MiMedx (MDXG) 10-Q 30 Oct 23 2023 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2023	Oct. 26, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
Document Transition Report	false
Entity File Number	001-35887
Entity Registrant Name	MIMEDX GROUP, INC.
Entity Incorporation, State or Country Code	FL
Entity Tax Identification Number	26-2792552
Entity Address, Address Line One	1775 West Oak Commons Ct NE
Entity Address, City or Town	Marietta
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30062
City Area Code	770
Local Phone Number	651-9100
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	MDXG
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		116,376,583
Entity Central Index Key	0001376339
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash	$ 81,164	$ 65,950
Accounts receivable, net	49,005	43,084
Inventory	19,068	13,183
Prepaid expenses	2,954	8,646
Other current assets	2,311	3,335
Total current assets	154,502	134,198
Property and equipment, net	7,094	7,856
Right of use asset	2,441	3,400
Goodwill	19,441	19,976
Intangible assets, net	5,395	5,852
Other assets	149	148
Total assets	189,022	171,430
Current liabilities:
Accounts payable	9,170	8,847
Accrued compensation	23,159	21,852
Accrued expenses	9,444	11,024
Other current liabilities	1,854	1,834
Total current liabilities	43,627	43,557
Long term debt, net	48,966	48,594
Other liabilities	2,605	4,773
Total liabilities	95,198	96,924
Commitments and contingencies (Note 13)
Convertible preferred stock Series B; $0.001 par value; 100,000 shares authorized, issued and outstanding at September 30, 2023 and December 31, 2022	92,494	92,494
Stockholders' equity (deficit)
Preferred stock Series A; $0.001 par value; 5,000,000 shares authorized, 0 issued and outstanding at September 30, 2023 and December 31, 2022	0	0
Common stock; $0.001 par value; 250,000,000 shares authorized, 116,359,748 issued and outstanding at September 30, 2023 and 187,500,000 shares authorized, 113,705,447 issued and outstanding at December 31, 2022	116	114
Additional paid-in capital	188,369	173,804
Accumulated deficit	(187,155)	(191,906)
Total stockholders' equity (deficit)	1,330	(17,988)
Total liabilities, convertible preferred stock, and stockholders’ equity (deficit)	$ 189,022	$ 171,430

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2023	Dec. 31, 2022
LIABILITIES, CONVERTIBLE PREFERRED STOCK, AND STOCKHOLDERS’ EQUITY (DEFICIT)
Series B convertible preferred stock par value (in dollars per share)	$ 0.001	$ 0.001
Series B convertible preferred stock, shares authorized (in shares)	100,000	100,000
Series B convertible preferred stock, shares issued (in shares)	100,000	100,000
Series B convertible preferred stock, shares outstanding (in shares)	100,000	100,000
Stockholders' equity (deficit)
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	250,000,000	187,500,000
Common stock, shares issued (in shares)	116,359,748	113,705,447
Common stock, shares outstanding (in shares)	116,359,748	113,705,447

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Net sales	$ 81,712	$ 67,689	$ 234,645	$ 193,466
Cost of sales	14,790	12,188	40,792	33,947
Gross profit	66,922	55,501	193,853	159,519
Operating expenses:
Selling, general and administrative	52,571	53,475	156,773	158,838
Research and development	3,175	5,953	18,168	17,429
Restructuring (Note 16)	208	0	3,464	0
Investigation, restatement and related	(38)	3,001	4,652	8,771
Amortization of intangible assets	190	175	570	519
Operating income (loss)	10,816	(7,103)	10,226	(26,038)
Other expense, net
Interest expense, net	(1,680)	(1,270)	(4,864)	(3,566)
Other expense, net	(11)	0	(42)	(1)
Income (loss) before income tax provision	9,125	(8,373)	5,320	(29,605)
Income tax provision expense	(591)	(53)	(569)	(178)
Net income (loss)	8,534	(8,426)	4,751	(29,783)
Net income (loss) available to common shareholders (Note 9)	$ 6,761	$ (10,096)	$ (433)	$ (34,667)
Net income (loss) per common share - basic (in dollars per share)	$ 0.06	$ (0.09)	$ 0	$ (0.31)
Net income (loss) per common share - diluted (in dollars per share)	$ 0.06	$ (0.09)	$ 0	$ (0.31)
Weighted average common shares outstanding - basic (in shares)	116,298,146	113,448,251	115,528,067	112,650,713
Weighted average common shares outstanding - diluted (in shares)	119,327,709	113,448,251	115,528,067	112,650,713

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' (DEFICIT) EQUITY - USD ($) $ in Thousands	Total	Common Stock Issued	Additional Paid-In Capital	Treasury Stock	Accumulated Deficit
Balance beginning of period (in shares) at Dec. 31, 2021		112,703,926
Balance, beginning of period at Dec. 31, 2021	$ 82	$ 113	$ 165,695	$ (4,017)	$ (161,709)
Treasury stock, beginning balance (in shares) at Dec. 31, 2021				778,710
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	10,798		10,798
Exercise of stock options (in shares)		133,762		151,239
Exercise of stock options	574		(697)	$ 1,271
Employee stock purchase plan	0
Issuance of restricted stock (in shares)		832,329		880,749
Issuance of restricted stock	0	$ 1	(3,960)	$ 3,959
Restricted stock shares canceled/forfeited (in shares)				5,338
Restricted stock shares canceled/forfeited	0		29	$ (29)
Shares repurchased for tax withholding (in shares)				249,778
Shares repurchased for tax withholding	(1,191)			$ (1,191)
Net income (loss)	(29,783)				(29,783)
Balance end of period (in shares) at Sep. 30, 2022		113,670,017
Balance, end of period at Sep. 30, 2022	(19,520)	$ 114	171,865	$ (7)	(191,492)
Treasury stock, ending balance (in shares) at Sep. 30, 2022				1,838
Balance beginning of period (in shares) at Jun. 30, 2022		113,609,274
Balance, beginning of period at Jun. 30, 2022	(13,603)	$ 114	169,352	$ (3)	(183,066)
Treasury stock, beginning balance (in shares) at Jun. 30, 2022				1,003
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	2,372		2,372
Exercise of stock options (in shares)		49,666		1,001
Exercise of stock options	137		132	$ 5
Issuance of restricted stock (in shares)		11,077
Restricted stock shares canceled/forfeited (in shares)				1,836
Restricted stock shares canceled/forfeited	0		9	$ (9)
Net income (loss)	(8,426)				(8,426)
Balance end of period (in shares) at Sep. 30, 2022		113,670,017
Balance, end of period at Sep. 30, 2022	$ (19,520)	$ 114	171,865	$ (7)	(191,492)
Treasury stock, ending balance (in shares) at Sep. 30, 2022				1,838
Balance beginning of period (in shares) at Dec. 31, 2022	113,705,447	113,705,447
Balance, beginning of period at Dec. 31, 2022	$ (17,988)	$ 114	173,804	$ 0	(191,906)
Treasury stock, beginning balance (in shares) at Dec. 31, 2022				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	$ 12,793		12,793
Exercise of stock options (in shares)	62,599	45,567		17,032
Exercise of stock options	$ 406		294	$ 112
Employee stock purchase plan (in shares)		444,809
Employee stock purchase plan	1,368		1,368
Issuance of restricted stock (in shares)		2,163,925		73,335
Issuance of restricted stock	0	$ 2	(268)	$ 266
Restricted stock shares canceled/forfeited (in shares)				90,367
Restricted stock shares canceled/forfeited	0		378	$ (378)
Net income (loss)	$ 4,751				4,751
Balance end of period (in shares) at Sep. 30, 2023	116,359,748	116,359,748
Balance, end of period at Sep. 30, 2023	$ 1,330	$ 116	188,369	$ 0	(187,155)
Treasury stock, ending balance (in shares) at Sep. 30, 2023				0
Balance beginning of period (in shares) at Jun. 30, 2023		116,109,125
Balance, beginning of period at Jun. 30, 2023	(12,666)	$ 116	182,907	$ 0	(195,689)
Treasury stock, beginning balance (in shares) at Jun. 30, 2023				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	4,388		4,388
Exercise of stock options (in shares)		41,233		17,032
Exercise of stock options	386		274	$ 112
Employee stock purchase plan (in shares)		209,390
Employee stock purchase plan	688		688
Issuance of restricted stock (in shares)				11,080
Issuance of restricted stock	0		(73)	$ 73
Restricted stock shares canceled/forfeited (in shares)				28,112
Restricted stock shares canceled/forfeited	0		185	$ (185)
Net income (loss)	$ 8,534				8,534
Balance end of period (in shares) at Sep. 30, 2023	116,359,748	116,359,748
Balance, end of period at Sep. 30, 2023	$ 1,330	$ 116	$ 188,369	$ 0	$ (187,155)
Treasury stock, ending balance (in shares) at Sep. 30, 2023				0

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash flows from operating activities:
Net income (loss)	$ 4,751	$ (29,783)
Adjustments to reconcile net income (loss) to net cash flows provided by (used in) operating activities:
Share-based compensation	12,793	10,798
Impairment of clinical trial assets	1,974	0
Depreciation	2,054	2,549
Non-cash lease expenses	959	931
Bad debt expense	737	2,817
Amortization of intangible assets	570	519
Impairment of goodwill	535	0
Amortization of deferred financing costs	373	348
Accretion of asset retirement obligation	70	69
Gain on fixed asset disposal	0	(17)
Increase (decrease) in cash resulting from changes in:
Accounts receivable	(6,659)	(3,295)
Inventory	(5,885)	(2,586)
Prepaid expenses	3,718	1,467
Other assets	1,024	(287)
Accounts payable	323	1,090
Accrued compensation	1,511	495
Accrued expenses	(1,289)	1,711
Other liabilities	(1,041)	905
Net cash flows provided by (used in) operating activities	16,518	(12,269)
Cash flows from investing activities:
Purchases of equipment	(1,560)	(847)
Patent application costs	(114)	(128)
Proceeds from sale of equipment	0	24
Net cash flows used in investing activities	(1,674)	(951)
Cash flows from financing activities:
Proceeds from exercise of stock options	406	574
Principal payments on finance lease	(36)	(29)
Stock repurchased for tax withholdings on vesting of restricted stock	0	(1,191)
Net cash flows provided by (used in) financing activities	370	(646)
Net change in cash	15,214	(13,866)
Cash and cash equivalents, beginning of period	65,950	87,083
Cash and cash equivalents, end of period	$ 81,164	$ 73,217

Nature of Business

Nature of Business	9 Months Ended
	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business	Nature of Business MiMedx Group, Inc. (together with its subsidiaries, except where the context otherwise requires, “ MIMEDX ,” or the “ Company ”) is a pioneer and leader in placental biologics focused on delivering innovative solutions to patients and the healthcare professionals who treat them. All of the Company’s products sold in the United States are regulated by the United States Food & Drug Administration (“ FDA ”). The Company’s business is focused primarily on the United States of America but the Company is pursuing opportunities for international expansion, with specific focus on the sale of its placental tissue products in Japan. During the three and nine months ended September 30, 2023, the Company operated as two defined, internal business units: Wound & Surgical and Regenerative Medicine. On June 20, 2023, the Company announced that it would disband its Regenerative Medicine business unit and suspended its associated Knee Osteoarthritis clinical trial program. All activities in Regenerative Medicine during the three months ended September 30, 2023 were part of the wind-down of the unit, primarily related to regulatory obligations associated with its clinical trial, and it is expected that these activities will materially conclude during the fourth quarter of 2023.

