Nevro (NVRO) 10-Q 7 May 24 2024 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2024	Apr. 30, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Trading Symbol	NVRO
Entity Registrant Name	Nevro Corp.
Entity Central Index Key	0001444380
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Current Reporting Status	Yes
Entity Small Business	false
Entity Shell Company	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		36,728,648
Entity File Number	001-36715
Entity Tax Identification Number	56-2568057
Entity Address, Address Line One	1800 Bridge Parkway
Entity Address, City or Town	Redwood City
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94065
City Area Code	650
Local Phone Number	251-0005
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Security Exchange Name	NYSE
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Common Stock, $0.001 par value per share

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 90,303	$ 104,217
Short-term investments	191,180	218,506
Accounts receivable, net of allowance for doubtful accounts of $1,128 and $1,048 at March 31, 2024 and December 31, 2023, respectively	76,918	79,377
Inventories	120,789	118,676
Prepaid expenses and other current assets	13,414	10,145
Total current assets	492,604	530,921
Property and equipment, net	24,708	24,568
Operating lease assets	7,764	8,944
Goodwill	38,324	38,164
Intangible assets, net	26,617	27,354
Other assets	5,427	5,156
Restricted cash	606	606
Total assets	596,050	635,713
Current liabilities
Accounts payable	21,208	22,520
Accrued liabilities	39,486	45,297
Contingent liabilities, current portion	220	9,836
Other current liabilities	5,860	5,722
Total current liabilities	66,774	83,375
Long-term debt	214,763	211,471
Long-term operating lease liabilities	3,136	4,634
Contingent liabilities, non-current portion	15,564	12,257
Warrant liability	15,179	28,739
Other long-term liabilities	2,093	2,092
Total liabilities	317,509	342,568
Commitments and contingencies (Note 6)
Stockholders’ equity
Preferred stock, $0.001 par value, 10,000,000 shares authorized at March 31, 2024 and December 31, 2023; zero shares issued and outstanding at March 31, 2024 and December 31, 2023
Common stock, $0.001 par value, 290,000,000 shares authorized at March 31,2024 and December 31, 2023; 37,369,746 and 37,044,390 shares issued at March 31, 2024 and December 31, 2023, respectively; 36,686,830 and 36,361,474 shares outstanding at March 31, 2024 and December 31, 2023, respectively	36	36
Additional paid-in capital	1,004,348	992,762
Accumulated other comprehensive income (loss)	(1,024)	(243)
Accumulated deficit	(724,819)	(699,410)
Total stockholders’ equity	278,541	293,145
Total liabilities and stockholders’ equity	$ 596,050	$ 635,713

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 1,128	$ 1,048
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	290,000,000	290,000,000
Common stock, shares issued	37,369,746	37,044,390
Common stock, shares outstanding	36,686,830	36,361,474

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Revenue		$ 101,899	$ 96,327
Cost of revenue	[1]	30,371	31,703
Gross profit		71,528	64,624
Operating expenses
Research and development		14,828	14,755
Sales, general and administrative		88,326	86,192
Amortization of intangibles		737
Change in fair value of contingent consideration		3,471
Total operating expenses		107,362	100,947
Income (Loss) from operations		(35,834)	(36,323)
Interest income		3,780	3,278
Interest expense		(6,512)	(1,613)
Change in fair market value of warrants		13,560
Other income (expense), net		(21)	(46)
Loss before income taxes		(25,027)	(34,704)
Provision for income taxes		382	325
Net loss		(25,409)	(35,029)
Other comprehensive income (loss):
Changes in foreign currency translation adjustment		(255)	506
Changes in unrealized gains on short-term investments, net		(526)	587
Net change in other comprehensive income (loss)		(781)	1,093
Comprehensive loss		$ (26,190)	$ (33,936)
Net loss per share, basic		$ (0.7)	$ (0.98)
Net loss per share, diluted		$ (0.7)	$ (0.98)
Weighted average number of shares used to compute basic net loss per share		36,467,371	35,584,685
Weighted average number of shares used to compute diluted net loss per share		36,467,371	35,584,685
[1] Exclusive of amortization of intangible assets, which is shown separately.

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Beginning balances at Dec. 31, 2022	$ 323,876	$ 35	$ 934,132	$ (607,197)	$ (3,094)
Beginning balances, shares at Dec. 31, 2022		35,520,507
Issuance of common stock upon release of restricted stock units		$ 1	(1)
Issuance of common stock upon release of restricted stock units, shares		243,276
Shares withheld for tax obligations	(2,273)		(2,273)
Shares withheld for tax obligations, shares		(69,763)
Stock based compensation	13,561		13,561
Net loss	(35,029)			(35,029)
Change in other comprehensive loss	1,093				1,093
Ending balances at Mar. 31, 2023	301,228	$ 36	945,419	(642,226)	(2,001)
Ending balances, shares at Mar. 31, 2023		35,694,020
Beginning balances at Dec. 31, 2023	293,145	$ 36	992,762	(699,410)	(243)
Beginning balances, shares at Dec. 31, 2023		36,361,474
Issuance of common stock upon release of restricted stock units, shares		408,083
Shares withheld for tax obligations	(1,251)		(1,251)
Shares withheld for tax obligations, shares		(82,727)
Stock based compensation	12,837		12,837
Net loss	(25,409)			(25,409)
Change in other comprehensive loss	(781)				(781)
Ending balances at Mar. 31, 2024	$ 278,541	$ 36	$ 1,004,348	$ (724,819)	$ (1,024)
Ending balances, shares at Mar. 31, 2024		36,686,830

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Cash flows from operating activities
Net income (loss)	$ (25,409)	$ (35,029)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization	2,053	1,541
Amortization of operating lease assets	1,179	1,088
Stock-based compensation expense	12,837	13,560
Amortization of intangibles	737
Amortization of premium (accretion of discount) on short-term investments	(1,155)	(878)
Provision for doubtful accounts	318	123
Write-down of inventory	652	1,253
Amortization of debt issuance costs	910	308
Non-cash interest expense	2,647
Change in fair value of warrants	(13,560)
Change in fair value of contingent consideration	3,471
Unrealized (gains) losses on foreign currency transactions	(404)	(166)
Changes in operating assets and liabilities
Accounts receivable	1,861	13,132
Inventories	(2,293)	(14,296)
Prepaid expenses and other current assets	(3,408)	(4,691)
Other assets	(273)	61
Accounts payable	(677)	2,783
Accrued liabilities	(10,644)	(6,752)
Other long-term liabilities	(1,498)	(1,351)
Net cash provided by (used in) operating activities	(32,656)	(29,314)
Cash flows from investing activities
Purchases of short-term investments	(63,685)	(54,560)
Proceeds from maturity of short-term investments	91,640	32,500
Payment for acquisition of business, net of cash acquired	160
Purchases of property and equipment	(2,793)	(2,588)
Net cash provided by (used in) investing activities	25,322	(24,648)
Cash flows from financing activities
Convertible notes debt issuance costs	(265)
Minimum tax withholding paid on behalf of employees for net share settlement	(1,251)	(2,273)
Payment of contingent consideration established in purchase accounting	(4,964)
Net cash provided by (used in) financing activities	(6,480)	(2,273)
Effect of exchange rate changes on cash and cash equivalents	(100)	89
Net increase (decrease) in cash, cash equivalents and restricted cash	(13,914)	(56,146)
Cash, cash equivalents and restricted cash
Cash, cash equivalents and restricted cash at beginning of period	104,823	120,979
Cash, cash equivalents and restricted cash at end of period	90,909	64,833
Significant non-cash transactions
Purchases of property and equipment in accounts payable	$ 253	$ 358

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (25,409)	$ (35,029)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	1. Summary of Significant Accounting Policies Basis of Presentation The accompanying interim condensed consolidated financial statements as of March 31, 2024 and for the three months ended March 31, 2024 and 2023, and the related interim information contained within the notes to the financial statements, are unaudited. The unaudited interim condensed consolidated financial statements (the condensed consolidated financial statements) have been prepared in accordance with generally accepted accounting principles in the United States (U.S. GAAP) for interim financial information and on the same basis as the audited financial statements included on the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 (the Annual Report) filed with the Securities and Exchange Commission (SEC) on February 23, 2024. The condensed consolidated financial statements are prepared in U.S. dollars and include the Company’s accounts and those of its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated. In the opinion of management, the accompanying unaudited interim condensed consolidated financial statements contain all adjustments (consisting of normal recurring adjustments) necessary to state fairly the Company’s financial position as of March 31, 2024, the results of its operations for the three months ended March 31, 2024 and 2023 and the consolidated statements of cash flows for the three months ended March 31, 2024 and 2023. All such adjustments are of a normal and recurring nature. The interim financial data as of March 31, 2024 is not necessarily indicative of the results to be expected for the year ending December 31, 2024, or for any future period. The consolidated balance sheet as of December 31, 2023 was derived from the audited financials as of that date. The accompanying condensed consolidated financial statements and related financial information should be read in conjunction with the audited consolidated financial statements and the related notes thereto for the year ended December 31, 2023 included in the Annual Report. Use of Estimates The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Estimates are based on historical experience, where applicable, and other assumptions believed to be reasonable by management. Actual results may differ from those estimates under different assumptions or conditions. Foreign Currency Translation Unrealized foreign exchange gains and losses from the remeasurement of assets and liabilities denominated in currencies other than the functional currency of the reporting entity are recorded in other income (expense), net. Additionally, realized gains and losses resulting from transactions denominated in currencies other than the local currency are recorded in other income (expense), net in the condensed consolidated statements of operations and comprehensive loss. The Company recorded net unrealized and net realized foreign currency transaction gains (losses) during the periods presented as follows (in thousands): Three Months Ended March 31, 2024 2023 Net unrealized foreign currency gain (loss) $ 352 $ 133 Net realized foreign currency gain (loss) ( 322 ) ( 128 ) Significant Accounting Policies There have been no material changes to the Company’s significant accounting policies from its Annual Report.

