per annum, payable quarterly; and (ii) payment-in-kind interest of 5% per annum, accruable quarterly as an addition to the unpaid principal balance of the Second Closing Note; and (c) an increase in the conversion price of the Second Closing Notes to $10.14 per share, subject to certain adjustments set forth in the SPA.

Leases (Details Narrative)

Leases (Details Narrative) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Lessee, Lease, Description [Line Items]
Lease cost (included in general and administrative expense)	$ 100	$ 30	$ 400	$ 100
Office Lease - Irvine, California
Lessee, Lease, Description [Line Items]
Commenced dated			Oct. 1, 2018
Lease expiration date			September 2023
Lease renewal term	5 years		5 years
Lease term	5 years		5 years
Office Lease - Solana Beach, California
Lessee, Lease, Description [Line Items]
Commenced dated			Dec. 15, 2020
Lease renewal term	5 years		5 years
Lease term	5 years		5 years
Lease expiration date			Dec. 31, 2026

Stockholders' Equity - Schedule

Stockholders' Equity - Schedule of Share-Based Compensation for Director Fees (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Equity [Abstract]
Stock Issued During Period, Shares, Other		6,141	3,829	25,704

Stockholders_ Equity - Schedule

Stockholders’ Equity - Schedule of Stock Option Activity (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)$ / sharesshares
Equity [Abstract]
Option shares outstanding at January 1, 2021 | shares	1,806,092
Weighted-average exercise price per share, outstanding | $ / shares	$ 7.12
Intrinsic value, outstanding | $	$ 20,760
Option shares granted | shares	121,703
Weighted-average exercise price per share, granted | $ / shares	$ 18.12
Option shares exercised | shares	(557,184)
Weighted-average exercise price per share, exercised | $ / shares	$ 2.69
Option shares expired / terminated | shares	(18,500)
Weighted-average exercise price per share, Expired / terminated | $ / shares	$ 20.46
Option shares outstanding at September 30, 2021 | shares	1,352,111
Weighted-average exercise price per share, outstanding | $ / shares	$ 9.75
Intrinsic value, outstanding | $	$ 15,328

Stockholders_ Equity - Schedu_2

Stockholders’ Equity - Schedule of Common Stock Warrant Activity (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)$ / sharesshares
Equity [Abstract]
Warrant shares outstanding at January 1, 2021 | shares	3,082,987
Weighted-average exercise price per share, outstanding | $ / shares	$ 3.82
Intrinsic value, outstanding | $	$ 37,379
Warrant shares exercised | shares	(2,023,190)
Weighted-average exercise price per share, exercised | $ / shares	$ 3.31
Warrant shares terminated | shares	(390,390)
Weighted-average exercise price per share, terminated | $ / shares	$ 7.78
Warrant shares outstanding at September 30, 2021 | shares	669,407
Weighted-average exercise price per share, outstanding | $ / shares	$ 2.97
Intrinsic value, outstanding | $	$ 9,895

Stockholders_ Equity (Details N

Stockholders’ Equity (Details Narrative) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020	Jun. 02, 2020
Subsidiary, Sale of Stock [Line Items]
Sale of stock, number of shares issued	2,127,660
Proceeds from issuance of stock	$ 46,800
Number of awards granted	121,703
Number of awards outstanding	1,352,111	1,806,092
Unrecognized compensation expense	$ 4,800
Compensation expense, period for recognition	2 years 3 months 18 days
Amended and Restated 2013 Incentive Compensation Plan
Subsidiary, Sale of Stock [Line Items]
Shares available for issuance	743,790		1,000,000
Common stock reserved for issuance			2,956,250
Number of awards granted	834,060
Number of awards outstanding	1,378,400
Employee Stock Purchase Plan
Subsidiary, Sale of Stock [Line Items]
Shares available for issuance	400,000
Public Offering
Subsidiary, Sale of Stock [Line Items]
Sale of stock, number of shares issued	2,127,660
Common stock initially offered at public offering	1,850,140
Public offering price, per share	$ 23.50
Shares sold pursuant to exercise of underwriters option	277,520
Price per share for underwriters option to purchase	$ 22.09
Proceeds from issuance of stock	$ 46,800

Subsequent Events (Details Narr

Subsequent Events (Details Narrative) - USD ($) $ in Thousands	Nov. 03, 2021	Sep. 30, 2021
Subsequent Event [Line Items]
Conversion of debt		$ 7,500
Conversion of debt, share issued		1,256,143
Subsequent Events | Security Purchase Agreement | Second Closing Note
Subsequent Event [Line Items]
Conversion of debt	$ 7,800
Amount of accrued and paid-in-kind interest included in converted debt	$ 50
Conversion of debt, share issued	773,446