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies Please see Note 2, Significant Accounting Policies , to the Company’s Consolidated Financial Statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022 (the “ 2022 Form 10-K ”), filed with the Securities and Exchange Commission (“ SEC ”) on February 28, 2023 for a description of all significant accounting policies. Basis of Presentation These unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three and nine months ended September 30, 2023 and 2022 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2022 was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2022 Form 10-K. Principles of Consolidation The consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. Use of Estimates GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment, estimates of impairment for goodwill and intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, management’s assessment of the Company’s ability to continue as a going concern, estimate of fair value and the probable achievement of share-based payments, estimates of returns and allowances, and valuation of deferred tax assets. Share-Based Compensation The Company grants share-based awards to employees and members of the Company’s Board of Directors (the “ Board ”). Awards to employees and the Board are generally made annually. Grants are issued outside of the annual cadence for certain new hires, promotions, and other events. The amount of expense to be recognized is determined by the fair value of the award using inputs available as of the grant date. The fair value of non-option share awards that are not subject to a market condition is the value of the common stock on the grant date. For non-option share awards that are subject to a market condition, the fair value of the common stock on the grant date is adjusted to reflect the value of the market condition, generally using a path-dependent pricing model, such as a Monte Carlo simulation. The fair value of stock option grants is estimated using an option pricing model, as appropriate based on the terms of the grant. Use of a valuation model requires management to make certain assumptions with respect to selected model inputs, which generally follows the inputs to a Black-Scholes option pricing model. Absent the availability of an option market with similar terms to the awarded options, the Company infers an expectation for volatility using the historical volatility of daily price changes in its share price for a period equal to the contractual or expected term of the option, as applicable, subject to adjustment for price activity associated with certain events which are not expected to recur during the relevant term. The expected term is derived based on the Company’s expectations for option exercise by the recipients. The Company uses U.S. Treasury yields with a maturity similar to the expected or contractual term, as applicable, as the basis for its risk-free interest rate assumption. The Company has never declared a dividend on its common stock and, therefore, assumes a dividend yield of 0%. Expense is recognized over the requisite service period to achieve a vesting condition associated with an award, which can either be explicitly defined by the award, implied by its terms, or derived from potential market movements. In situations where multiple vesting conditions must be achieved, the longest service period is used as a basis for expense recognition. Derived service periods associated with market conditions are accelerated if such market conditions are met prior to the initially-assessed derived service period, but are not deferred if the market conditions are not met prior to the end of the initially-assessed derived service period. For awards with only service-based vesting conditions, the Company recognizes share-based compensation expense on a straight-line basis through the vesting date of the last tranche of the award. For awards which vest based on more than service conditions, the Company recognizes share-based compensation expense using a graded-vesting method, treating each tranche as if it were a separately-granted award and recognizing expense through the vesting date of each individual tranche. In each scenario, the Company recognizes share-based compensation expense to the extent that the associated service and performance conditions are considered probable to occur. Determinations of probability are made each reporting period and the Company uses available evidence considered relevant for evaluating the performance conditions. The Company recognizes the cumulative effect of changes in the probability of occurrence in the period of re-evaluation. The probability of occurrence and ultimate resolution of a market condition is not considered in expense recognition. Consequently, the Company could recognize expense for awards that do not ultimately vest. Basic and Diluted Net Income (Loss) Per Common Share Basic net income (loss) per common share is calculated as net income (loss) available to common stockholders divided by weighted average common shares outstanding for the applicable period. Net income (loss) available to common stockholders is calculated by adjusting net income (loss) for periodic accumulated dividends on the Company’s Series B Convertible Preferred Stock (“ Series B Preferred Stock ”). This amount is divided by the weighted average common shares outstanding during the period. Weighted average common shares outstanding is calculated as shares of the Company outstanding adjusted for the portion of the period for which they are outstanding. Unvested non-option share awards are excluded from the calculation of weighted average common shares outstanding until they have vested. Unexercised stock options are excluded from the calculation of weighted average common shares outstanding until they are exercised. Shares issuable pursuant to the Company’s Employee Stock Purchase Plan (“ ESPP ”) are included for the minimum number of shares issuable beginning at the point in time that all contingencies for share issuance are resolved. Diluted net income (loss) per common share adjusts basic net income (loss) per common share for convertible securities, options, equity incentive awards, and other share-based payment awards which have yet to vest and vest only on the satisfaction of a service condition. Equity incentive awards and options that are subject to a performance or market condition are included only if the performance or market condition would be satisfied if the end of the applicable period were the end of the performance period. In any case, these adjustments are reflected in the calculation of diluted net income (loss) per common share to the extent that they reduce basic net income (loss) per common share. The Company uses the if-converted method to calculate the dilutive effect of the Series B Preferred Stock and other convertible securities to the extent they are outstanding. The if-converted method assumes that convertible securities are converted at the later of the issuance date and the beginning of the period. If the hypothetical conversion of convertible securities, and the consequential avoidance of any accumulated preferred dividends, would decrease basic net income (loss) per common share, these effects are incorporated in the calculation of diluted net income (loss) per common share, adjusted for the portion of the period the securities were outstanding. The Company uses the treasury stock method to calculate the dilutive effect of options, non-option share awards, and certain other share-based payments. The treasury stock method assumes that the proceeds from exercise are used to repurchase common shares at the weighted average market price during the period, increasing the denominator for the net effect of shares issued upon exercise less hypothetical shares repurchased. Shares issuable pursuant to the ESPP are included in the calculation of diluted net loss per common share to the extent that such shares would be issued based on the share price at the conclusion of the period, to the extent such shares are not already included in the calculation of weighted average common shares outstanding. Recently Adopted Accounting Pronouncements In March 2020, the Financial Accounting Standards Board issued Accounting Standards Update (“ ASU ”) 2020-04, “ Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ” ASU 2020-04 provides temporary expedients to accounting guidance for certain contract modifications and hedging arrangements to ease financial reporting burdens as a result of market transitions from certain reference rates, including the London Interbank Offered Rate (“ LIBOR ”). The updates are effective immediately and may be applied prospectively to contract modifications made and hedging relationships entered into or evaluated on or before December 31, 2024. In June 2023, the Company entered into Amendment No. 2 (the “ Second Amendment ”) to the loan agreement, dated as of June 30, 2020, by and among the Company, Hayfin Services, LLP (“ Hayfin ”), an affiliate of Hayfin Capital Management LLP, and certain other parties, (as amended, the “ Hayfin Loan Agreement ”), pursuant to which the reference rate used to determine the interest rate was changed from the London Interbank Offered Rate (“ LIBOR ”) to the Secured Overnight Financing Rate (“ SOFR ”). Because the only terms of the Second Amendment that affected the Company’s contractual cash flows were related to the changes in the reference rate, the Company adopted the optional guidance prescribed by Topic 848 to this transaction. The adoption of ASU 2020-04 and its application to the Second Amendment did not materially impact the Company’s unaudited condensed consolidated financial statements as of or for the three or nine months ended September 30, 2023. Recently Issued Accounting Pronouncements Not Yet Adopted All ASUs issued and not yet effective for the three and nine months ended September 30, 2023, and through the date of this report, were assessed and determined to be either not applicable or are expected to have minimal impact on the Company’s financial position and results of operations.

Accounts Receivable, Net

Accounts Receivable, Net	9 Months Ended
	Sep. 30, 2023
Receivables [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net Accounts receivable, net, consisted of the following (in thousands): September 30, 2023 December 31, 2022 Accounts receivable, gross $ 51,579 $ 46,867 Less: allowance for doubtful accounts (2,574) (3,783) Accounts receivable, net $ 49,005 $ 43,084 Activity related to the Company’s allowance for doubtful accounts for the three months ended September 30, 2023 and 2022 were as follows (in thousands): 2023 2022 Balance at July 1 $ 2,196 $ 3,471 Bad debt expense 447 426 Write-offs (69) (67) Balance at September 30 $ 2,574 $ 3,830 Activity related to the Company’s allowance for doubtful accounts for the nine months ended September 30, 2023 and 2022 were as follows (in thousands): 2023 2022 Balance at January 1 $ 3,783 $ 1,187 Bad debt expense 737 2,817 Write-offs (1,946) (174) Balance at September 30 $ 2,574 $ 3,830

Inventory

Inventory	9 Months Ended
	Sep. 30, 2023
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consisted of the following (in thousands): September 30, 2023 December 31, 2022 Raw materials $ 838 $ 810 Work in process 10,547 6,855 Finished goods 7,683 5,518 Inventory $ 19,068 $ 13,183

Property and Equipment, Net

Property and Equipment, Net	9 Months Ended
	Sep. 30, 2023
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and Equipment, Net Property and equipment, net, consisted of the following (in thousands): September 30, 2023 December 31, 2022 Laboratory and clean room equipment $ 17,551 $ 16,422 Furniture and equipment 15,255 15,016 Leasehold improvements 9,418 9,190 Construction in progress 1,656 1,983 Asset retirement cost 960 983 Finance lease right-of-use asset 189 189 Property and equipment, gross 45,029 43,783 Less: accumulated depreciation and amortization (37,935) (35,927) Property and equipment, net $ 7,094 $ 7,856 Depreciation expense for the three and nine months ended September 30, 2023 and 2022 is summarized in the table below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Depreciation expense $ 653 $ 831 $ 2,054 $ 2,549 Depreciation expense is allocated amongst cost of sales, research and development expense, and selling, general, and administrative expense on the unaudited condensed consolidated statements of operations.

Goodwill and Intangible Assets,

Goodwill and Intangible Assets, Net	9 Months Ended
	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets, Net	Goodwill and Intangible Assets, Net Goodwill The following table provides a summary of goodwill activity for the nine months ended September 30, 2023 (in thousands): Wound & Surgical Regenerative Medicine Goodwill Balance as of December 31, 2022 $ 19,441 $ 535 $ 19,976 Impairment of goodwill — (535) (535) Balance as of September 30, 2023 $ 19,441 $ — $ 19,441 There was no goodwill activity during the three months ended September 30, 2023 or during the three or nine months ended September 30, 2022. Impairment of Regenerative Medicine Business Unit On June 20, 2023, the Company announced the disbanding of its Regenerative Medicine business unit and the suspension of its Knee Osteoarthritis clinical trial program. As a result of this event, the Company evaluated goodwill associated with the Regenerative Medicine reporting unit for potential impairment. The Company estimated fair value for the reporting unit using the income approach; specifically, a discounted cash flow method. As a result of this assessment, management concluded that the carrying value of the reporting unit exceeded its carrying value by an amount that exceeded its goodwill balance. Accordingly, the Company recognized an impairment loss for the full amount of the goodwill ascribed to the Regenerative Medicine reporting unit. The impairment loss is included as a component of restructuring expense in the unaudited condensed statement of operations for the nine months ended September 30, 2023. Intangible Assets, Net Intangible assets, net, are summarized as follows (in thousands): September 30, 2023 December 31, 2022 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 9,969 $ (7,638) $ 2,331 $ 9,923 $ (7,106) $ 2,817 Licenses 1,000 (42) 958 1,000 (4) $ 996 Total amortized intangible assets $ 10,969 $ (7,680) $ 3,289 $ 10,923 $ (7,110) $ 3,813 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 1,098 1,098 1,031 1,031 Total intangible assets $ 13,075 $ 5,395 $ 12,962 $ 5,852 Expected future amortization of intangible assets as of September 30, 2023, is as follows (in thousands): Year ending December 31, Estimated 2023 (excluding the nine months ended September 30, 2023) $ 190 2024 759 2025 364 2026 210 2027 209 Thereafter 1,557 Total amortized intangible assets $ 3,289

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2023
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consisted of the following (in thousands): September 30, 2023 December 31, 2022 Commissions to sales agents $ 3,213 $ 2,941 Accrued rebates 1,244 707 Legal and settlement costs 1,025 4,447 Estimated sales returns 910 659 Accrued group purchasing organization fees 713 638 Accrued clinical trials 694 90 Accrued contract termination costs 547 — Accrued travel 259 566 Other 839 976 Accrued expenses $ 9,444 $ 11,024