Revenue

Revenue	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenue	2. Revenue The following table presents revenue by geography, based on the billing address of the customer (in thousands): Three Months Ended March 31, 2024 2023 United States $ 87,038 $ 82,321 International 14,861 14,006 Total revenue $ 101,899 $ 96,327 The United States is the only country that accounts for 10% or more of the revenue during the periods presented: Three Months Ended March 31, 2024 2023 United States 85 % 85 % There were no customers that accounted for 10 % or more of the Company’s revenue for each of the three months ended March 31, 2024 and 2023 . Additionally, there were no customers that accounted for 10 % or more of the Company’s accounts receivable balance as of March 31, 2024 and December 31, 2023. For the three months ended March 31, 2024, the Company recognized bad debt expenses of $ 0.3 million. For of the three months ended March 31, 2023 , the Company recognized bad debt expenses of $ 0.1 million.

Lease Accounting

Lease Accounting	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Lease Accounting	3. Lease Accounting The Company has operating leases for office space, a manufacturing facility, warehouse, research and development facilities and equipment. Leases with terms of 12 months or less are not recorded on the balance sheet, as the related lease expenses are recognized on a straight-line basis over the lease term. The Company accounts for lease components (such as fixed payments) separately from non-lease components (such as common area expenses). The weighted average lease terms and discounts rates are as follows: March 31, 2024 December 31, 2023 Operating Lease Term and Discount Rate Weighted-average remaining lease term 2.71 years 2.86 years Weighted-average discount rate 7.0 % 7.0 % As of March 31, 2024, the maturity of lease liabilities are as follows (in thousands): Operating Leases 2024, remaining months $ 4,678 2025 2,849 2026 405 2027 417 2028 430 Thereafter 1,130 Total lease payments 9,909 Less: Interest ( 913 ) Present value of lease liabilities $ 8,996 Supplemental lease cost information are as follows (in thousands): Three Months Ended March 31, 2024 2023 Operating lease cost $ 1,342 $ 1,342 Supplemental balance sheet information are as follows (in thousands): March 31, 2024 December 31, 2023 Operating Leases: Operating lease assets $ 7,764 $ 8,944 Other current liabilities $ 5,860 $ 5,722 Long term operating lease liabilities 3,136 4,634 Total operating lease liabilities $ 8,996 $ 10,356 Supplemental cash flow information are as follows (in thousands): Three Months Ended March 31, 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flow from operating leases $ 1,523 $ 1,478 See Note 6 for further details of the Company’s lease commitments.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	4. Fair Value Measurements Cash Equivalents and Short-Term Investments The Company’s money market funds are classified within Level 1 of the fair value hierarchy and are valued based on quoted prices in active markets for identical securities. The Company’s short-term investments are comprised of agency bonds, commercial paper, corporate notes and treasury bonds. All short-term investments have been classified within Level 1 or Level 2 of the fair value hierarchy because of the sufficient observable inputs for revaluation. The Company’s Level 2 investments are valued using third-party pricing sources. The pricing services utilize industry-standard valuation models, including both income and market-based approaches, for which all significant inputs are observable, either directly or indirectly, to estimate fair value. These inputs include reported trades of and broker/dealer quotes on the same or similar investments, issuer credit spreads, benchmark investments, prepayment/default projections based on historical data and other observable inputs. The following table sets forth the Company’s financial instruments that were measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands): Balance as of March 31, 2024 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 71,119 $ — $ — $ 71,119 Agency bonds (ii) — 25,972 — 25,972 Commercial paper (ii) — 7,497 — 7,497 Treasury bonds (ii) 157,712 — — 157,712 Total assets $ 228,831 $ 33,469 $ — $ 262,300 Balance as of December 31, 2023 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 82,886 $ — $ — $ 82,886 Agency bonds (ii) — 99,054 — 99,054 Commercial paper (ii) — 22,374 — 22,374 Corporate notes (ii) — 3,490 — 3,490 Treasury bonds (ii) 93,588 — — 93,588 Total assets $ 176,474 $ 124,918 $ — $ 301,392 (i) Included in cash and cash equivalents on the condensed consolidated balance sheets. (ii) Included in short-term investments on the condensed consolidated balance sheets. Convertible Senior Notes As of March 31, 2024 and December 31, 2023 , the fair value of the 2.75 % convertible senior notes due 2025 (the 2025 Notes) was $ 35.8 million and $ 35.6 million, respectively. The fair value was determined on the basis of market prices observable for similar instruments and is considered Level 2 in the fair value hierarchy (See Note 7 for additional information regarding the 2025 Notes). Warrant Liability In November 2023, the Company entered into a Credit Agreement and Guaranty (the Braidwell Credit Agreement) with Braidwell LP (together with its affiliates, Braidwell). In connection with the Braidwell Credit Agreement, the Company issued warrants (the Braidwell Warrants) to Braidwell to purchase an aggregate of approximately 2.58 million shares of the Company's common stock. The Braidwell Warrants are valued using the Black Scholes valuation model and are considered Level 3 in the fair value hierarchy. As of March 31, 2024 and December 31, 2023, the fair value of the Braidwell Warrants was $ 15.2 million and $ 28.7 million, respectively. Assumptions for the warrant liability are as follows: March 31, 2024 December 31, 2023 Expected term (in years) 5.7 6.0 Expected volatility 53 % 53 % Risk-free interest rate 3.94 % 3.50 % Dividend yield 0 % 0 % Contingent Consideration In connection with the Company's acquisition of Interventional Pain Technologies, Inc. (Vyrsa) in the fourth quarter of 2023, the Company is subject to certain contingent consideration. Changes in the fair value of the contingent consideration liability for the three months ended March 31, 2024 were as follows (in thousands): Balance as of December 31, 2023 $ 22,093 Change in fair value of contingent consideration $ 3,471 Contingent consideration payments $ ( 9,780 ) Balance as of March 31, 2024 $ 15,784 Upon the achievement of the regulatory approval milestone in the three months ended March 31, 2024, the Company accrued an additional $ 5.0 million and made contingent consideration payments of $ 9.8 million. This resulted in $ 0.2 million remaining in the current portion of contingent liabilities as of March 31, 2024. Additionally, the Company reduced the valuation of the remaining milestones by $ 1.5 million. The regulatory approval milestone and product development milestone consideration are valued using the probability-weighted average discount cash flow model, and the revenue milestone consideration is valued using the Monte Carlo simulation model. The contingent consideration is considered Level 3 in the fair value hierarchy. As of March 31, 2024, the fair value of the contingent consideration related to the product development and revenue milestones were $ 1.6 million and $ 13.9 million, respectively. As of December 31, 2023, the fair value of the contingent consideration related to the regulatory approval, product development and revenue milestones were $ 5.0 million, $ 1.7 million and $ 15.5 million, respectively. Significant unobservable inputs for the contingent consideration are as follows: Contingent Liability Fair Value at Valuation Technique Unobservable Input Range Product Development $ 1,641 Probability-Weighted Probability of Payment 75 % Milestone Average Discount Risk-Free Rate 4.9 % — 5.2 % Cash Flow Credit Spread 6.3 % Projected Year of Payment 2025 Revenue Milestone $ 13,923 Monte Carlo Simulation Discount Rate 10.7 % — 11.3 % Revenue Volatility 17.0 % Projected Year of Payment 2026 — 2027 Contingent Liability Fair Value at December 31, 2023 Valuation Technique Unobservable Input Range Regulatory Approval $ 4,964 Probability-Weighted Probability of Payment 80 % Milestone Average Discount Risk-Free Rate 5.2 % — 5.3 % Cash Flow Credit Spread 4.3 % Projected Year of Payment 2024 Product Development $ 1,677 Probability-Weighted Probability of Payment 50 % Milestone Average Discount Risk-Free Rate 4.9 % — 5.1 % Cash Flow Credit Spread 4.3 % Projected Year of Payment 2024 — 2025 Revenue Milestone $ 15,452 Monte Carlo Simulation Discount Rate 8.7 % — 9.3 % Revenue Volatility 17.0 % Projected Year of Payment 2025 — 2027