Long Term Debt, Net

Long Term Debt, Net	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Long Term Debt, Net	Long Term Debt, Net Hayfin Loan Agreement On June 30, 2020, the Company entered into the Hayfin Loan Agreement, which provided the Company with a $50 million senior secured term loan (the “ Term Loan ”). The Term Loan matures on June 30, 2025 (the “ Maturity Date ”). Interest on any borrowings is based on SOFR, plus a fallback provision of 0.15%, subject a floor of 1.5% (the “Floor”), plus a Margin of 6.75% (the “Margin” ). The Term Loan carried an interest rate of 12.3% as of September 30, 2023. As of September 30, 2023, the Company was in compliance with all applicable financial covenants under the Hayfin Loan Agreement. The balances of the Term Loan as of September 30, 2023 and December 31, 2022 were as follows (in thousands): September 30, 2023 December 31, 2022 Outstanding principal $ 50,000 $ 50,000 Deferred financing costs (896) (1,219) Original issue discount (138) (187) Long term debt, net $ 48,966 $ 48,594 Interest expense related to the Term Loan, included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Stated interest $ 1,554 $ 1,151 $ 4,498 $ 3,225 Amortization of deferred financing costs 111 103 323 302 Accretion of original issue discount 17 16 50 46 Interest expense $ 1,682 $ 1,270 $ 4,871 $ 3,573 A summary of principal payments due on the Term Loan, by year, from September 30, 2023 through maturity are as follows (in thousands): Year ending December 31, Principal 2023 (excluding the nine months ended September 30, 2023) $ — 2024 — 2025 50,000 2026 — 2027 — Thereafter — Outstanding principal $ 50,000

Net Income (Loss) Per Common Sh

Net Income (Loss) Per Common Share	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Net Income (Loss) Per Common Share	Net Income (Loss) Per Common ShareNet income (loss) per common share is calculated using two methods: basic and diluted. Basic Net Income (Loss) Per Common Share The following table provides a reconciliation of net loss to net loss available to common stockholders and calculation of basic net loss per common share for each of the three and nine months ended September 30, 2023 and 2022 (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net income (loss) $ 8,534 $ (8,426) $ 4,751 $ (29,783) Accumulated dividends on Series B Preferred Stock 1,773 1,670 5,184 4,884 Net income (loss) available to common stockholders $ 6,761 $ (10,096) $ (433) $ (34,667) Weighted average common shares outstanding 116,298,146 113,448,251 115,528,067 112,650,713 Basic net income (loss) per common share $ 0.06 $ (0.09) $ (0.00) $ (0.31) Diluted Net Income (Loss) Per Common Share The following table sets forth the computation of diluted net loss per common share (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net income (loss) available to common stockholders $ 6,761 $ (10,096) $ (433) $ (34,667) Adjustments: Accumulated dividends on Series B Convertible Preferred Stock 1,773 1,670 5,184 4,884 Less: antidilutive adjustments (1,773) (1,670) (5,184) (4,884) Total adjustments — — — — Numerator $ 6,761 $ (10,096) $ (433) $ (34,667) Weighted average shares outstanding 116,298,146 113,448,251 115,528,067 112,650,713 Adjustments: Potential common shares (a) Restricted stock unit awards 1,845,832 — — — Outstanding stock options 1,131,410 — — — Performance stock unit awards 35,441 — — — Restricted stock awards 15,767 — — — Employee stock purchase plan 1,113 — — — Total adjustments 3,029,563 — — — Weighted average shares outstanding adjusted for potential common shares 119,327,709 113,448,251 115,528,067 112,650,713 Diluted net income (loss) per common share $ 0.06 $ (0.09) $ (0.00) $ (0.31) (a) Weighted average common shares outstanding for the calculation of diluted net income (loss) per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented. Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Series B Convertible Preferred Stock 30,445,997 28,685,739 29,559,946 27,850,916 Restricted stock unit awards — 474,355 1,219,776 574,507 Performance stock unit awards — 59,996 13,425 40,141 Employee stock purchase plan — 4,536 372 1,517 Restricted stock awards — 22,327 23,733 293,778 Outstanding stock options — 22,528 107,897 97,190 Potential common shares 30,445,997 29,269,481 30,925,149 28,858,049

Equity

Equity	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Equity	Equity Series B Convertible Preferred Stock The Company has not declared or paid any dividends on the Series B Preferred Stock since issuance. Dividends accumulated but not paid as of September 30, 2023 were $19.0 million. As this amount has not been declared, the Company has not recorded this amount on its unaudited condensed consolidated balance sheet as of September 30, 2023. Based on accumulated dividends as of September 30, 2023, the Series B Preferred Stock was convertible into an aggregate of 30,906,441 shares of the Company’s common stock as of that date. Equity Incentive Awards The Company has issued restricted stock awards (“ RSAs ”), restricted stock unit awards (“ RSUs ”), and performance stock unit awards (“ PSUs ”, together with RSAs and RSUs, collectively, the “Equity Incentive Awards” ) to its employees. The following is summary information for Equity Incentive Awards for the nine months ended September 30, 2023. As of September 30, 2023, there was $24.1 million of unrecognized share-based compensation expense related to the Equity Incentive Awards. This expense is expected to be recognized over a weighted-average period of 2.33 years, which approximates the remaining vesting period of these grants. The table below summarizes activity of unvested Equity Incentive Awards by award type from January 1, 2023 through September 30, 2023. RSA RSU PSU Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Unvested at January 1, 2023 122,755 $ 6.13 4,774,971 $ 6.28 241,072 $ 4.62 Granted — — 3,266,244 4.65 3,851,427 3.83 Vested (13,624) 6.18 (2,237,260) 6.20 — — Forfeited (90,367) 5.83 (1,715,136) 5.45 (365,227) 4.24 Unvested at September 30, 2023 18,764 $ 7.55 4,088,819 $ 5.38 3,727,272 $ 3.84 Stock Options A summary of stock option activity for the nine months ended September 30, 2023 is presented below: Number of Weighted- Weighted- Aggregate Outstanding at January 1, 2023 933,894 $ 6.46 Granted 3,694,000 3.77 Exercised (62,599) 6.50 Vested options expired (423,213) 5.81 Outstanding at September 30, 2023 4,142,082 4.13 6.31 13,178,214 Exercisable at September 30, 2023 448,082 $ 7.06 0.60 $ 174,314 As of September 30, 2023, there was $5.5 million of unrecognized share-based compensation expense related to Stock Options. This expense is expected to be recognized over a weighted-average period of 2.22 years. CEO Performance Grant On January 27, 2023, the Company’s Board of Directors appointed Joseph H. Capper to serve as Chief Executive Officer. The Company entered into a Letter Agreement with Mr. Capper that included, among other things, a grant of 3,300,000 PSUs (the “ CEO Performance PSUs ”) and a non-qualified stock option (the “ CEO Performance Option ”, collectively with the CEO Performance PSUs, the “ CEO Performance Grant ”) for 3,600,000 shares of the Company’s common stock. In addition to continued employment with the Company, the occurrence and extent of vesting of each component of the CEO Performance Grant is dependent upon the Company’s operating and share price performance: the CEO Performance PSUs vest on the basis of achieved revenue growth, while the CEO Performance Option vests on the basis of share price appreciation. CEO Performance PSUs The CEO Performance PSUs vest in a single tranche on the earlier of the filing date of the Company’s 2026 Annual Report on Form 10-K and March 15, 2027. The occurrence and extent of vesting depends on the Company’s compound annual growth rate (“ CAGR ”) achieved with respect to its revenue growth between the year ended December 31, 2022 and the year ending December 31, 2026. The PSUs may vest with respect to 50% to 200% of the granted number of PSUs, depending on the extent of CAGR achievement. Failure to achieve the CAGR associated with 50% of achievement would result in no vesting. Management determined the probable level of vesting using internally-developed forecasts for the relevant period representing the Company’s best estimate for revenue, with a factor applied to calculate the highest level of CAGR evaluated to be probable of occurrence based on that estimate. The Company recognized $0.4 million and $1.1 million of expense related to the CEO Performance PSUs during the three and nine months ended September 30, 2023, respectively. CEO Performance Option The CEO Performance Option grants Mr. Capper the right to purchase up to 3,600,000 shares of common stock for $3.70 per share. The CEO Performance Option vests based on the satisfaction of service and market conditions. Mr. Capper may vest in 25% of the CEO Performance Option on each of the first four anniversary dates of the date of grant provided that he remains employed by the Company and provided that specified share price goals are achieved at any point between the date of grant and January 31, 2027. There are three separate share price goals associated with the CEO Performance Option. If specified share price goals are met at one level, one-third of the option may vest, at a second level, a further one-third may vest, and at a third level, the full amount of the option may vest. Satisfaction of the share price goals is based on the average of the closing price of the Company’s common stock during any 20 consecutive trading days through January 31, 2027 exceeding the stipulated share price goal. The CEO Performance Option expires on February 1, 2030. The Company estimated the fair value of the awards using a Monte Carlo simulation using the following assumptions: Assumption Stock price on grant date $ 3.70 Exercise price $ 3.70 Risk-free interest rate 3.58 % Expected volatility (annualized) 75.00 % Dividend yield — % Weighted average grant date fair value $ 1.93 The risk-free interest rate was derived based on the U.S. Treasury Yield curve in effect at the date of grant for maturities of similar periods to the contractual term. The expected volatility was estimated principally based on the Company’s historical daily stock price movements for a term similar in length to the contractual term. The dividend yield was based on the Company’s history of dividends on its common stock. The fair value was determined using an expected term which reflects the anticipated holding and post-vesting behavior pattern, calculated for each individual simulation. The total grant date fair value of the CEO Performance Option was $7.0 million. The fair value associated with each tranche of the award will be recognized, straight-line, over the associated requisite service period for that tranche, subject to acceleration if the market condition is met prior to the end of the derived service period. Failure to meet the market condition for an award does not result in reversal of previously-recognized expense, so long as the service is provided for the duration of the required service period. The Company recognized $0.7 million and $2.0 million of expense related to the CEO Performance Option during the three and nine months ended September 30, 2023, respectively. CFO Inducement Grant On July 5, 2023, the Company announced that Doug Rice was appointed to serve as Chief Financial Officer of the Company, effective that day. Mr. Rice’s compensation included, among other things, a grant of 162,000 PSUs, 97,200 RSUs, and 94,000 stock options (the “ CFO Options ”), as a material inducement to his hiring. The PSUs vest based on a three-year performance period ending on December 31, 2025 based upon the achievement of specified performance conditions, subject to Mr. Rice’s continued employment, except in the case of Mr. Rice’s death or disability. The awards can vest between 50% and 150% of the original number of PSUs, depending on actual performance. Vesting is limited to 100% of the award in the event that certain share price conditions are not achieved. The total grant date fair value of the PSUs was $1.5 million. The RSUs vest in three equal tranches on each of the first three anniversary dates of the grant date, provided Mr. Rice remains in continuous service with the Company. The total grant date fair value of the RSUs was $0.6 million. The CFO Options vest in four equal tranches on each of the first four anniversary dates of the grant date, subject to Mr. Rice’s continued employment. The CFO Options expire on July 5, 2030. The total grant date fair value of the CFO Options was $0.4 million.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesThe effective tax rates for the Company were 6.5% and (0.6)% for the three months ended September 30, 2023 and 2022, respectively. The effective tax rates for the Company were 10.7% and (0.6)% for the nine months ended September 30, 2023 and 2022, respectively. The effective tax rates for 2023 reflect the utilization of net operating losses and certain tax credits. The effective tax rates for 2022 reflect net operating losses offset by a valuation allowance.

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	9 Months Ended
	Sep. 30, 2023
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Nine Months Ended September 30, 2023 2022 Cash paid for interest $ 4,496 $ 3,233 Cash paid for income taxes 210 184 Non-cash activities: Issuance of shares pursuant to employee stock purchase plan 1,368 — Purchases of equipment in accounts payable 126 353 Right of use assets arising from operating lease liabilities — (37)

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Nordic Agreement In June 2022, the Company entered into a collaboration agreement (the “ Nordic Agreement ”) with Nordic Bioscience Clinical Development A/S (“ NBCD ”) to provide full operational support for the Company’s KOA clinical trial program. Under the terms of the Nordic Agreement, the Company was obligated to pay $10.2 million upon the achievement of specified milestones over the course of the clinical trial. In July 2023, the Company terminated the Nordic Agreement, in accordance with which the Company is obligated to reimburse NBCD for services performed through the effective termination date and for non-cancelable obligations reasonably incurred prior to that date. In addition, the Company and NBCD have certain regulatory obligations for all trial participants enrolled in the study prior to the suspension of clinical trial activities. Refer to Note 16, “ Restructuring, ” for additional discussion. Litigation and Regulatory Matters In the ordinary course of business, the Company and its subsidiaries may be a party to pending and threatened legal, regulatory, and governmental actions and proceedings (including those described below). In view of the inherent difficulty of predicting the outcome of such matters, particularly where the plaintiffs or claimants seek very large or indeterminate damages or where the matters present novel legal theories or involve a large number of parties, the Company generally cannot predict what the eventual outcome of the pending matters will be, what the timing of the ultimate resolution of these matters will be, or what the eventual recovery, loss, fines or penalties related to each pending matter may be. The Company’s unaudited condensed consolidated balance sheet as of September 30, 2023 reflects the Company’s current best estimate of probable losses associated with these matters, including costs to comply with various settlement agreements, where applicable. For more information regarding the Company’s legal proceedings, refer to Note 16, “ Commitments and Contingencies ” in the 2022 Form 10-K. The Company has not accrued for any potential losses related to legal matters as of September 30, 2023. The following is a description of certain litigation and regulatory matters to which the Company is a party: Securities Class Action On January 16, 2019, the United States District Court for the Northern District of Georgia entered an order consolidating two purported securities class actions (MacPhee v. MiMedx Group, Inc., et al. filed February 23, 2018 and Kline v. MiMedx Group, Inc., et al. filed February 26, 2018). The order also appointed Carpenters Pension Fund of Illinois (“ CPFI ”) as lead plaintiff. On May 1, 2019, CPFI filed a consolidated amended complaint, naming as defendants the Company, Michael J. Senken, Parker H. “Pete” Petit, William C. Taylor, Christopher M. Cashman and Cherry Bekaert & Holland LLP. The amended complaint (the “ Securities Class Action Complaint ”) alleged violations of Section 10(b) of the Securities Exchange Act of 1934, as amended (the “ Exchange Act ”), Rule 10b-5 promulgated thereunder, and Section 20(a) of the Exchange Act. It asserted a class period of March 7, 2013 through June 29, 2018. Following the filing of motions to dismiss by the various defendants, CPFI was granted leave to file an amended complaint. CPFI filed its amended complaint against the Company, Michael J. Senken, Parker H. Petit, William C. Taylor, and Cherry Bekaert & Holland (Christopher Cashman was dropped as a defendant) on March 30, 2020. The defendants filed motions to dismiss on May 29, 2020. On March 25, 2021, the Court granted defendants’ respective motions to dismiss, finding that CPFI lacked standing to bring the underlying claims and also could not establish loss causation because it sold all of its shares in the Company prior to any corrective disclosures, and dismissed the case. On April 22, 2021, CPFI filed a motion for reconsideration of the dismissal and for leave to amend to add a new plaintiff to attempt to cure the standing and loss causation issues. On January 28, 2022, the Court denied CPFI’s motion to reconsider and motion to substitute class representative. On February 25, 2022, CPFI filed a Notice of Appeal in the 11th Circuit Court of Appeals. On July 10, 2023, the Court of Appeals affirmed the District Court’s dismissal of the case and the denial of the motion for leave to amend. On July 31, 2023, CPFI filed a petition for rehearing en banc , which was denied on September 6, 2023. Welker v. MiMedx, et. al. On November 4, 2022, Troy Welker and Min Turner, former option holders of the Company, brought a lawsuit in Fulton County State Court against the Company, former directors Terry Dewberry and Charles Evans, and former officers Parker H. “Pete” Petit, William C. Taylor, and Michael Senken alleging violations of the Georgia Racketeer Influenced and Corrupt Organizations (“ RICO ”) Act against all defendants, and conspiracy to violate the Georgia RICO Act and breach of fiduciary duty against the individual defendants. The Company is defending against the allegations and removed the case to the United States District Court for the Northern District of Georgia. Plaintiffs filed a motion to remand back to state court, which was granted. The Company has filed its answer and a motion to dismiss, which is currently pending. Former Employee Litigation and Related Matters On January 12, 2021, the Company filed suit in the Circuit Court of the Eleventh Judicial District in and for Miami-Dade County, Florida (MiMedx Group, Inc. v. Petit, et. al.) against its former CEO, Parker H. “Pete” Petit, and its former COO, William C. Taylor, seeking a determination of its rights and obligations under indemnification agreements with Petit and Taylor following a federal jury’s guilty verdict against Petit for securities fraud and Taylor for conspiracy to commit securities fraud. The Company is seeking a declaratory judgment that it is not obligated to indemnify or advance expenses to Petit and Taylor in connection with certain cases to which Petit and Taylor are parties and also seeking to recoup amounts previously paid on behalf of Petit and Taylor in connection with such cases. On April 22, 2021, Petit and Taylor filed an answer and asserted counterclaims against the Company alleging breach of their indemnification agreements, breach of the covenant of good faith and fair dealing with respect to their indemnification agreements, and seeking a declaration that the Company remains obligated to indemnify and advance fees in connection with certain cases. Petit and Taylor simultaneously also filed a motion seeking to compel the Company to advance and reinstate its payments of Petit and Taylor’s legal expenses. The Company opposed Petit and Taylor’s motion and a hearing was set for June 23, 2021. At the joint request of the parties, the hearing was cancelled to allow the parties to attend a mediation to attempt a resolution of this matter; such mediation was held on August 11, 2021. Following the mediation, the Company and Mr. Taylor reached an agreement to settle the matter between them. Negotiations with Mr. Petit are ongoing. Other Matters Under the Florida Business Corporation Act and agreements with its current and former officers and directors, the Company is obligated to indemnify its current and former officers and directors who are made party to a proceeding, including a proceeding brought by or in the right of the corporation, with certain exceptions, and to advance expenses to defend such matters. The Company has previously borne substantial costs to satisfy these indemnification and expense advance obligations and may continue to incur such costs in the future. Costs incurred pursuant to these agreements are included in investigation, restatement and related expense in the unaudited condensed consolidated statements of operations. In addition to the matters described above, the Company is a party to a variety of other legal matters that arise in the ordinary course of the Company’s business, none of which are deemed to be individually material at this time. Due to the inherent uncertainty of litigation, there can be no assurance that the resolution of any particular claim or proceeding would not have a material adverse effect on the Company’s business, results of operations, financial position or liquidity.

Revenue

Revenue	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue	Revenue Net Sales by Site of Service The Company has three sites of service for its products (1) Hospital settings and wound care clinics, which are stable reimbursement settings in which products are used for surgical applications, (2) Private offices, which generally represents doctors and practitioners with independent operations, and (3) Other, which includes federal facilities, international sales, and other sites of service. Below is a summary of net sales by site of service (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Hospital $ 47,350 $ 40,174 $ 136,108 $ 116,081 Private Office 22,951 19,572 68,188 54,768 Other 11,411 7,943 30,349 22,617 Total $ 81,712 $ 67,689 $ 234,645 $ 193,466 The Company did not have significant foreign operations or a single external customer from which 10% or more of revenues were derived during the three or nine months ended September 30, 2023 or 2022. Net Sales by Product The Company has two primary classes of products: (1) Advanced Wound Care, or Section 361, products, consisting of its tissue and cord sheet allograft products as well as certain particulate products subject to regulation under Section 361 of the Public Health Service Act and related regulations (“ Section 361 ”), and (2) Section 351 products, consisting of the Company’s micronized and certain other particulate products subject to regulation under Section 351 of the Public Health Service Act and related regulations ( “Section 351” ). Advanced Wound Care is further disaggregated between the Company’s Tissue/Other and Cord products. Below is a summary of net sales by class of product (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Advanced Wound Care Tissue/Other $ 75,570 $ 61,131 $ 216,825 $ 174,256 Cord 6,066 5,678 17,259 17,165 Total Advanced Wound Care 81,636 66,809 234,084 191,421 Section 351 (1) 76 880 561 2,045 Total $ 81,712 $ 67,689 $ 234,645 $ 193,466 (1) Revenue recognized from collections relating to revenue transactions for which performance obligations were fulfilled prior to October 1, 2019, the date at which the Company changed its pattern of revenue recognition, for the three and nine months ended September 30, 2022 of $0.1 million and $0.2 million, respectively, which were separately presented in previously-issued financial statements, are presented as part of Section 351 in the table above.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2023
Segment Reporting [Abstract]
Segment Information	Segment Information The Company had two reportable segments during the three and nine months ended September 30, 2023: Wound & Surgical and Regenerative Medicine. • Wound & Surgical focused on the Advanced Wound Care and Surgical Recovery markets through the sale of the Company’s portfolio of products and product development to serve these primary end markets. Its platform technologies include tissue allografts derived from human placental membrane (EPIFIX®, AMNIOFIX®, and AMNIOEFFECT®), tissue allografts derived from human umbilical cord (EPICORD® and AMNIOCORD®), and a particulate extracellular matrix derived from human placental disc (AXIOFILL®). This segment is also responsible for international sales of the Company’s Section 351 products. • Prior to June 20, 2023, Regenerative Medicine focused solely on Regenerative Medicine technologies, specifically progressing the Company’s placental biologics platform towards registration as an FDA-approved biological drug. On June 20, 2023, the Company announced a plan to disband the Regenerative Medicine business unit and suspended its Knee Osteoarthritis clinical trial program. The Company is actively managing wind-down activities for its Regenerative Medicine business unit, primarily related to regulatory obligations associated with its clinical trial. The Company expects that these activities will materially conclude in the fourth quarter of 2023. The accounting policies of the segments were the same as the Company’s accounting policies. See Note 2, “ Significant Accounting Policies ,” included in the 2022 Form 10-K. The Company evaluated the performance of its segments and allocated resources based on segment contribution, defined as net sales less (i) cost of sales, (ii) selling, general and administrative expense, (iii) research and development expense, (iv) amortization of intangible assets, and (v) restructuring. The only components which comprised income (loss) before income tax provision that were not included in operating income (loss) were interest expense, net and other expense, net. The Company did not allocate any assets to the reportable segments. No asset information was reported or disclosed to the chief operating decision maker in the financial information for each segment. Net sales and segment contribution by each reportable segment for the three months ended September 30, 2023 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 80,376 $ — $ 1,336 $ 81,712 Cost of sales 13,305 — 1,485 14,790 Selling, general and administrative expense 38,687 — 13,884 52,571 Research and development expense 3,175 — — 3,175 Restructuring — 208 — 208 Amortization of intangible assets — — 190 190 Segment contribution $ 25,209 $ (208) Investigation, restatement and related expense (38) Operating income $ 10,816 Supplemental information Depreciation expense $ 423 $ — $ 230 $ 653 Share-based compensation $ 1,902 $ — $ 2,486 $ 4,388 Net sales and segment contribution by each reportable segment for the three months ended September 30, 2022 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 66,873 $ — $ 816 $ 67,689 Cost of sales 11,159 — 1,029 12,188 Selling, general and administrative expense 35,530 — 17,945 53,475 Research and development expense 1,680 4,273 — 5,953 Amortization of intangible assets — — 175 175 Segment contribution $ 18,504 $ (4,273) Investigation, restatement and related expense 3,001 Operating loss $ (7,103) Supplemental information Depreciation expense $ 451 $ 36 $ 344 $ 831 Share-based compensation $ 1,945 $ 347 $ 80 $ 2,372 Net sales and segment contribution by each reportable segment for the nine months ended September 30, 2023 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 231,466 $ — $ 3,179 $ 234,645 Cost of sales 37,373 — 3,419 40,792 Selling, general and administrative expense 114,853 — 41,920 156,773 Research and development expense 6,330 11,838 — 18,168 Restructuring — 3,464 — 3,464 Amortization of intangible assets — — 570 570 Segment contribution $ 72,910 $ (15,302) Investigation, restatement and related expense 4,652 Operating income $ 10,226 Supplemental information Depreciation expense $ 1,208 $ 135 $ 711 $ 2,054 Share-based compensation $ 5,130 $ 259 $ 7,404 $ 12,793 Net sales and segment contribution by each reportable segment for the nine months ended September 30, 2022 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 191,297 $ — $ 2,169 $ 193,466 Cost of sales 31,126 — 2,821 33,947 Selling, general and administrative expense 108,256 — 50,582 158,838 Research and development expense 6,068 11,361 — 17,429 Amortization of intangible assets — — 519 519 Segment contribution $ 45,847 $ (11,361) Investigation, restatement and related expense 8,771 Operating loss $ (26,038) Supplemental information Depreciation expense $ 1,364 $ 120 $ 1,065 $ 2,549 Share-based compensation $ 5,609 $ 910 $ 4,279 $ 10,798