Balance Sheet Components

Balance Sheet Components	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	5. Balance Sheet Components Cash and Cash Equivalents The Company considers all highly-liquid investments purchased with an original maturity of three months or less at the date of purchase to be cash equivalents. Cash and cash equivalents include money market funds in the amount of $ 71.1 million and $ 82.9 million as of March 31, 2024 and December 31, 2023, respectively. As of March 31, 2024 and December 31, 2023, the Company’s cash equivalents were held at institutions in the United States and include deposits in a money market fund which was unrestricted as to withdrawal or use. The Company also held cash in foreign banks of approximately $ 8.5 million at March 31, 2024 and $ 9.4 million at December 31, 2023 that was not insured. The Company has not experienced any losses on its deposits of cash and cash equivalents. Investments The Company measures its cash equivalents and short-term investments at fair value, with unrealized gains and losses recorded in accumulated other comprehensive income within stockholders’ equity. The Company regularly reviews its investments and evaluates the current expected credit loss by considering factors such as historical experience, market data, and the near-term prospects of the investee. The following is a summary of the gross unrealized gains and unrealized losses on the Company’s investment securities, excluding investments in money market funds (in thousands): March 31, 2024 Amortized Gross Gross Aggregate Investment Securities Agency bonds $ 25,969 $ 14 $ ( 11 ) $ 25,972 Commercial paper 7,497 — — 7,497 Treasury bonds 157,984 47 ( 319 ) 157,712 Total securities $ 191,450 $ 61 $ ( 330 ) $ 191,181 December 31, 2023 Amortized Gross Gross Aggregate Investment Securities Agency bonds $ 99,076 $ 68 $ ( 90 ) $ 99,054 Commercial paper 22,369 5 — 22,374 Corporate notes 3,491 — ( 1 ) 3,490 Treasury bonds 93,312 317 ( 41 ) 93,588 Total securities $ 218,248 $ 390 $ ( 132 ) $ 218,506 Realized gains or losses and other-than-temporary impairments, if any, on available-for-sale securities are reported in other income (expense), net as incurred. The cost of securities sold is determined based on the specific identification method. The amount of realized gains and realized losses on investments recorded for the periods presented has not been material. The contractual maturities of the Company’s investment securities as of March 31, 2024 were as follows (in thousands): Amortized Cost Fair Value Amounts maturing within one year $ 117,853 $ 117,851 Amounts maturing after one year through five years 73,597 73,330 Total investment securities $ 191,450 $ 191,181 Inventories (in thousands) March 31, December 31, 2024 2023 Raw materials $ 52,994 $ 64,974 Work in process 7,205 2,149 Finished goods 60,590 51,553 Total inventories $ 120,789 $ 118,676 Inventories are stated at the lower of cost or net realizable value. Cost is determined using the standard cost method which approximates the first-in, first-out basis. Net realizable value is determined as the prices in the ordinary course of business, less reasonably predictable costs of completion, disposal and transportation. The Company regularly reviews inventory quantities compared to forecasted sales to record a provision for excess and obsolete inventory when appropriate. Inventory write-downs are recorded for excess and obsolete inventory. The Company estimates forecasted sales by considering product acceptance in the marketplace, customer demand, historical sales, product obsolescence and technological innovations. The Company periodically evaluates the carrying value of inventory on hand for potential excess amount over demand using the same lower of cost or net realizable value approach as that has been used to value the inventory. The Company also periodically evaluates inventory quantities in consideration of actual loss experience. As a result of these evaluations, the Company recognized total write-downs of $ 0.7 million and $ 1.3 million, for its inventories for the three months ended March 31, 2024 and 2023 , respectively. Property and Equipment, Net (in thousands) March 31, December 31, 2024 2023 Laboratory and manufacturing equipment $ 15,979 $ 15,414 Computer equipment and software 16,302 15,451 Internally developed software 9,082 8,831 Furniture and fixtures 4,745 4,745 Leasehold improvements 10,924 10,924 Construction in process 5,391 4,865 Total 62,423 60,230 Less: Accumulated depreciation and amortization ( 37,715 ) ( 35,662 ) Property and equipment, net $ 24,708 $ 24,568 The Company recognized depreciation and amortization expense on property and equipment as follows (in thousands): Three Months Ended March 31, 2024 2023 Depreciation and amortization expense $ 2,053 $ 1,541 Accrued Liabilities (in thousands) March 31, December 31, 2024 2023 Accrued payroll and related expenses $ 27,705 $ 31,715 Accrued professional fees 953 2,909 Accrued taxes 2,081 1,482 Accrued clinical and research expenses 685 752 Accrued interest 1,363 1,123 Accrued warranty 2,003 1,531 Accrued other 4,696 5,785 Total accrued liabilities $ 39,486 $ 45,297

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	6. Commitments and Contingencies Operating Leases In March 2015 , the Company entered into a lease agreement for approximately 50,000 square feet of office space located in Redwood City, California for a period beginning on June 30, 2015 and ending in May 2022 , with initial annual payments of approximately $ 2.0 million, increasing to $ 2.4 million annually during the final year of the lease term. In December 2016, the Company entered into a first amendment to the lease for an additional approximately 50,000 square feet of office space adjacent to the premises under the original lease (the Expansion Premises), with initial annual payments of $ 1.2 million, increasing to $ 2.9 million in the final year of the amended lease term. The lease for the Expansion Premises commenced on June 1, 2018 , and it will expire on May 31, 2025 . The first amendment also extends the lease term for the original premises to terminate on the same date as the Expansion Premises. In April 2024, the Company entered into an amendment which reduced the total office space to approximately 78,000 square feet, beginning on June 1, 2024 and ending on December 31, 2031 , with initial annual payments of approximately $ 3.0 million, increasing to approximately $ 5.7 million during the final year of the lease term. The Company entered into a separate non-cancellable facility lease for warehouse space beginning on March 1, 2017 through February 28, 2022 , under which it is obligated to pay approximately $ 0.4 million in lease payments over the term of the lease. In October 2021, the Company entered into a first amendment of the warehouse lease, which extends the lease term to terminate on May 31, 2025 and under which the Company is obligated to pay approximately $ 0.4 million over the term of the extension period. In August 2020 , the Company entered into a lease for approximately 35,411 square feet of space for a manufacturing facility in Costa Rica to begin in April 2021 and to last through June 2031 , under which it is obligated to pay approximately $ 3.9 million in lease payments over the term of the lease. On the commencement date in April 2021, the Company classified and measured the lease, resulting in the recording of operating assets of $ 2.9 million and operating lease liabilities of $ 2.9 million. See Note 3 for further discussion on Lease Accounting. Warranty Obligations The Company provides a limited one- to five-year warranty and warrants that its products will operate substantially in conformity with product specifications. The Company records an estimate for the provision for warranty claims in cost of revenue when the related revenues are recognized. This estimate is based on historical and anticipated rates of warranty claims, the cost per claim and the number of units sold. The Company regularly assesses the adequacy of its recorded warranty obligations and adjusts the amounts as necessary. Activities related to warranty obligations were as follows (in thousands): Three Months Ended March 31, 2024 2023 Beginning balance $ 1,531 $ 866 Provision for warranty 1,359 1,763 Utilization ( 887 ) ( 1,482 ) Ending balance $ 2,003 $ 1,147 Contingencies From time to time, the Company may have certain contingent liabilities that arise in the ordinary course of business activities related to, for example, employment matters and patent issues. The Company accrues a liability for such matters when it is probable that future expenditures will be made and such expenditures can be reasonably estimated. When determining the estimated loss or range of loss, significant judgment is required. Indemnification The Company enters into standard indemnification arrangements in the ordinary course of business. Pursuant to these arrangements, the Company indemnifies, holds harmless and agrees to reimburse the indemnified parties for losses suffered or incurred by the indemnified party, in connection with any trade secret, copyright, patent or other intellectual property infringement claim by any third-party with respect to the Company’s technology. The term of these indemnification agreements is generally perpetual. The maximum potential amount of future payments the Company could be required to make under these agreements is not determinable because it involves claims that may be made against the Company in the future, but have not yet been made. The Company has entered into indemnification agreements with its directors and officers that may require the Company to indemnify its directors and officers against liabilities that may arise by reason of their status or service as directors or officers, other than liabilities arising from willful misconduct of the individual. The maximum potential amount of future payments the Company could be required to make under these indemnification agreements is unlimited; however, the Company has director and officer insurance coverage that reduces the Company’s exposure and enables the Company to recover a portion of any future amounts paid. The Company believes the estimated fair value of these indemnification agreements in excess of applicable insurance coverage is minimal. Legal Matters The Company is and may from time to time continue to be involved in various legal proceedings to defend its intellectual property, including several pending European patent oppositions at the European Patent Office (EPO) initiated by the Company’s competitors Medtronic and Boston Scientific. In addition, the Company is and may from time to time also be involved in various legal proceedings, such as employment matters, product liability matters, and professional liability matters, which the Company does not deem to be material to its business and condensed consolidated financial statements at this stage. Flathead Partners Litigation/Arbitration On July 15, 2022, the Company filed a lawsuit in the U.S. District Court for the Northern District of California for breach of contract against Flathead Partners, LLC, the Mayo Foundation for Medical Education and Research, and Mayo Clinic Ventures (herein referred to as “Flathead Partners”). The Company’s suit alleged that Flathead Partners breached the 2006 license agreement between the Company and the Mayo Clinic (referred to in the Company’s 10-K filing as the “Mayo License”), when Flathead Partners unilaterally asserted control of pending U.S. Patent Application 16/286,389 (the “’389 Application”), which is subject to the Mayo License. The suit sought to enjoin the Flathead Partners from taking any action at the U.S. Patent Office with respect to the ‘389 Application, and to thereafter engage in an arbitration as called for in the Mayo License. On July 27, 2022, the Flathead Partners agreed to enter into an arbitration to determine which party shall have control of prosecution of the ‘389 Application, and whether there are ongoing royalty obligations under the Mayo License. Therefore, Nevro dismissed the lawsuit in the Northern District of California. The parties then engaged in an arbitration. An arbitration hearing was held during the week of September 11, 2023, and a ruling was issued on April 8, 2024 requiring that Flathead Partners transfer back to the Company the power to control and direct prosecution of the ‘389 Application and its patent family. The April 8, 2024 ruling also concluded that Nevro did not owe Flathead Partners royalties under the Mayo License. More specifically, the Arbitrator found that Flathead Partners had breached the Mayo License, and that the Company had not breached the Mayo License. The Arbitrator awarded the Company $ 0.2 million in damages, to be paid by Flathead Partners by May 8, 2024; the Company’s attorneys’ fees and costs for the Northern District of California litigation (a final amount to be awarded after accounting submissions in May 2024); and prejudgment interest at a rate of 10 %, with prejudgment interest running from June 1, 2022. Civil Investigative Demand In December 2022, the Company received a civil investigative demand (CID) pursuant to the federal False Claims Act from the United States Attorney’s Office for the Northern District of California seeking information relating to the Company’s spinal cord stimulation system (SCS System). The CID primarily relates to marketing, promotion and billing practices, not the therapeutic or safety attributes of the Company’s SCS System. The Company maintains rigorous policies and procedures designed to promote compliance with the federal False Claims Act and other regulatory requirements, and is cooperating in this matter and providing the requested information.

Debt

Debt	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Debt	7. Debt 2025 Notes and Convertible Note Hedge and Warrant Transactions During the three months ended March 31, 2024, the conditions allowing holders of the 2025 Notes to convert have not been met. Therefore, the 2025 Notes are not convertible during the three months ended June 30, 2024. As of March 31, 2024 , the if-converted value of the 2025 Notes did no t exceed the principal value of those notes. The net carrying amount of the liability component of the 2025 Notes was as follows (in thousands): March 31, December 31, 2024 2023 Principal $ 38,038 $ 38,038 Unamortized issuance cost ( 262 ) ( 326 ) Net carrying amount $ 37,776 $ 37,712 The following table sets forth the interest expense recognized related to the 2025 Notes (in thousands): Three Months Ended March 31, 2024 2023 Contractual interest expense $ 261 $ 1,305 Amortization of debt issuance costs 64 308 Total interest expense $ 325 $ 1,613 Credit Agreement with Braidwell LP The Braidwell Credit Agreement provides for a term loan facility in the amount of $ 200.0 million, which was funded in its entirety in November 2023. Loans borrowed pursuant to the Credit Agreement (the Braidwell Term Loans) bear interest at a rate per annum equal to Term Secured Overnight Financing Rate (as defined in the Credit Agreement and with a floor of 3.50 %) plus 5.25 %. At the option of the Company, a portion of the interest payable on the Braidwell Term Loans equal to (i) (a) on or prior to the first anniversary of the Closing Date (as defined in the Credit Agreement), 5.25 %, (b) following the first anniversary of the Closing Date and on or prior to the third anniversary of the Closing Date, 2.50 % and (c) following the third anniversary of the Closing Date, 1.50 %, may be paid in-kind rather than in cash. The portion of the interest payable that the Company elects to be paid-in-kind results in an increase to the principal of the Braidwell Term Loans, which for the three months ended March 31, 2024 was $ 2.6 million. The Braidwell Term Loans do not amortize, and have a maturity date of November 30, 2029. As of March 31, 2024, the Company was in compliance with covenants under the Braidwell Credit Agreement. The net carrying amount of the liability component of the Braidwell Term Loans was as follows (in thousands): March 31, December 31, 2024 2023 Principal $ 210,448 $ 207,801 Unamortized issuance cost ( 33,461 ) ( 34,042 ) Net carrying amount $ 176,987 $ 173,759 The following table sets forth the interest expense recognized related to the Braidwell Term Loans (in thousands): Three Months Ended March 31, 2024 Contractual interest expense $ 5,341 Amortization of debt issuance costs 845 Total interest expense $ 6,186

Goodwill and Intangible Assets

Goodwill and Intangible Assets	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	8. Goodwill and Intangible Assets Goodwill is recorded when the purchase price of an acquisition exceeds the fair value of the net tangible and identifiable intangible assets acquired. The gross carrying amount of goodwill was $ 38.3 million as of March 31, 2024 and $ 38.2 million as of December 31, 2023. The following table presents details of the Company’s intangible assets (in thousands): March 31, 2024 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Intangible assets with finite lives: Developed technology $ 26,800 $ ( 894 ) $ 25,906 Customer relationships 800 ( 89 ) 711 Total $ 27,600 $ ( 983 ) $ 26,617 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Intangible assets with finite lives: Developed technology $ 26,800 $ ( 223 ) $ 26,577 Customer relationships 800 ( 23 ) 777 Total $ 27,600 $ ( 246 ) $ 27,354 Future amortization expense of these intangibles assets as of March 31, 2024 is as follows (in thousands): Future Amortization Expense 2024, remaining months $ 2,210 2025 2,947 2026 2,924 2027 2,680 2028 2,680 Thereafter 13,176 Total future amortization expense 26,617

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2024
Equity [Abstract]
Stock-Based Compensation	9. Stock-Based Compensation The Company accounts for stock-based compensation arrangements with employees in accordance with Accounting Standards Codification (ASC) 718, Compensation—Stock Compensation. ASC 718 requires the recognition of compensation expense, using a fair value-based method, for costs related to all share-based payments including stock options. The Company estimates forfeitures expected to occur to determine the amount of compensation cost recognized in each period. In addition to restricted stock units, the Company grants performance stock units (PSUs) to certain members of the management team. These PSUs vest over a three-year period, subject to continued service, and are based on (1) the total shareholder return (TSR) of the Company’s common stock price compared to the S&P Healthcare Equipment Select Industry Index (the Index) over a two-year period or (2) specific revenue targets over a two-year performance period. Additionally, in 2022, the Company made PSU grants to its then CEO that included attainment criteria that required the Company's stock price to reach certain pre-specified stock prices. Since TSR and stock price attainment are considered market conditions, the PSUs based on TSR and stock price attainment have fair values that are determined at the grant date using the Monte Carlo simulation model, with the recorded expense based on fair value. Since revenue targets are considered performance conditions, the PSUs based on revenue targets have a fair value that is equal to the closing stock price on the grant date, with the recorded expense based on the fair value and the probability of achievement, which is reassessed at each reporting period. The PSU grant activity is as follows: Three Months Ended Three Months Ended March 31, 2024 March 31, 2023 Shares Weighted Average Fair Value Shares Weighted Average Fair Value Total shareholder return 239,723 $ 21.02 87,531 $ 45.49 Revenue targets 239,734 $ 15.32 87,557 $ 32.31 Total PSUs granted 479,457 $ 18.17 175,088 $ 38.90 A summary of stock-based compensation expense by line items in the consolidated statements of operations is as follows (in thousands): Three Months Ended March 31, 2024 2023 Cost of revenue 559 442 Research and development 2,802 2,644 Sales, general and administrative 9,477 10,474 Total stock-based compensation expense 12,838 13,560 A summary of pre-tax stock-based compensation expense by category was as follows (in thousands): Three Months Ended March 31, 2024 2023 Stock Options — 295 Restricted stock units 10,750 9,555 Performance stock units 1,584 2,832 Employee stock purchase plan 504 878 Total stock-based compensation expense 12,838 13,560

Basic and Diluted Net Income (L

Basic and Diluted Net Income (Loss) Per Share	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Basic and Diluted Net Income (Loss) Per Share	. Basic and Diluted Net Income (Loss) Per Share Basic net loss per share is computed by dividing the net loss by the weighted average number of common shares outstanding for the period. Diluted net income (loss) per share is computed by dividing the net income (loss) by the weighted average number of common shares and dilutive common stock equivalents outstanding for the period, if inclusion of these is dilutive. The Company uses the if-converted method and presumes share settlement for its 2025 Notes when calculating the dilutive effect of these notes. In connection with the offerings of the convertible senior notes, the Company entered into convertible note hedges and warrants. However, the convertible note hedges are not included when calculating potentially dilutive shares since their effect is always anti-dilutive. Warrants were considered anti-dilutive to the extent that their strike price were above the Company's average share price during the period. The following table summarizes the computation of basic and diluted net loss per share (in thousands, except share and per share data): Three Months Ended March 31, 2024 2023 Net loss, basic and diluted $ ( 25,409 ) $ ( 35,029 ) Weighted average shares used to compute 36,467,371 35,584,685 Net loss per share, basic and diluted $ ( 0.70 ) $ ( 0.98 ) The following potentially dilutive securities outstanding at the end of the periods presented have been excluded from the computation of diluted shares outstanding, as the effect would be anti-dilutive: Three Months Ended March 31, 2024 2023 Unreleased restricted stock and performance stock units 4,861,788 2,403,168 Options to purchase common stock 386,382 606,785 Convertible senior notes 362,267 1,807,141 Warrants related to the issuance of convertible senior notes 1,807,141 1,807,141 Warrants related to term debt 2,587,742 — Total 10,005,320 6,624,235

Employee Benefit Plans

Employee Benefit Plans	3 Months Ended
	Mar. 31, 2024
Postemployment Benefits [Abstract]
Employee Benefit Plans	11. Employee Benefit Plans 401(k) Plan In 2007, the Company adopted a 401(k) plan for its employees whereby eligible employees may contribute up to the maximum amount permitted by the Internal Revenue Code. In June 2016, the Company adopted a policy to match a portion of employee contributions for all qualified employees participating in the 401(k) plan. The Company recorded an expense for matching contributions of $ 2.4 million for each of the three months ended March 31, 2024 and 2023 .