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2023
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring On June 20, 2023, the Company announced that it was suspending all activities associated with its knee osteoarthritis clinical trial program and disbanding its Regenerative Medicine business unit (the “ Restructuring ”). This was the result of the Company’s decision to focus on its Wound & Surgical business to drive profitability and cash flows. The Company anticipates that activities related to the Restructuring will materially conclude in the fourth quarter of 2023. Expenses associated with the Restructuring are recognized as the associated liabilities are incurred in an amount equal to the fair value to settle the liability. Severance As part of the Restructuring, the Company separated from certain employees whose primary responsibilities were toward the advancement of the Company’s knee osteoarthritis clinical trial program. The Company offered an aggregate of severance arrangements of $2.1 million to separated employees during the nine months ended September 30, 2023. This amount was recognized as part of research and development expense on the unaudited condensed consolidated statements of operations for the nine months ended September 30, 2023, as these arrangements were determined not to qualify for accounting as a one-time separation benefit under ASC 420. Of the total severance amount, $1.8 million was paid out during the three months ended September 30, 2023. The remaining $0.3 million is reflected in accrued compensation on the unaudited condensed consolidated balance sheet as of September 30, 2023. Impairments On June 23, 2023, the Company provided notice to NBCD of the termination of the Nordic Agreement. As part of the Restructuring, the Company no longer anticipated that it would receive any benefits pursuant to the clinical trial program. Accordingly, it recognized an impairment of clinical trial assets related to the Nordic Agreement and all pass-through vendors of $2.1 million during the nine months ended months ended September 30, 2023, respectively. This amount is reflected as part of restructuring expense on the unaudited condensed consolidated statements of operations for the nine months ended months September 30, 2023. In addition, the Company recorded goodwill impairment for $0.5 million, reflecting all goodwill assigned to the Regenerative Medicine reporting unit. This amount is reflected as part of restructuring expense on the unaudited condensed consolidated statements of operations for the nine months ended September 30, 2023. See Note 6, “ Goodwill and Intangible Assets, Net ,” for further information regarding the impairment of goodwill due to the disbanding of the Company’s Regenerative Medicine business unit. Contract Termination Costs

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events Hayfin Preferred Share Repurchase On October 27, 2023, the Company executed a Securities Purchase Agreement with certain entities managed by or affiliated with Hayfin Capital Management LLP (the “ Hayfin Shareholders ”) to repurchase 5,000 shares of the Company’s Series B Preferred Stock for $9.5 million (the “ Repurchase ”). As part of the Repurchase, the Hayfin Shareholders entered into customary lock-up provisions requiring them to retain the balance of their equity positions for a period of at least one year.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation These unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three and nine months ended September 30, 2023 and 2022 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2022 was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2022 Form 10-K.
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation.
Use of Estimates	Use of Estimates GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment, estimates of impairment for goodwill and intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, management’s assessment of the Company’s ability to continue as a going concern, estimate of fair value and the probable achievement of share-based payments, estimates of returns and allowances, and valuation of deferred tax assets.
Share-Based Compensation	Share-Based Compensation The Company grants share-based awards to employees and members of the Company’s Board of Directors (the “ Board ”). Awards to employees and the Board are generally made annually. Grants are issued outside of the annual cadence for certain new hires, promotions, and other events. The amount of expense to be recognized is determined by the fair value of the award using inputs available as of the grant date. The fair value of non-option share awards that are not subject to a market condition is the value of the common stock on the grant date. For non-option share awards that are subject to a market condition, the fair value of the common stock on the grant date is adjusted to reflect the value of the market condition, generally using a path-dependent pricing model, such as a Monte Carlo simulation. The fair value of stock option grants is estimated using an option pricing model, as appropriate based on the terms of the grant. Use of a valuation model requires management to make certain assumptions with respect to selected model inputs, which generally follows the inputs to a Black-Scholes option pricing model. Absent the availability of an option market with similar terms to the awarded options, the Company infers an expectation for volatility using the historical volatility of daily price changes in its share price for a period equal to the contractual or expected term of the option, as applicable, subject to adjustment for price activity associated with certain events which are not expected to recur during the relevant term. The expected term is derived based on the Company’s expectations for option exercise by the recipients. The Company uses U.S. Treasury yields with a maturity similar to the expected or contractual term, as applicable, as the basis for its risk-free interest rate assumption. The Company has never declared a dividend on its common stock and, therefore, assumes a dividend yield of 0%. Expense is recognized over the requisite service period to achieve a vesting condition associated with an award, which can either be explicitly defined by the award, implied by its terms, or derived from potential market movements. In situations where multiple vesting conditions must be achieved, the longest service period is used as a basis for expense recognition. Derived service periods associated with market conditions are accelerated if such market conditions are met prior to the initially-assessed derived service period, but are not deferred if the market conditions are not met prior to the end of the initially-assessed derived service period. For awards with only service-based vesting conditions, the Company recognizes share-based compensation expense on a straight-line basis through the vesting date of the last tranche of the award. For awards which vest based on more than service conditions, the Company recognizes share-based compensation expense using a graded-vesting method, treating each tranche as if it were a separately-granted award and recognizing expense through the vesting date of each individual tranche. In each scenario, the Company recognizes share-based compensation expense to the extent that the associated service and performance conditions are considered probable to occur. Determinations of probability are made each reporting period and the Company uses available evidence considered relevant for evaluating the performance conditions. The Company recognizes the cumulative effect of changes in the probability of occurrence in the period of re-evaluation. The probability of occurrence and ultimate resolution of a market condition is not considered in expense recognition. Consequently, the Company could recognize expense for awards that do not ultimately vest.
Basic and Diluted Net Income (Loss) Per Common Share	Basic and Diluted Net Income (Loss) Per Common Share Basic net income (loss) per common share is calculated as net income (loss) available to common stockholders divided by weighted average common shares outstanding for the applicable period. Net income (loss) available to common stockholders is calculated by adjusting net income (loss) for periodic accumulated dividends on the Company’s Series B Convertible Preferred Stock (“ Series B Preferred Stock ”). This amount is divided by the weighted average common shares outstanding during the period. Weighted average common shares outstanding is calculated as shares of the Company outstanding adjusted for the portion of the period for which they are outstanding. Unvested non-option share awards are excluded from the calculation of weighted average common shares outstanding until they have vested. Unexercised stock options are excluded from the calculation of weighted average common shares outstanding until they are exercised. Shares issuable pursuant to the Company’s Employee Stock Purchase Plan (“ ESPP ”) are included for the minimum number of shares issuable beginning at the point in time that all contingencies for share issuance are resolved. Diluted net income (loss) per common share adjusts basic net income (loss) per common share for convertible securities, options, equity incentive awards, and other share-based payment awards which have yet to vest and vest only on the satisfaction of a service condition. Equity incentive awards and options that are subject to a performance or market condition are included only if the performance or market condition would be satisfied if the end of the applicable period were the end of the performance period. In any case, these adjustments are reflected in the calculation of diluted net income (loss) per common share to the extent that they reduce basic net income (loss) per common share. The Company uses the if-converted method to calculate the dilutive effect of the Series B Preferred Stock and other convertible securities to the extent they are outstanding. The if-converted method assumes that convertible securities are converted at the later of the issuance date and the beginning of the period. If the hypothetical conversion of convertible securities, and the consequential avoidance of any accumulated preferred dividends, would decrease basic net income (loss) per common share, these effects are incorporated in the calculation of diluted net income (loss) per common share, adjusted for the portion of the period the securities were outstanding. The Company uses the treasury stock method to calculate the dilutive effect of options, non-option share awards, and certain other share-based payments. The treasury stock method assumes that the proceeds from exercise are used to repurchase common shares at the weighted average market price during the period, increasing the denominator for the net effect of shares issued upon exercise less hypothetical shares repurchased. Shares issuable pursuant to the ESPP are included in the calculation of diluted net loss per common share to the extent that such shares would be issued based on the share price at the conclusion of the period, to the extent such shares are not already included in the calculation of weighted average common shares outstanding.
Recently Adopted Accounting Pronouncements and Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Adopted Accounting Pronouncements In March 2020, the Financial Accounting Standards Board issued Accounting Standards Update (“ ASU ”) 2020-04, “ Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ” ASU 2020-04 provides temporary expedients to accounting guidance for certain contract modifications and hedging arrangements to ease financial reporting burdens as a result of market transitions from certain reference rates, including the London Interbank Offered Rate (“ LIBOR ”). The updates are effective immediately and may be applied prospectively to contract modifications made and hedging relationships entered into or evaluated on or before December 31, 2024. In June 2023, the Company entered into Amendment No. 2 (the “ Second Amendment ”) to the loan agreement, dated as of June 30, 2020, by and among the Company, Hayfin Services, LLP (“ Hayfin ”), an affiliate of Hayfin Capital Management LLP, and certain other parties, (as amended, the “ Hayfin Loan Agreement ”), pursuant to which the reference rate used to determine the interest rate was changed from the London Interbank Offered Rate (“ LIBOR ”) to the Secured Overnight Financing Rate (“ SOFR ”). Because the only terms of the Second Amendment that affected the Company’s contractual cash flows were related to the changes in the reference rate, the Company adopted the optional guidance prescribed by Topic 848 to this transaction. The adoption of ASU 2020-04 and its application to the Second Amendment did not materially impact the Company’s unaudited condensed consolidated financial statements as of or for the three or nine months ended September 30, 2023. Recently Issued Accounting Pronouncements Not Yet Adopted All ASUs issued and not yet effective for the three and nine months ended September 30, 2023, and through the date of this report, were assessed and determined to be either not applicable or are expected to have minimal impact on the Company’s financial position and results of operations.
Segment Information	The accounting policies of the segments were the same as the Company’s accounting policies. See Note 2, “ Significant Accounting Policies ,” included in the 2022 Form 10-K. The Company evaluated the performance of its segments and allocated resources based on segment contribution, defined as net sales less (i) cost of sales, (ii) selling, general and administrative expense, (iii) research and development expense, (iv) amortization of intangible assets, and (v) restructuring. The only components which comprised income (loss) before income tax provision that were not included in operating income (loss) were interest expense, net and other expense, net. The Company did not allocate any assets to the reportable segments. No asset information was reported or disclosed to the chief operating decision maker in the financial information for each segment.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	9 Months Ended
	Sep. 30, 2023
Receivables [Abstract]
Schedule of Accounts Receivable, Net	Accounts receivable, net, consisted of the following (in thousands): September 30, 2023 December 31, 2022 Accounts receivable, gross $ 51,579 $ 46,867 Less: allowance for doubtful accounts (2,574) (3,783) Accounts receivable, net $ 49,005 $ 43,084
Schedule of Activity Related to the Allowance for Doubtful Accounts	Activity related to the Company’s allowance for doubtful accounts for the three months ended September 30, 2023 and 2022 were as follows (in thousands): 2023 2022 Balance at July 1 $ 2,196 $ 3,471 Bad debt expense 447 426 Write-offs (69) (67) Balance at September 30 $ 2,574 $ 3,830 Activity related to the Company’s allowance for doubtful accounts for the nine months ended September 30, 2023 and 2022 were as follows (in thousands): 2023 2022 Balance at January 1 $ 3,783 $ 1,187 Bad debt expense 737 2,817 Write-offs (1,946) (174) Balance at September 30 $ 2,574 $ 3,830