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2024
Subsequent Events [Abstract]
Subsequent Event	12. Subsequent Event On May 5, 2024, the Company approved additional restructuring steps to further accelerate its path to profitability (the “ Restructuring ” ). Operating expenses in the second quarter of 2024 will reflect a $ 4 million to $ 5 million restructuring charge, consisting of one-time severance and other termination benefit costs. The Company expects that the Restructuring, including related cash payments, will be substantially complete by the end of the second quarter of 2024. The timing and cost estimates related to the Restructuring are subject to a number of assumptions and actual results may differ materially from those expected and disclosed above.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying interim condensed consolidated financial statements as of March 31, 2024 and for the three months ended March 31, 2024 and 2023, and the related interim information contained within the notes to the financial statements, are unaudited. The unaudited interim condensed consolidated financial statements (the condensed consolidated financial statements) have been prepared in accordance with generally accepted accounting principles in the United States (U.S. GAAP) for interim financial information and on the same basis as the audited financial statements included on the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 (the Annual Report) filed with the Securities and Exchange Commission (SEC) on February 23, 2024. The condensed consolidated financial statements are prepared in U.S. dollars and include the Company’s accounts and those of its wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated. In the opinion of management, the accompanying unaudited interim condensed consolidated financial statements contain all adjustments (consisting of normal recurring adjustments) necessary to state fairly the Company’s financial position as of March 31, 2024, the results of its operations for the three months ended March 31, 2024 and 2023 and the consolidated statements of cash flows for the three months ended March 31, 2024 and 2023. All such adjustments are of a normal and recurring nature. The interim financial data as of March 31, 2024 is not necessarily indicative of the results to be expected for the year ending December 31, 2024, or for any future period. The consolidated balance sheet as of December 31, 2023 was derived from the audited financials as of that date. The accompanying condensed consolidated financial statements and related financial information should be read in conjunction with the audited consolidated financial statements and the related notes thereto for the year ended December 31, 2023 included in the Annual Report.
Use of Estimates	Use of Estimates The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Estimates are based on historical experience, where applicable, and other assumptions believed to be reasonable by management. Actual results may differ from those estimates under different assumptions or conditions.
Foreign Currency Translation	Foreign Currency Translation Unrealized foreign exchange gains and losses from the remeasurement of assets and liabilities denominated in currencies other than the functional currency of the reporting entity are recorded in other income (expense), net. Additionally, realized gains and losses resulting from transactions denominated in currencies other than the local currency are recorded in other income (expense), net in the condensed consolidated statements of operations and comprehensive loss. The Company recorded net unrealized and net realized foreign currency transaction gains (losses) during the periods presented as follows (in thousands): Three Months Ended March 31, 2024 2023 Net unrealized foreign currency gain (loss) $ 352 $ 133 Net realized foreign currency gain (loss) ( 322 ) ( 128 )
Significant Accounting Policies	Significant Accounting Policies There have been no material changes to the Company’s significant accounting policies from its Annual Report.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly-liquid investments purchased with an original maturity of three months or less at the date of purchase to be cash equivalents. Cash and cash equivalents include money market funds in the amount of $ 71.1 million and $ 82.9 million as of March 31, 2024 and December 31, 2023, respectively. As of March 31, 2024 and December 31, 2023, the Company’s cash equivalents were held at institutions in the United States and include deposits in a money market fund which was unrestricted as to withdrawal or use. The Company also held cash in foreign banks of approximately $ 8.5 million at March 31, 2024 and $ 9.4 million at December 31, 2023 that was not insured. The Company has not experienced any losses on its deposits of cash and cash equivalents.
Inventories	Inventories Inventories are stated at the lower of cost or net realizable value. Cost is determined using the standard cost method which approximates the first-in, first-out basis. Net realizable value is determined as the prices in the ordinary course of business, less reasonably predictable costs of completion, disposal and transportation. The Company regularly reviews inventory quantities compared to forecasted sales to record a provision for excess and obsolete inventory when appropriate. Inventory write-downs are recorded for excess and obsolete inventory. The Company estimates forecasted sales by considering product acceptance in the marketplace, customer demand, historical sales, product obsolescence and technological innovations. The Company periodically evaluates the carrying value of inventory on hand for potential excess amount over demand using the same lower of cost or net realizable value approach as that has been used to value the inventory. The Company also periodically evaluates inventory quantities in consideration of actual loss experience. As a result of these evaluations, the Company recognized total write-downs of $ 0.7 million and $ 1.3 million, for its inventories for the three months ended March 31, 2024 and 2023 , respectively.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Net Unrealized and Net Realized Foreign Currency Transaction Gains (Losses)	The Company recorded net unrealized and net realized foreign currency transaction gains (losses) during the periods presented as follows (in thousands): Three Months Ended March 31, 2024 2023 Net unrealized foreign currency gain (loss) $ 352 $ 133 Net realized foreign currency gain (loss) ( 322 ) ( 128 )

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Summary of Revenue by Geography on Billing Address of Customer	The following table presents revenue by geography, based on the billing address of the customer (in thousands): Three Months Ended March 31, 2024 2023 United States $ 87,038 $ 82,321 International 14,861 14,006 Total revenue $ 101,899 $ 96,327
Schedule of Revenue by Major Customers by Geographic Area	The United States is the only country that accounts for 10% or more of the revenue during the periods presented: Three Months Ended March 31, 2024 2023 United States 85 % 85 %

Lease Accounting (Tables)

Lease Accounting (Tables)	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Schedule of Weighted Average Lease Terms and Discounts Rates	The weighted average lease terms and discounts rates are as follows: March 31, 2024 December 31, 2023 Operating Lease Term and Discount Rate Weighted-average remaining lease term 2.71 years 2.86 years Weighted-average discount rate 7.0 % 7.0 %
Schedule of Maturity of Lease Liabilities	As of March 31, 2024, the maturity of lease liabilities are as follows (in thousands): Operating Leases 2024, remaining months $ 4,678 2025 2,849 2026 405 2027 417 2028 430 Thereafter 1,130 Total lease payments 9,909 Less: Interest ( 913 ) Present value of lease liabilities $ 8,996
Supplemental Lease Cost Information	Supplemental lease cost information are as follows (in thousands): Three Months Ended March 31, 2024 2023 Operating lease cost $ 1,342 $ 1,342
Schedule Of Operating Lease Assets and Liabilities	Supplemental balance sheet information are as follows (in thousands): March 31, 2024 December 31, 2023 Operating Leases: Operating lease assets $ 7,764 $ 8,944 Other current liabilities $ 5,860 $ 5,722 Long term operating lease liabilities 3,136 4,634 Total operating lease liabilities $ 8,996 $ 10,356
Schedule of Supplemental Cash Flow Information Related to Lease	Supplemental cash flow information are as follows (in thousands): Three Months Ended March 31, 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flow from operating leases $ 1,523 $ 1,478

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2024
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Financial Instruments Measured at Fair Value on Recurring Basis	The following table sets forth the Company’s financial instruments that were measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands): Balance as of March 31, 2024 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 71,119 $ — $ — $ 71,119 Agency bonds (ii) — 25,972 — 25,972 Commercial paper (ii) — 7,497 — 7,497 Treasury bonds (ii) 157,712 — — 157,712 Total assets $ 228,831 $ 33,469 $ — $ 262,300 Balance as of December 31, 2023 Level 1 Level 2 Level 3 Total Assets: Money market funds (i) $ 82,886 $ — $ — $ 82,886 Agency bonds (ii) — 99,054 — 99,054 Commercial paper (ii) — 22,374 — 22,374 Corporate notes (ii) — 3,490 — 3,490 Treasury bonds (ii) 93,588 — — 93,588 Total assets $ 176,474 $ 124,918 $ — $ 301,392 (i) Included in cash and cash equivalents on the condensed consolidated balance sheets. (ii) Included in short-term investments on the condensed consolidated balance sheets.
Summary of Assumptions and Significant Unobservable Inputs	Significant unobservable inputs for the contingent consideration are as follows: Contingent Liability Fair Value at Valuation Technique Unobservable Input Range Product Development $ 1,641 Probability-Weighted Probability of Payment 75 % Milestone Average Discount Risk-Free Rate 4.9 % — 5.2 % Cash Flow Credit Spread 6.3 % Projected Year of Payment 2025 Revenue Milestone $ 13,923 Monte Carlo Simulation Discount Rate 10.7 % — 11.3 % Revenue Volatility 17.0 % Projected Year of Payment 2026 — 2027 Contingent Liability Fair Value at December 31, 2023 Valuation Technique Unobservable Input Range Regulatory Approval $ 4,964 Probability-Weighted Probability of Payment 80 % Milestone Average Discount Risk-Free Rate 5.2 % — 5.3 % Cash Flow Credit Spread 4.3 % Projected Year of Payment 2024 Product Development $ 1,677 Probability-Weighted Probability of Payment 50 % Milestone Average Discount Risk-Free Rate 4.9 % — 5.1 % Cash Flow Credit Spread 4.3 % Projected Year of Payment 2024 — 2025 Revenue Milestone $ 15,452 Monte Carlo Simulation Discount Rate 8.7 % — 9.3 % Revenue Volatility 17.0 % Projected Year of Payment 2025 — 2027
Schedule of Changes in Fair Value of Contingent Consideration Liability	Changes in the fair value of the contingent consideration liability for the three months ended March 31, 2024 were as follows (in thousands): Balance as of December 31, 2023 $ 22,093 Change in fair value of contingent consideration $ 3,471 Contingent consideration payments $ ( 9,780 ) Balance as of March 31, 2024 $ 15,784
Warrant [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Summary of Assumptions and Significant Unobservable Inputs	Assumptions for the warrant liability are as follows: March 31, 2024 December 31, 2023 Expected term (in years) 5.7 6.0 Expected volatility 53 % 53 % Risk-free interest rate 3.94 % 3.50 % Dividend yield 0 % 0 %