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2023
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consisted of the following (in thousands): September 30, 2023 December 31, 2022 Raw materials $ 838 $ 810 Work in process 10,547 6,855 Finished goods 7,683 5,518 Inventory $ 19,068 $ 13,183

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	9 Months Ended
	Sep. 30, 2023
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment, Net	Property and equipment, net, consisted of the following (in thousands): September 30, 2023 December 31, 2022 Laboratory and clean room equipment $ 17,551 $ 16,422 Furniture and equipment 15,255 15,016 Leasehold improvements 9,418 9,190 Construction in progress 1,656 1,983 Asset retirement cost 960 983 Finance lease right-of-use asset 189 189 Property and equipment, gross 45,029 43,783 Less: accumulated depreciation and amortization (37,935) (35,927) Property and equipment, net $ 7,094 $ 7,856
Schedule of Depreciation Expense	Depreciation expense for the three and nine months ended September 30, 2023 and 2022 is summarized in the table below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Depreciation expense $ 653 $ 831 $ 2,054 $ 2,549

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets, Net (Tables)	9 Months Ended
	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill Activity	The following table provides a summary of goodwill activity for the nine months ended September 30, 2023 (in thousands): Wound & Surgical Regenerative Medicine Goodwill Balance as of December 31, 2022 $ 19,441 $ 535 $ 19,976 Impairment of goodwill — (535) (535) Balance as of September 30, 2023 $ 19,441 $ — $ 19,441
Schedule of Intangible Assets, Net	Intangible assets, net, are summarized as follows (in thousands): September 30, 2023 December 31, 2022 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 9,969 $ (7,638) $ 2,331 $ 9,923 $ (7,106) $ 2,817 Licenses 1,000 (42) 958 1,000 (4) $ 996 Total amortized intangible assets $ 10,969 $ (7,680) $ 3,289 $ 10,923 $ (7,110) $ 3,813 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 1,098 1,098 1,031 1,031 Total intangible assets $ 13,075 $ 5,395 $ 12,962 $ 5,852
Schedule of Expected Future Amortization of Intangible Assets	Expected future amortization of intangible assets as of September 30, 2023, is as follows (in thousands): Year ending December 31, Estimated 2023 (excluding the nine months ended September 30, 2023) $ 190 2024 759 2025 364 2026 210 2027 209 Thereafter 1,557 Total amortized intangible assets $ 3,289

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2023
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consisted of the following (in thousands): September 30, 2023 December 31, 2022 Commissions to sales agents $ 3,213 $ 2,941 Accrued rebates 1,244 707 Legal and settlement costs 1,025 4,447 Estimated sales returns 910 659 Accrued group purchasing organization fees 713 638 Accrued clinical trials 694 90 Accrued contract termination costs 547 — Accrued travel 259 566 Other 839 976 Accrued expenses $ 9,444 $ 11,024

Long Term Debt, Net (Tables)

Long Term Debt, Net (Tables)	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Schedule of Balances of Term Loan	The balances of the Term Loan as of September 30, 2023 and December 31, 2022 were as follows (in thousands): September 30, 2023 December 31, 2022 Outstanding principal $ 50,000 $ 50,000 Deferred financing costs (896) (1,219) Original issue discount (138) (187) Long term debt, net $ 48,966 $ 48,594
Schedule of Interest Expense Related to the Term Loan	Interest expense related to the Term Loan, included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Stated interest $ 1,554 $ 1,151 $ 4,498 $ 3,225 Amortization of deferred financing costs 111 103 323 302 Accretion of original issue discount 17 16 50 46 Interest expense $ 1,682 $ 1,270 $ 4,871 $ 3,573
Schedule of Principal Payments due on Term Loan	A summary of principal payments due on the Term Loan, by year, from September 30, 2023 through maturity are as follows (in thousands): Year ending December 31, Principal 2023 (excluding the nine months ended September 30, 2023) $ — 2024 — 2025 50,000 2026 — 2027 — Thereafter — Outstanding principal $ 50,000

Net Income (Loss) Per Common _2

Net Income (Loss) Per Common Share (Tables)	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Schedule of Basic Net Income (Loss) Per Common Share	The following table provides a reconciliation of net loss to net loss available to common stockholders and calculation of basic net loss per common share for each of the three and nine months ended September 30, 2023 and 2022 (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net income (loss) $ 8,534 $ (8,426) $ 4,751 $ (29,783) Accumulated dividends on Series B Preferred Stock 1,773 1,670 5,184 4,884 Net income (loss) available to common stockholders $ 6,761 $ (10,096) $ (433) $ (34,667) Weighted average common shares outstanding 116,298,146 113,448,251 115,528,067 112,650,713 Basic net income (loss) per common share $ 0.06 $ (0.09) $ (0.00) $ (0.31)
Schedule of Diluted Net Income (Loss) Per Common Share	The following table sets forth the computation of diluted net loss per common share (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net income (loss) available to common stockholders $ 6,761 $ (10,096) $ (433) $ (34,667) Adjustments: Accumulated dividends on Series B Convertible Preferred Stock 1,773 1,670 5,184 4,884 Less: antidilutive adjustments (1,773) (1,670) (5,184) (4,884) Total adjustments — — — — Numerator $ 6,761 $ (10,096) $ (433) $ (34,667) Weighted average shares outstanding 116,298,146 113,448,251 115,528,067 112,650,713 Adjustments: Potential common shares (a) Restricted stock unit awards 1,845,832 — — — Outstanding stock options 1,131,410 — — — Performance stock unit awards 35,441 — — — Restricted stock awards 15,767 — — — Employee stock purchase plan 1,113 — — — Total adjustments 3,029,563 — — — Weighted average shares outstanding adjusted for potential common shares 119,327,709 113,448,251 115,528,067 112,650,713 Diluted net income (loss) per common share $ 0.06 $ (0.09) $ (0.00) $ (0.31) (a) Weighted average common shares outstanding for the calculation of diluted net income (loss) per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented.
Schedule of Antidilutive Securities	Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Series B Convertible Preferred Stock 30,445,997 28,685,739 29,559,946 27,850,916 Restricted stock unit awards — 474,355 1,219,776 574,507 Performance stock unit awards — 59,996 13,425 40,141 Employee stock purchase plan — 4,536 372 1,517 Restricted stock awards — 22,327 23,733 293,778 Outstanding stock options — 22,528 107,897 97,190 Potential common shares 30,445,997 29,269,481 30,925,149 28,858,049

Equity (Tables)

Equity (Tables)	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Schedule of Activity of Unvested Equity Incentive Awards by Award Type	The table below summarizes activity of unvested Equity Incentive Awards by award type from January 1, 2023 through September 30, 2023. RSA RSU PSU Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Unvested at January 1, 2023 122,755 $ 6.13 4,774,971 $ 6.28 241,072 $ 4.62 Granted — — 3,266,244 4.65 3,851,427 3.83 Vested (13,624) 6.18 (2,237,260) 6.20 — — Forfeited (90,367) 5.83 (1,715,136) 5.45 (365,227) 4.24 Unvested at September 30, 2023 18,764 $ 7.55 4,088,819 $ 5.38 3,727,272 $ 3.84
Schedule of Stock Options Activity	A summary of stock option activity for the nine months ended September 30, 2023 is presented below: Number of Weighted- Weighted- Aggregate Outstanding at January 1, 2023 933,894 $ 6.46 Granted 3,694,000 3.77 Exercised (62,599) 6.50 Vested options expired (423,213) 5.81 Outstanding at September 30, 2023 4,142,082 4.13 6.31 13,178,214 Exercisable at September 30, 2023 448,082 $ 7.06 0.60 $ 174,314
Schedule of Fair Value Assumptions	The Company estimated the fair value of the awards using a Monte Carlo simulation using the following assumptions: Assumption Stock price on grant date $ 3.70 Exercise price $ 3.70 Risk-free interest rate 3.58 % Expected volatility (annualized) 75.00 % Dividend yield — % Weighted average grant date fair value $ 1.93

Supplemental Disclosure of Ca_2

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities (Tables)	9 Months Ended
	Sep. 30, 2023
Supplemental Cash Flow Elements [Abstract]
Schedule of Selected Cash Payments, Receipts, and Non-Cash Activities	Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Nine Months Ended September 30, 2023 2022 Cash paid for interest $ 4,496 $ 3,233 Cash paid for income taxes 210 184 Non-cash activities: Issuance of shares pursuant to employee stock purchase plan 1,368 — Purchases of equipment in accounts payable 126 353 Right of use assets arising from operating lease liabilities — (37)

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Schedule of Net Sales	Below is a summary of net sales by site of service (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Hospital $ 47,350 $ 40,174 $ 136,108 $ 116,081 Private Office 22,951 19,572 68,188 54,768 Other 11,411 7,943 30,349 22,617 Total $ 81,712 $ 67,689 $ 234,645 $ 193,466 Below is a summary of net sales by class of product (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Advanced Wound Care Tissue/Other $ 75,570 $ 61,131 $ 216,825 $ 174,256 Cord 6,066 5,678 17,259 17,165 Total Advanced Wound Care 81,636 66,809 234,084 191,421 Section 351 (1) 76 880 561 2,045 Total $ 81,712 $ 67,689 $ 234,645 $ 193,466 (1) Revenue recognized from collections relating to revenue transactions for which performance obligations were fulfilled prior to October 1, 2019, the date at which the Company changed its pattern of revenue recognition, for the three and nine months ended September 30, 2022 of $0.1 million and $0.2 million, respectively, which were separately presented in previously-issued financial statements, are presented as part of Section 351 in the table above.