Balance Sheet Components (Table

Balance Sheet Components (Tables)	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Summary of Gross Unrealized Gains and Unrealized Losses of Investment Securities Excluding Investments in Money Market Funds	The following is a summary of the gross unrealized gains and unrealized losses on the Company’s investment securities, excluding investments in money market funds (in thousands): March 31, 2024 Amortized Gross Gross Aggregate Investment Securities Agency bonds $ 25,969 $ 14 $ ( 11 ) $ 25,972 Commercial paper 7,497 — — 7,497 Treasury bonds 157,984 47 ( 319 ) 157,712 Total securities $ 191,450 $ 61 $ ( 330 ) $ 191,181 December 31, 2023 Amortized Gross Gross Aggregate Investment Securities Agency bonds $ 99,076 $ 68 $ ( 90 ) $ 99,054 Commercial paper 22,369 5 — 22,374 Corporate notes 3,491 — ( 1 ) 3,490 Treasury bonds 93,312 317 ( 41 ) 93,588 Total securities $ 218,248 $ 390 $ ( 132 ) $ 218,506
Summary of Contractual Maturities of Investment Securities	The contractual maturities of the Company’s investment securities as of March 31, 2024 were as follows (in thousands): Amortized Cost Fair Value Amounts maturing within one year $ 117,853 $ 117,851 Amounts maturing after one year through five years 73,597 73,330 Total investment securities $ 191,450 $ 191,181
Components of Inventories	Inventories (in thousands) March 31, December 31, 2024 2023 Raw materials $ 52,994 $ 64,974 Work in process 7,205 2,149 Finished goods 60,590 51,553 Total inventories $ 120,789 $ 118,676
Schedule of Property and Equipment, Net and Depreciation and Amortization Expense	Property and Equipment, Net (in thousands) March 31, December 31, 2024 2023 Laboratory and manufacturing equipment $ 15,979 $ 15,414 Computer equipment and software 16,302 15,451 Internally developed software 9,082 8,831 Furniture and fixtures 4,745 4,745 Leasehold improvements 10,924 10,924 Construction in process 5,391 4,865 Total 62,423 60,230 Less: Accumulated depreciation and amortization ( 37,715 ) ( 35,662 ) Property and equipment, net $ 24,708 $ 24,568 The Company recognized depreciation and amortization expense on property and equipment as follows (in thousands): Three Months Ended March 31, 2024 2023 Depreciation and amortization expense $ 2,053 $ 1,541
Summary of Accrued Liabilities	Accrued Liabilities (in thousands) March 31, December 31, 2024 2023 Accrued payroll and related expenses $ 27,705 $ 31,715 Accrued professional fees 953 2,909 Accrued taxes 2,081 1,482 Accrued clinical and research expenses 685 752 Accrued interest 1,363 1,123 Accrued warranty 2,003 1,531 Accrued other 4,696 5,785 Total accrued liabilities $ 39,486 $ 45,297

Commitments and Contingencies (

Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Schedule of Activities Related to Warranty Obligations	Activities related to warranty obligations were as follows (in thousands): Three Months Ended March 31, 2024 2023 Beginning balance $ 1,531 $ 866 Provision for warranty 1,359 1,763 Utilization ( 887 ) ( 1,482 ) Ending balance $ 2,003 $ 1,147

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Liability Component Braidwell Term Loans [Member]
Debt Instrument [Line Items]
Net Carrying Amount of Convertible Debt	The net carrying amount of the liability component of the Braidwell Term Loans was as follows (in thousands): March 31, December 31, 2024 2023 Principal $ 210,448 $ 207,801 Unamortized issuance cost ( 33,461 ) ( 34,042 ) Net carrying amount $ 176,987 $ 173,759
Braidwell Term Loans [Member]
Debt Instrument [Line Items]
Interest Expense Recognized Related to Convertible Notes	The following table sets forth the interest expense recognized related to the Braidwell Term Loans (in thousands): Three Months Ended March 31, 2024 Contractual interest expense $ 5,341 Amortization of debt issuance costs 845 Total interest expense $ 6,186
2025 Notes and Convertible Notes [Member]
Debt Instrument [Line Items]
Interest Expense Recognized Related to Convertible Notes	The following table sets forth the interest expense recognized related to the 2025 Notes (in thousands): Three Months Ended March 31, 2024 2023 Contractual interest expense $ 261 $ 1,305 Amortization of debt issuance costs 64 308 Total interest expense $ 325 $ 1,613
2025 Notes and Convertible Notes [Member] | Debt, Liability Component [Member]
Debt Instrument [Line Items]
Net Carrying Amount of Convertible Debt	The net carrying amount of the liability component of the 2025 Notes was as follows (in thousands): March 31, December 31, 2024 2023 Principal $ 38,038 $ 38,038 Unamortized issuance cost ( 262 ) ( 326 ) Net carrying amount $ 37,776 $ 37,712

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Intangible Assets	The following table presents details of the Company’s intangible assets (in thousands): March 31, 2024 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Intangible assets with finite lives: Developed technology $ 26,800 $ ( 894 ) $ 25,906 Customer relationships 800 ( 89 ) 711 Total $ 27,600 $ ( 983 ) $ 26,617 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Intangible assets with finite lives: Developed technology $ 26,800 $ ( 223 ) $ 26,577 Customer relationships 800 ( 23 ) 777 Total $ 27,600 $ ( 246 ) $ 27,354
Summary of Future Amortization Expense of Intangible Assets	Future amortization expense of these intangibles assets as of March 31, 2024 is as follows (in thousands): Future Amortization Expense 2024, remaining months $ 2,210 2025 2,947 2026 2,924 2027 2,680 2028 2,680 Thereafter 13,176 Total future amortization expense 26,617

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Summary of Stock-Based Compensation Expense by Line Items in Consolidated Statements of Operations	A summary of stock-based compensation expense by line items in the consolidated statements of operations is as follows (in thousands): Three Months Ended March 31, 2024 2023 Cost of revenue 559 442 Research and development 2,802 2,644 Sales, general and administrative 9,477 10,474 Total stock-based compensation expense 12,838 13,560
Summary of Stock-Based Compensation Expense	A summary of pre-tax stock-based compensation expense by category was as follows (in thousands): Three Months Ended March 31, 2024 2023 Stock Options — 295 Restricted stock units 10,750 9,555 Performance stock units 1,584 2,832 Employee stock purchase plan 504 878 Total stock-based compensation expense 12,838 13,560
Performance Stock Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Schedule of PSU Grant Activity	The PSU grant activity is as follows: Three Months Ended Three Months Ended March 31, 2024 March 31, 2023 Shares Weighted Average Fair Value Shares Weighted Average Fair Value Total shareholder return 239,723 $ 21.02 87,531 $ 45.49 Revenue targets 239,734 $ 15.32 87,557 $ 32.31 Total PSUs granted 479,457 $ 18.17 175,088 $ 38.90

Basic and Diluted Net Income _2

Basic and Diluted Net Income (Loss) Per Share (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Computation of Basic and Diluted Net Loss per Share	The following table summarizes the computation of basic and diluted net loss per share (in thousands, except share and per share data): Three Months Ended March 31, 2024 2023 Net loss, basic and diluted $ ( 25,409 ) $ ( 35,029 ) Weighted average shares used to compute 36,467,371 35,584,685 Net loss per share, basic and diluted $ ( 0.70 ) $ ( 0.98 )
Computation of Potentially Dilutive Securities Outstanding Excluded from Computation of Diluted Shares	The following potentially dilutive securities outstanding at the end of the periods presented have been excluded from the computation of diluted shares outstanding, as the effect would be anti-dilutive: Three Months Ended March 31, 2024 2023 Unreleased restricted stock and performance stock units 4,861,788 2,403,168 Options to purchase common stock 386,382 606,785 Convertible senior notes 362,267 1,807,141 Warrants related to the issuance of convertible senior notes 1,807,141 1,807,141 Warrants related to term debt 2,587,742 — Total 10,005,320 6,624,235

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Net Unrealized and Net Realized Foreign Currency Transaction Gains (Losses) (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Accounting Policies [Abstract]
Net unrealized foreign currency gain (loss)	$ 352	$ 133
Net realized foreign currency gain (loss)	$ (322)	$ (128)

Revenue - Summary of Revenue by

Revenue - Summary of Revenue by Geography on Billing Address of Customer (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Disaggregation Of Revenue [Line Items]
Total revenue	$ 101,899	$ 96,327
United States [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	87,038	82,321
International [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	$ 14,861	$ 14,006