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2023
Segment Reporting [Abstract]
Schedule of Net Sales and Segment Contribution for Each Reportable Segment	Net sales and segment contribution by each reportable segment for the three months ended September 30, 2023 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 80,376 $ — $ 1,336 $ 81,712 Cost of sales 13,305 — 1,485 14,790 Selling, general and administrative expense 38,687 — 13,884 52,571 Research and development expense 3,175 — — 3,175 Restructuring — 208 — 208 Amortization of intangible assets — — 190 190 Segment contribution $ 25,209 $ (208) Investigation, restatement and related expense (38) Operating income $ 10,816 Supplemental information Depreciation expense $ 423 $ — $ 230 $ 653 Share-based compensation $ 1,902 $ — $ 2,486 $ 4,388 Net sales and segment contribution by each reportable segment for the three months ended September 30, 2022 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 66,873 $ — $ 816 $ 67,689 Cost of sales 11,159 — 1,029 12,188 Selling, general and administrative expense 35,530 — 17,945 53,475 Research and development expense 1,680 4,273 — 5,953 Amortization of intangible assets — — 175 175 Segment contribution $ 18,504 $ (4,273) Investigation, restatement and related expense 3,001 Operating loss $ (7,103) Supplemental information Depreciation expense $ 451 $ 36 $ 344 $ 831 Share-based compensation $ 1,945 $ 347 $ 80 $ 2,372 Net sales and segment contribution by each reportable segment for the nine months ended September 30, 2023 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 231,466 $ — $ 3,179 $ 234,645 Cost of sales 37,373 — 3,419 40,792 Selling, general and administrative expense 114,853 — 41,920 156,773 Research and development expense 6,330 11,838 — 18,168 Restructuring — 3,464 — 3,464 Amortization of intangible assets — — 570 570 Segment contribution $ 72,910 $ (15,302) Investigation, restatement and related expense 4,652 Operating income $ 10,226 Supplemental information Depreciation expense $ 1,208 $ 135 $ 711 $ 2,054 Share-based compensation $ 5,130 $ 259 $ 7,404 $ 12,793 Net sales and segment contribution by each reportable segment for the nine months ended September 30, 2022 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 191,297 $ — $ 2,169 $ 193,466 Cost of sales 31,126 — 2,821 33,947 Selling, general and administrative expense 108,256 — 50,582 158,838 Research and development expense 6,068 11,361 — 17,429 Amortization of intangible assets — — 519 519 Segment contribution $ 45,847 $ (11,361) Investigation, restatement and related expense 8,771 Operating loss $ (26,038) Supplemental information Depreciation expense $ 1,364 $ 120 $ 1,065 $ 2,549 Share-based compensation $ 5,609 $ 910 $ 4,279 $ 10,798

Nature of Business (Details)

Nature of Business (Details) - segment	3 Months Ended	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of reportable segments	2	2

Significant Accounting Polici_3

Significant Accounting Policies (Details)	9 Months Ended
	Sep. 30, 2023
Employee Stock Option
Dividends Payable [Line Items]
Expected dividend yield	0%

Accounts Receivable, Net - Sche

Accounts Receivable, Net - Schedule of Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Jun. 30, 2023	Dec. 31, 2022	Sep. 30, 2022	Jun. 30, 2022	Dec. 31, 2021
Receivables [Abstract]
Accounts receivable, gross	$ 51,579		$ 46,867
Less: allowance for doubtful accounts	(2,574)	$ (2,196)	(3,783)	$ (3,830)	$ (3,471)	$ (1,187)
Accounts receivable, net	$ 49,005		$ 43,084

Accounts Receivable, Net - Sc_2

Accounts Receivable, Net - Schedule of Activities Related to the Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Allowance for Doubtful Accounts
Beginning balance	$ 2,196	$ 3,471	$ 3,783	$ 1,187
Bad debt expense	447	426	737	2,817
Write-offs	(69)	(67)	(1,946)	(174)
Ending balance	$ 2,574	$ 3,830	$ 2,574	$ 3,830

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 838	$ 810
Work in process	10,547	6,855
Finished goods	7,683	5,518
Inventory	$ 19,068	$ 13,183

Property and Equipment, Net - S

Property and Equipment, Net - Schedule of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Finance lease right-of-use asset	$ 189	$ 189
Property and equipment, gross	45,029	43,783
Less: accumulated depreciation and amortization	(37,935)	(35,927)
Property and equipment, net	7,094	7,856
Laboratory and clean room equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	17,551	16,422
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	15,255	15,016
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	9,418	9,190
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,656	1,983
Asset retirement cost
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 960	$ 983

Property and Equipment, Net -_2

Property and Equipment, Net - Schedule of Depreciation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 653	$ 831	$ 2,054	$ 2,549

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets, Net - Schedule of Goodwill Activity (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Goodwill [Roll Forward]
Beginning Balance			$ 19,976,000
Impairment of goodwill			(535,000)	$ 0
Ending Balance	$ 19,441,000		19,441,000
Goodwill activity	0	$ 0		$ 0
Wound & Surgical
Goodwill [Roll Forward]
Beginning Balance			19,441,000
Impairment of goodwill			0
Ending Balance	19,441,000		19,441,000
Regenerative Medicine
Goodwill [Roll Forward]
Beginning Balance			535,000
Impairment of goodwill			(535,000)
Ending Balance	$ 0		$ 0

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets, Net - Schedule of Intangible Assets, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 10,969	$ 10,923
Accumulated Amortization	(7,680)	(7,110)
Net Carrying Amount	3,289	3,813
Indefinite-lived Intangible Assets [Line Items]
Total intangible assets, gross carrying amount	13,075	12,962
Total intangible assets, net carrying amount	5,395	5,852
Tradenames and trademarks
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,008	1,008
Patents in Process
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,098	1,031
Patents and know-how
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	9,969	9,923
Accumulated Amortization	(7,638)	(7,106)
Net Carrying Amount	2,331	2,817
Licenses
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,000	1,000
Accumulated Amortization	(42)	(4)
Net Carrying Amount	$ 958	$ 996

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets, Net - Schedule of Expected Future Amortization of Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Estimated future amortization expense [Abstract]
2023 (excluding the nine months ended September 30, 2023)	$ 190
2024	759
2025	364
2026	210
2027	209
Thereafter	1,557
Net Carrying Amount	$ 3,289	$ 3,813

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Commissions to sales agents	$ 3,213	$ 2,941
Accrued rebates	1,244	707
Legal and settlement costs	1,025	4,447
Estimated sales returns	910	659
Accrued group purchasing organization fees	713	638
Accrued clinical trials	694	90
Accrued contract termination costs	547	0
Accrued travel	259	566
Other	839	976
Accrued expenses	$ 9,444	$ 11,024

Long Term Debt, Net - Narrative

Long Term Debt, Net - Narrative (Details) - Term loan - Hayfin Loan Agreement Term Loan - USD ($)	Jul. 02, 2020	Sep. 30, 2023	Jun. 20, 2023
Debt Instrument [Line Items]
Principal issued			$ 50,000,000
Effective interest rate		12.30%
Fair value of the term loan		$ 47,700,000
Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate	0.15%
Floor rate	1.50%
Margin rate	6.75%

Long Term Debt, Net - Schedule

Long Term Debt, Net - Schedule of Balances of Term Loan (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Outstanding principal	$ 50,000
Term loan | Hayfin Loan Agreement Term Loan
Debt Instrument [Line Items]
Outstanding principal	50,000	$ 50,000
Deferred financing costs	(896)	(1,219)
Original issue discount	(138)	(187)
Long term debt, net	$ 48,966	$ 48,594

Long Term Debt, Net - Schedul_2

Long Term Debt, Net - Schedule of Interest Expense Related to the Term Loan (Details) - Term loan - Hayfin Loan Agreement Term Loan - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Debt Instrument [Line Items]
Stated interest	$ 1,554	$ 1,151	$ 4,498	$ 3,225
Amortization of deferred financing costs	111	103	323	302
Accretion of original issue discount	17	16	50	46
Interest expense	$ 1,682	$ 1,270	$ 4,871	$ 3,573

Long Term Debt, Net - Schedul_3

Long Term Debt, Net - Schedule of Principal Payments due on Term Loan (Details) $ in Thousands	Sep. 30, 2023 USD ($)
Debt Disclosure [Abstract]
2023 (excluding the nine months ended September 30, 2023)	$ 0
2024	0
2025	50,000
2026	0
2027	0
Thereafter	0
Outstanding principal	$ 50,000

Net Income (Loss) Per Common _3

Net Income (Loss) Per Common Share - Schedule of Basic Net Income (Loss) Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Net income (loss)	$ 8,534	$ (8,426)	$ 4,751	$ (29,783)
Accumulated dividends on Series B Preferred Stock	1,773	1,670	5,184	4,884
Net income (loss) available to common stockholders	$ 6,761	$ (10,096)	$ (433)	$ (34,667)
Weighted average common shares outstanding (in shares)	116,298,146	113,448,251	115,528,067	112,650,713
Basic net income (loss) per common share (in dollars per share)	$ 0.06	$ (0.09)	$ 0	$ (0.31)

Net Income (Loss) Per Common _4

Net Income (Loss) Per Common Share - Schedule of Diluted Net Income (Loss) Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share, Diluted, by Common Class, Including Two Class Method [Line Items]
Net income (loss) available to common stockholders	$ 6,761	$ (10,096)	$ (433)	$ (34,667)
Adjustments:
Accumulated dividends on Series B Convertible Preferred Stock	1,773	1,670	5,184	4,884
Less: antidilutive adjustments	(1,773)	(1,670)	(5,184)	(4,884)
Total adjustments	0	0	0	0
Numerator	$ 6,761	$ (10,096)	$ (433)	$ (34,667)
Weighted average shares outstanding	116,298,146	113,448,251	115,528,067	112,650,713
Potential common shares
Total adjustments	3,029,563	0	0	0
Weighted average shares outstanding adjusted for potential common shares	119,327,709	113,448,251	115,528,067	112,650,713
Diluted net income (loss) per common share (in dollars per share)	$ 0.06	$ (0.09)	$ 0	$ (0.31)
Restricted stock unit awards
Potential common shares
Stock-based awards	1,845,832	0	0	0
Outstanding stock options
Potential common shares
Stock-based awards	1,131,410	0	0	0
Performance stock unit awards
Potential common shares
Stock-based awards	35,441	0	0	0
Restricted stock awards
Potential common shares
Stock-based awards	15,767	0	0	0
Employee stock purchase plan
Potential common shares
Stock-based awards	1,113	0	0	0

Net Income (Loss) Per Common _5

Net Income (Loss) Per Common Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	30,445,997	29,269,481	30,925,149	28,858,049
Series B Convertible Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	30,445,997	28,685,739	29,559,946	27,850,916
Restricted stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	0	474,355	1,219,776	574,507
Performance stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	0	59,996	13,425	40,141
Employee stock purchase plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	0	4,536	372	1,517
Restricted stock awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	0	22,327	23,733	293,778
Outstanding stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	0	22,528	107,897	97,190

Equity - Narrative (Details)

Equity - Narrative (Details) $ / shares in Units, $ in Millions			3 Months Ended	9 Months Ended
	Jul. 05, 2023 USD ($) shares	Jan. 27, 2023 USD ($) goal trading_day $ / shares shares	Sep. 30, 2023 USD ($) shares	Sep. 30, 2023 USD ($) $ / shares shares
Dividends Payable [Line Items]
Options granted in period (in shares) | shares				3,694,000
Granted (in dollars per share) | $ / shares				$ 3.77
Executive Officer
Dividends Payable [Line Items]
Options granted in period (in shares) | shares		3,600,000
Granted (in dollars per share) | $ / shares		$ 3.70
Number of separate share price goals | goal		3
Trading days | trading_day		20
Grant date fair value | $		$ 7
Executive Officer | Tranche One
Dividends Payable [Line Items]
Vesting percentage		25%
Award vesting percentage if performance metrics are achieved		33.33%
Executive Officer | Tranche Two
Dividends Payable [Line Items]
Vesting percentage		25%
Award vesting percentage if performance metrics are achieved		33.33%
Executive Officer | Tranche Three
Dividends Payable [Line Items]
Vesting percentage		25%
Award vesting percentage if performance metrics are achieved		33.33%
Executive Officer | Tranche Four
Dividends Payable [Line Items]
Vesting percentage		25%
Equity Incentive Awards
Dividends Payable [Line Items]
Total unrecognized stock-based compensation related to time-based, nonvested restricted stock | $			$ 24.1	$ 24.1
Expenses expected to be recognized over a weighted-average period (in years)				2 years 3 months 29 days
Performance stock unit awards
Dividends Payable [Line Items]
Awards granted in period (in shares) | shares				3,851,427
Performance stock unit awards | Executive Officer
Dividends Payable [Line Items]
Awards granted in period (in shares) | shares		3,300,000
Performance achievement percentage threshold in order to vest		50%
Share based compensation expense | $			0.4	$ 1.1
Performance stock unit awards | Executive Officer | Minimum
Dividends Payable [Line Items]
Percentage of granted shares to vest		50%
Performance stock unit awards | Executive Officer | Maximum
Dividends Payable [Line Items]
Percentage of granted shares to vest		200%
Performance stock unit awards | Chief Financial Officer
Dividends Payable [Line Items]
Awards granted in period (in shares) | shares	162,000
Vesting percentage	100%
Vesting period	3 years
Share based compensation total grant value | $	$ 1.5
Performance stock unit awards | Chief Financial Officer | Minimum
Dividends Payable [Line Items]
Vesting percentage	50%
Performance stock unit awards | Chief Financial Officer | Maximum
Dividends Payable [Line Items]
Vesting percentage	150%
Stock options
Dividends Payable [Line Items]
Total unrecognized stock-based compensation related to time-based, nonvested restricted stock | $			5.5	$ 5.5
Expenses expected to be recognized over a weighted-average period (in years)				2 years 2 months 19 days
Stock options | Executive Officer
Dividends Payable [Line Items]
Share based compensation expense | $			0.7	$ 2
Stock options | Chief Financial Officer
Dividends Payable [Line Items]
Options granted in period (in shares) | shares	94,000
Share based compensation total grant value | $	$ 0.4
Stock options | Chief Financial Officer | Tranche One
Dividends Payable [Line Items]
Vesting percentage	25%
Stock options | Chief Financial Officer | Tranche Two
Dividends Payable [Line Items]
Vesting percentage	25%
Stock options | Chief Financial Officer | Tranche Three
Dividends Payable [Line Items]
Vesting percentage	25%
Stock options | Chief Financial Officer | Tranche Four
Dividends Payable [Line Items]
Vesting percentage	25%
RSU
Dividends Payable [Line Items]
Awards granted in period (in shares) | shares				3,266,244
RSU | Chief Financial Officer
Dividends Payable [Line Items]
Awards granted in period (in shares) | shares	97,200
Share based compensation total grant value | $	$ 0.6
RSU | Chief Financial Officer | Tranche One
Dividends Payable [Line Items]
Vesting percentage	33.33%
RSU | Chief Financial Officer | Tranche Two
Dividends Payable [Line Items]
Vesting percentage	33.33%
RSU | Chief Financial Officer | Tranche Three
Dividends Payable [Line Items]
Vesting percentage	33.33%
Series B Convertible Preferred Stock
Dividends Payable [Line Items]
Dividends accumulated but not paid | $			$ 19	$ 19
Convertible shares issuable (in shares) | shares			30,906,441	30,906,441