Revenue - Schedule of Revenue b

Revenue - Schedule of Revenue by Major Customers by Geographic Area (Detail)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenue [Member] | Geographic Concentration Risk [Member] | United States [Member]
Concentration Risk [Line Items]
Revenue	85%	85%

Revenue - Additional Informatio

Revenue - Additional Information (Detail) $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2024 USD ($) Customer	Mar. 31, 2023 USD ($) Customer	Dec. 31, 2023 Customer
Disaggregation Of Revenue [Line Items]
Bad debt expenses | $	$ 0.3	$ 0.1
Major Customers [Member] | Customer Concentration Risk [Member] | Revenue [Member]
Disaggregation Of Revenue [Line Items]
Concentration risk, percentage	10%	10%
Number of customers accounted 10% or more concentration risk	0	0
Major Customers [Member] | Credit Concentration Risk [Member] | Accounts Receivable [Member]
Disaggregation Of Revenue [Line Items]
Concentration risk, percentage	10%		10%
Number of customers accounted 10% or more concentration risk	0		0

Lease Accounting - Schedule of

Lease Accounting - Schedule of Weighted Average Lease Terms and Discounts Rates (Detail)	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Weighted-average remaining lease term	2 years 8 months 15 days	2 years 10 months 9 days
Weighted-average discount rate	7%	7%

Lease Accounting - Schedule o_2

Lease Accounting - Schedule of Maturity of Lease Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
2024, remaining months	$ 4,678
2025	2,849
2026	405
2027	417
2028	430
Thereafter	1,130
Total lease payments	9,909
Less: Interest	(913)
Present value of lease liabilities	$ 8,996	$ 10,356

Lease Accounting - Supplemental

Lease Accounting - Supplemental Lease Cost Information (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Operating lease cost	$ 1,342	$ 1,342

Lease Accounting - Summary of O

Lease Accounting - Summary of Operating Lease Assets and Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Operating Leases:
Operating lease assets	$ 7,764	$ 8,944
Other current liabilities	$ 5,860	$ 5,722
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other current liabilities	Other current liabilities
Long term operating lease liabilities	$ 3,136	$ 4,634
Total operating lease liabilities	$ 8,996	$ 10,356

Lease Accounting - Schedule o_3

Lease Accounting - Schedule of Supplemental Cash Flow Information Related to Lease (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flow from operating leases	$ 1,523	$ 1,478

Fair Value Measurements - Finan

Fair Value Measurements - Financial Instruments Measured at Fair Value on Recurring Basis (Detail) - Fair Value Measurements Recurring [Member] - USD ($) $ in Thousands		Mar. 31, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets		$ 262,300	$ 301,392
Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets		228,831	176,474
Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets		33,469	124,918
Money Market Funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[1]	71,119	82,886
Money Market Funds [Member] | Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[1]	71,119	82,886
Agency Bonds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]	25,972	99,054
Agency Bonds [Member] | Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]	25,972	99,054
Commercial Paper [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]	7,497	22,374
Commercial Paper [Member] | Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]	7,497	22,374
Corporate Notes [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]		3,490
Corporate Notes [Member] | Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]		3,490
Treasury Bonds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]	157,712	93,588
Treasury Bonds [Member] | Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	[2]	$ 157,712	$ 93,588
[1] Included in cash and cash equivalents on the condensed consolidated balance sheets. Included in short-term investments on the condensed consolidated balance sheets.

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023	Nov. 30, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	$ 15,784	$ 22,093
Contingent consideration payments	$ 9,780
2.75% Convertible Senior Notes due 2025 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt instrument, interest rate	2.75%	2.75%
Debt instrument due year	2025	2025
Fair value of notes	$ 35,800	$ 35,600
Warrant [Member] | Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of warrants	15,200	28,700
Revenue Milestone [Member] | Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	13,923	15,452
Regulatory Approval [Member] | Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration		5,000
Contingent consideration payments	9,800
Accrued additional liability for contingent consideration	5,000
Remaining current portion of contingent liabilities	200
Reduced valuation of remaining milestones amount	1,500
Product Development [Member] | Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of contingent consideration	$ 1,600	$ 1,700
Common Stock [Member] | Credit Agreement with Braidwell LP [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Number of warrants issued to purchase of shares			2,580,000

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Assumptions for Warrant Liability (Details)	Mar. 31, 2024	Dec. 31, 2023
Expected Term [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrant liability expected term (in years)	5 years 8 months 12 days	6 years
Expected Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrant liability measurement input	53	53
Risk-free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrant liability measurement input	3.94	3.5
Dividend Yield [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrant liability measurement input	0	0

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Changes in Fair Value of Contingent Consideration Liability (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2024 USD ($)
Fair Value Disclosures [Abstract]
Balance as of December 31, 2023	$ 22,093
Change in fair value of contingent consideration	3,471
Contingent consideration payments	(9,780)
Balance as of March 31, 2024	$ 15,784

Fair Value Measurements - Sch_2

Fair Value Measurements - Schedule of Significant Unobservable Inputs for Contingent Consideration (Details) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value of contingent consideration	$ 15,784	$ 22,093
Revenue Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value of contingent consideration	13,923	15,452
Regulatory Approval Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value of contingent consideration		4,964
Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value of contingent consideration	$ 1,641	$ 1,677
Probability of Payment [Member] | Regulatory Approval Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs		0.80
Probability of Payment [Member] | Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs	0.75	0.50
Credit Spread [Member] | Regulatory Approval Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs		0.043
Credit Spread [Member] | Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs	0.063	0.043
Projected Year of Payment [Member] | Regulatory Approval Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration year		2024
Projected Year of Payment [Member] | Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration year	2025
Revenue Volatility [Member] | Revenue Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs	0.17	0.17
Maximum [Member] | Risk-free Interest Rate [Member] | Regulatory Approval Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs		0.053
Maximum [Member] | Risk-free Interest Rate [Member] | Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs	0.052	0.051
Maximum [Member] | Projected Year of Payment [Member] | Revenue Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration year	2027	2027
Maximum [Member] | Projected Year of Payment [Member] | Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration year		2025
Maximum [Member] | Discount Rate [Member] | Revenue Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs	0.113	0.093
Minimum [Member] | Risk-free Interest Rate [Member] | Regulatory Approval Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs		0.052
Minimum [Member] | Risk-free Interest Rate [Member] | Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs	0.049	0.049
Minimum [Member] | Projected Year of Payment [Member] | Revenue Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration year	2026	2025
Minimum [Member] | Projected Year of Payment [Member] | Product Development Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration year		2024
Minimum [Member] | Discount Rate [Member] | Revenue Milestone [Member] | Level 3 [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair value contingent consideration inputs	0.107	0.087

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Cash and Cash Equivalents [Abstract]
Money market funds	$ 71.1		$ 82.9
Cash held in foreign banks	8.5		$ 9.4
Inventory Disclosure [Abstract]
Write down of inventory	$ 0.7	$ 1.3

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Gross Unrealized Gains and Unrealized Losses of Investment Securities Excluding Investments in Money Market Funds (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	$ 191,450	$ 218,248
Gross Unrealized Holding Gains	61	390
Gross Unrealized Holding Losses	(330)	(132)
Aggregate Fair Value	191,181	218,506
Agency Bonds [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	25,969	99,076
Gross Unrealized Holding Gains	14	68
Gross Unrealized Holding Losses	(11)	(90)
Aggregate Fair Value	25,972	99,054
Commercial Paper [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	7,497	22,369
Gross Unrealized Holding Gains		5
Aggregate Fair Value	7,497	22,374
Corporate Notes [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost		3,491
Gross Unrealized Holding Losses		(1)
Aggregate Fair Value		3,490
Treasury Bonds [Member]
Schedule of Available-for-sale Securities [Line Items]
Amortized Cost	157,984	93,312
Gross Unrealized Holding Gains	47	317
Gross Unrealized Holding Losses	(319)	(41)
Aggregate Fair Value	$ 157,712	$ 93,588

Balance Sheet Components - Su_2

Balance Sheet Components - Summary of Contractual Maturities of Investment Securities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Investments, Debt and Equity Securities [Abstract]
Amortized Cost, Amounts maturing within one year	$ 117,853
Amortized Cost, Amounts maturing after one year through five years	73,597
Amortized Cost	191,450	$ 218,248
Fair Value, Amounts maturing within one year	117,851
Fair Value, Amounts maturing after one year through five years	73,330
Fair Value, Total investment securities	$ 191,181	$ 218,506

Balance Sheet Components - Comp

Balance Sheet Components - Components of Inventories (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Raw materials	$ 52,994	$ 64,974
Work in process	7,205	2,149
Finished goods	60,590	51,553
Total inventories	$ 120,789	$ 118,676

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 62,423	$ 60,230
Less: Accumulated depreciation and amortization	(37,715)	(35,662)
Property and equipment, net	24,708	24,568
Laboratory and Manufacturing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	15,979	15,414
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	16,302	15,451
Internally Developed Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	9,082	8,831
Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	4,745	4,745
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	10,924	10,924
Construction in Process [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 5,391	$ 4,865

Balance Sheet Components - Sc_2

Balance Sheet Components - Schedule of Property and Equipment, Depreciation and Amortization Expense (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Property, Plant and Equipment [Abstract]
Depreciation and amortization expense	$ 2,053	$ 1,541

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Accrued payroll and related expenses	$ 27,705	$ 31,715
Accrued professional fees	953	2,909
Accrued taxes	2,081	1,482
Accrued clinical and research expenses	685	752
Accrued interest	1,363	1,123
Accrued warranty	2,003	1,531	$ 1,147	$ 866
Accrued other	4,696	5,785
Total accrued liabilities	$ 39,486	$ 45,297

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) $ in Millions		1 Months Ended					3 Months Ended
	May 08, 2024 USD ($)	Apr. 30, 2024 USD ($) ft²	Oct. 31, 2021 USD ($)	Aug. 31, 2020 USD ($) ft²	Dec. 31, 2016 USD ($) ft²	Mar. 31, 2015 USD ($) ft²	Mar. 31, 2024 USD ($)	Jun. 01, 2022	Apr. 30, 2021 USD ($)
Other Commitments [Line Items]
Additional operating lease assets									$ 2.9
Additional operating lease liabilities									$ 2.9
Standard product warranty, description							limited one- to five-year warranty
Prejudgment interest rate								10%
Costa Rica [Member]
Other Commitments [Line Items]
Lease agreement, commencement period				2020-08
Area of office space | ft²				35,411
Lease agreement, effective month and year				2021-04
Lease agreement, expiration period				2031-06
Lease agreement, lease expense				$ 3.9
Subsequent Event [Member]
Other Commitments [Line Items]
Arbitrator awarded damages	$ 0.2
Redwood Office Agreement [Member]
Other Commitments [Line Items]
Lease agreement, commencement period							2015-03
Area of office space | ft²						50,000
Lease agreement, effective date						Jun. 30, 2015
Lease agreement, expiration period						2022-05
Lease expense, payment due						$ 2
Annual lease expense payable in final year of lease term						$ 2.4
Redwood Office Agreement [Member] | Subsequent Event [Member] | Amendment 1 [Member]
Other Commitments [Line Items]
Lease agreement, effective date		Jun. 01, 2024
Leases Agreement, Expiration Date		Dec. 31, 2031
Lease expense, payment due		$ 3
Annual lease expense payable in final year of lease term		$ 5.7
Redwood Office Agreement Additional Expansion Premises [Member] | Amendment 1 [Member]
Other Commitments [Line Items]
Area of office space | ft²					50,000
Lease expense, payment due					$ 1.2
Annual lease expense payable in final year of lease term					$ 2.9
Commencement date description							The lease for the Expansion Premises commenced on June 1, 2018
Lease commencement date					Jun. 01, 2018
Lease agreement, expiration date					May 31, 2025
Redwood Office Agreement Additional Expansion Premises [Member] | Subsequent Event [Member] | Amendment 1 [Member]
Other Commitments [Line Items]
Area of office space | ft²		78,000
Non-cancellable Facility Lease [Member]
Other Commitments [Line Items]
Lease agreement, effective date							Mar. 01, 2017
Lease agreement, expiration date							Feb. 28, 2022
Lease agreement, lease expense							$ 0.4
Non-cancellable Facility Lease [Member] | Amendment 1 [Member]
Other Commitments [Line Items]
Lease agreement, expiration date			May 31, 2025
Lease agreement, lease expense			$ 0.4

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Activities Related to Warranty Obligations (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Beginning balance	$ 1,531	$ 866
Provision for warranty	1,359	1,763
Utilization	(887)	(1,482)
Ending balance	$ 2,003	$ 1,147

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended
	Nov. 30, 2023	Mar. 31, 2024
Braidwell Term Loans [Member]
Debt Instrument [Line Items]
Increase in principal		$ 2,600,000
Credit Agreement with Braidwell LP [Member] | Line of Credit [Member]
Debt Instrument [Line Items]
Principal amount	$ 200,000,000
Credit Agreement with Braidwell LP [Member] | Braidwell Term Loans [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	5.25%
Credit Agreement with Braidwell LP [Member] | Braidwell Term Loans [Member] | Base Rate [Member]
Debt Instrument [Line Items]
Debt instrument reference rate floor	3.50%
Credit Agreement with Braidwell LP [Member] | Braidwell Term Loans, On or prior to the first anniversary of the Closing Date [Member]
Debt Instrument [Line Items]
Debt instrument, interest payable percentage	5.25%
Credit Agreement with Braidwell LP [Member] | Braidwell Term Loans, First anniversary of the Closing Date and on or prior to the third anniversary of the Closing Date [Member]
Debt Instrument [Line Items]
Debt instrument, interest payable percentage	2.50%
Credit Agreement with Braidwell LP [Member] | Braidwell Term Loans, Third anniversary of the Closing Date [Member] | Paid in-kind [Member]
Debt Instrument [Line Items]
Debt instrument, interest payable percentage	1.50%
2025 Notes and Convertible Notes [Member]
Debt Instrument [Line Items]
Converted value in excess of principal		$ 0

Debt - Net Carrying Amount of L

Debt - Net Carrying Amount of Liability Component of Convertible Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Debt Liability Component Braidwell Term Loans [Member]
Debt Instrument [Line Items]
Principal	$ 210,448	$ 207,801
Unamortized issuance cost	(33,461)	(34,042)
Net carrying amount	176,987	173,759
2025 Notes [Member]
Debt Instrument [Line Items]
Principal	38,038	38,038
Unamortized issuance cost	(262)	(326)
Net carrying amount	$ 37,776	$ 37,712

Debt - Interest Expense Recogni

Debt - Interest Expense Recognized Related to Convertible Notes (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Debt Instrument [Line Items]
Amortization of debt issuance costs	$ 910	$ 308
Braidwell Term Loans [Member]
Debt Instrument [Line Items]
Contractual interest expense	5,341
Amortization of debt issuance costs	845
Total interest expense	6,186
2025 Notes [Member]
Debt Instrument [Line Items]
Contractual interest expense	261	1,305
Amortization of debt issuance costs	64	308
Total interest expense	$ 325	$ 1,613

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	$ 38.3	$ 38.2

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Summary of Intangible Assets (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 27,600	$ 27,600
Accumulated Amortization	(983)	(246)
Net Carrying Amount	26,617	27,354
Developed Technology [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	26,800	26,800
Accumulated Amortization	(894)	(223)
Net Carrying Amount	25,906	26,577
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	800	800
Accumulated Amortization	(89)	(23)
Net Carrying Amount	$ 711	$ 777

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Summary of Future Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
2024, remaining months	$ 2,210
2025	2,947
2026	2,924
2027	2,680
2028	2,680
Thereafter	13,176
Net Carrying Amount	$ 26,617	$ 27,354

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of PSU Grant Activity (Detail) - Performance Stock Units [Member] - $ / shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares	479,457	175,088
Weighted Average Fair Value	$ 18.17	$ 38.9
Total Shareholder Return [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares	239,723	87,531
Weighted Average Fair Value	$ 21.02	$ 45.49
Revenue Targets [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares	239,734	87,557
Weighted Average Fair Value	$ 15.32	$ 32.31

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - Performance Stock Units [Member] - Management Team [Member]	3 Months Ended
	Mar. 31, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting period	3 years
Targeted composite index period	2 years
Revenue targets performance period	2 years

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock-Based Compensation Expense by Line Items in Consolidated Statements of Operations (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	$ 12,838	$ 13,560
Cost of Revenue [Member]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	559	442
Research and Development [Member]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	2,802	2,644
Selling, General and Administrative [Member]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	$ 9,477	$ 10,474

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	$ 12,838	$ 13,560
Stock Options [Member]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	0	295
Restricted Stock Units [Member]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	10,750	9,555
Performance Stock Units [Member]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	1,584	2,832
Employee Stock Purchase Plan [Member]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	$ 504	$ 878

Basic and Diluted Net Income _3

Basic and Diluted Net Income (Loss) Per Share - Computation of Basic and Diluted Net Loss per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Net loss, basic	$ (25,409)	$ (35,029)
Net loss, diluted	$ (25,409)	$ (35,029)
Weighted average shares used to compute basic net loss per share	36,467,371	35,584,685
Weighted average of shares used to compute diluted net loss per share	36,467,371	35,584,685
Net loss per share, basic	$ (0.7)	$ (0.98)
Net loss per share, diluted	$ (0.7)	$ (0.98)

Basic and Diluted Net Income _4

Basic and Diluted Net Income (Loss) Per Share - Computation of Potentially Dilutive Securities Outstanding Excluded from Computation of Diluted Shares (Detail) - shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted shares outstanding	10,005,320	6,624,235
Unreleased Restricted Stock and Performance Stock Units [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted shares outstanding	4,861,788	2,403,168
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted shares outstanding	386,382	606,785
Convertible Senior Notes [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted shares outstanding	362,267	1,807,141
Warrants Related to the Issuance of Convertible Senior Notes [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted shares outstanding	1,807,141	1,807,141
Warrants Related to Term Debt [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted shares outstanding	2,587,742

Employee Benefit Plans - Additi

Employee Benefit Plans - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Retirement Benefits [Abstract]
Expense for matching contributions	$ 2.4	$ 2.4

Subsequent Event - Additional I

Subsequent Event - Additional Information (Detail) - Forecast [Member] $ in Millions	3 Months Ended
	Jun. 30, 2024 USD ($)
One-time Termination Benefits [Member] | Minimum [Member]
Subsequent Event [Line Items]
Restructuring charge, consisting of one-time severance and other termination benefit costs	$ 4
Contract Termination [Member] | Maximum [Member]
Subsequent Event [Line Items]
Restructuring charge, consisting of one-time severance and other termination benefit costs	$ 5