Equity - Schedule of Activity o

Equity - Schedule of Activity of Unvested Equity Incentive Awards by Award Type (Details)	9 Months Ended
	Sep. 30, 2023 $ / shares shares
RSA
Number of Shares
Unvested, Beginning Balance (in shares) | shares	122,755
Granted (in shares) | shares	0
Vested (in shares) | shares	(13,624)
Forfeited (in shares) | shares	(90,367)
Unvested, Ending Balance (in shares) | shares	18,764
Weighted-Average Grant Date Fair Value
Unvested, Beginning Balance (in dollars per share) | $ / shares	$ 6.13
Granted (in dollars per share) | $ / shares	0
Vested (in dollars per share) | $ / shares	6.18
Forfeited (in dollars per share) | $ / shares	5.83
Unvested, Ending Balance (in dollars per share) | $ / shares	$ 7.55
RSU
Number of Shares
Unvested, Beginning Balance (in shares) | shares	4,774,971
Granted (in shares) | shares	3,266,244
Vested (in shares) | shares	(2,237,260)
Forfeited (in shares) | shares	(1,715,136)
Unvested, Ending Balance (in shares) | shares	4,088,819
Weighted-Average Grant Date Fair Value
Unvested, Beginning Balance (in dollars per share) | $ / shares	$ 6.28
Granted (in dollars per share) | $ / shares	4.65
Vested (in dollars per share) | $ / shares	6.20
Forfeited (in dollars per share) | $ / shares	5.45
Unvested, Ending Balance (in dollars per share) | $ / shares	$ 5.38
PSU
Number of Shares
Unvested, Beginning Balance (in shares) | shares	241,072
Granted (in shares) | shares	3,851,427
Vested (in shares) | shares	0
Forfeited (in shares) | shares	(365,227)
Unvested, Ending Balance (in shares) | shares	3,727,272
Weighted-Average Grant Date Fair Value
Unvested, Beginning Balance (in dollars per share) | $ / shares	$ 4.62
Granted (in dollars per share) | $ / shares	3.83
Vested (in dollars per share) | $ / shares	0
Forfeited (in dollars per share) | $ / shares	4.24
Unvested, Ending Balance (in dollars per share) | $ / shares	$ 3.84

Equity - Schedule of Stock Opti

Equity - Schedule of Stock Options Activity (Details) - USD ($)	9 Months Ended
	Sep. 30, 2023
Number of Shares
Outstanding, beginning of period (in shares)	933,894
Granted (in shares)	3,694,000
Exercised (in shares)	(62,599)
Vested options expired (in shares)	(423,213)
Outstanding, end of period (in shares)	4,142,082
Exercisable (in shares)	448,082
Weighted- Average Exercise Price
Outstanding, beginning of period (in dollars per share)	$ 6.46
Granted (in dollars per share)	3.77
Exercised (in dollars per share)	6.50
Vested options expired (in dollars per share)	5.81
Outstanding, end of period (in dollars per share)	4.13
Exercisable (in dollars per share)	$ 7.06
Weighted- Average Remaining Contractual Term (in years)
Outstanding	6 years 3 months 21 days
Exercisable	7 months 6 days
Aggregate Intrinsic Value
Outstanding	$ 13,178,214
Exercisable	$ 174,314

Equity - Schedule of Fair Value

Equity - Schedule of Fair Value Assumptions (Details) - Stock options	9 Months Ended
	Sep. 30, 2023 $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend yield	0%
Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock price on grant date (in dollars per share)	$ 3.70
Exercise price (in dollars per share)	$ 3.70
Risk-free interest rate	3.58%
Expected volatility (annualized)	75%
Dividend yield	0%
Weighted average grant date fair value (in dollars per share)	$ 1.93

Income Taxes (Details)

Income Taxes (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Effective tax rate	6.50%	(0.60%)	10.70%	(0.60%)

Supplemental Disclosure of Ca_3

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities - Schedule of Selected Cash Payments, Receipts, and Non-Cash Activities (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2023	Sep. 30, 2022
Supplemental Cash Flow Elements [Abstract]
Cash paid for interest		$ 4,496	$ 3,233
Cash paid for income taxes		210	184
Non-cash activities:
Issuance of shares pursuant to employee stock purchase plan	$ 688	1,368	0
Purchases of equipment in accounts payable		126	353
Right of use assets arising from operating lease liabilities		$ 0	$ (37)

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions		1 Months Ended
	Jan. 16, 2019 class_action	Jun. 30, 2022 USD ($)
Loss Contingencies [Line Items]
Number of securities class actions | class_action	2
Research and Development Arrangement | Nordic Bioscience Clinical Development A/S
Loss Contingencies [Line Items]
Long-term purchase commitment amount | $		$ 10.2

Revenue - Schedule of Net Sales

Revenue - Schedule of Net Sales by Site Of Service (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023 USD ($) service_site	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($) service_site	Sep. 30, 2022 USD ($)
Revenue from Contract with Customer [Abstract]
Number of sites of service | service_site	3		3
Revenue, Major Customer [Line Items]
Net sales	$ 81,712	$ 67,689	$ 234,645	$ 193,466
Hospital
Revenue, Major Customer [Line Items]
Net sales	47,350	40,174	136,108	116,081
Private Office
Revenue, Major Customer [Line Items]
Net sales	22,951	19,572	68,188	54,768
Other
Revenue, Major Customer [Line Items]
Net sales	$ 11,411	$ 7,943	$ 30,349	$ 22,617

Revenue - Schedule of Net Sal_2

Revenue - Schedule of Net Sales by Product Type (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023 USD ($) product	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($) product	Sep. 30, 2022 USD ($)
Revenue from Contract with Customer [Abstract]
Number of products | product	2		2
Revenue, Major Customer [Line Items]
Net sales	$ 81,712	$ 67,689	$ 234,645	$ 193,466
Advanced Wound Care
Revenue, Major Customer [Line Items]
Net sales	81,636	66,809	234,084	191,421
Tissue/Other
Revenue, Major Customer [Line Items]
Net sales	75,570	61,131	216,825	174,256
Cord
Revenue, Major Customer [Line Items]
Net sales	6,066	5,678	17,259	17,165
Section 351
Revenue, Major Customer [Line Items]
Net sales	76	$ 880	561	$ 2,045
Other
Revenue, Major Customer [Line Items]
Net sales	$ 100		$ 200

Segment Information - Narrative

Segment Information - Narrative (Details) - segment	3 Months Ended	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2023
Segment Reporting [Abstract]
Number of reportable segments	2	2

Segment Information -Net Sales

Segment Information -Net Sales and Segment Contribution for Each Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting Information [Line Items]
Net sales	$ 81,712	$ 67,689	$ 234,645	$ 193,466
Cost of sales	14,790	12,188	40,792	33,947
Selling, general and administrative expense	52,571	53,475	156,773	158,838
Research and development expense	3,175	5,953	18,168	17,429
Restructuring	208	0	3,464	0
Amortization of intangible assets	190	175	570	519
Investigation, restatement and related expense	(38)	3,001	4,652	8,771
Operating income (loss)	10,816	(7,103)	10,226	(26,038)
Supplemental information
Depreciation expense	653	831	2,054	2,549
Share-based compensation	4,388	2,372	12,793	10,798
Corporate & Other
Segment Reporting Information [Line Items]
Net sales	1,336	816	3,179	2,169
Cost of sales	1,485	1,029	3,419	2,821
Selling, general and administrative expense	13,884	17,945	41,920	50,582
Research and development expense	0	0	0	0
Restructuring	0		0
Amortization of intangible assets	190	175	570	519
Supplemental information
Depreciation expense	230	344	711	1,065
Share-based compensation	2,486	80	7,404	4,279
Wound & Surgical | Operating Segments
Segment Reporting Information [Line Items]
Net sales	80,376	66,873	231,466	191,297
Cost of sales	13,305	11,159	37,373	31,126
Selling, general and administrative expense	38,687	35,530	114,853	108,256
Research and development expense	3,175	1,680	6,330	6,068
Restructuring	0		0
Amortization of intangible assets	0	0	0	0
Segment contribution	25,209	18,504	72,910	45,847
Supplemental information
Depreciation expense	423	451	1,208	1,364
Share-based compensation	1,902	1,945	5,130	5,609
Regenerative Medicine | Operating Segments
Segment Reporting Information [Line Items]
Net sales	0	0	0	0
Cost of sales	0	0	0	0
Selling, general and administrative expense	0	0	0	0
Research and development expense	0	4,273	11,838	11,361
Restructuring	208		3,464
Amortization of intangible assets	0	0	0	0
Segment contribution	(208)	(4,273)	(15,302)	(11,361)
Supplemental information
Depreciation expense	0	36	135	120
Share-based compensation	$ 0	$ 347	$ 259	$ 910

Restructuring - Narrative (Deta

Restructuring - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Restructuring Cost and Reserve [Line Items]
Impairment of clinical trial assets			$ 1,974	$ 0
Impairment of goodwill			535	0
Restructuring expenses incurred	$ 208	$ 0	3,464	$ 0
Regenerative Medicine
Restructuring Cost and Reserve [Line Items]
Impairment of goodwill			535
June 2023 Restructuring
Restructuring Cost and Reserve [Line Items]
Severance arrangements	1,800		2,100
Impairment of clinical trial assets			2,100
June 2023 Restructuring | Employee Severance
Restructuring Cost and Reserve [Line Items]
Restructuring reserve	300		300
June 2023 Restructuring | Termination of Contract
Restructuring Cost and Reserve [Line Items]
Restructuring expenses incurred	200		$ 800
Adjustment to reduce accrual of contract termination costs	$ 200

Subsequent Events (Details)

Subsequent Events (Details) - Subsequent Event - Series B Convertible Preferred Stock $ in Millions	Oct. 27, 2023 USD ($) shares
Subsequent Event [Line Items]
Repurchase of stock (in shares) | shares	5,000
Repurchase of stock | $	$ 9.5