Xtant Medical (XTNT) 10-K 24 Mar 16 2015 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2015	Feb. 25, 2016	Jun. 30, 2015
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2015
Document Fiscal Year Focus	2,015
Document Fiscal Period Focus	FY
Entity Registrant Name	Xtant Medical Holdings, Inc.
Entity Central Index Key	1,453,593
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Filer Category	Smaller Reporting Company
Entity Public Float			$ 25,708,995
Trading Symbol	XTNT
Entity Common Stock, Shares Outstanding		11,897,601

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Current Assets:
Cash and cash equivalents	$ 6,368,016	$ 4,468,208
Trade accounts receivable, net of allowance for doubtful accounts of $2,579,634 and $1,392,989, respectively	15,385,218	4,427,081
Inventories, net	22,684,716	9,558,648
Prepaid and other current assets	985,471	654,140
Total current assets	45,423,421	19,108,077
Non-current inventories	1,607,915	1,934,258
Property and equipment, net	11,816,629	4,654,527
Goodwill	41,534,626	0
Intangible assets, net	40,237,289	655,490
Other assets	2,439,558	1,598,539
Total Assets	143,059,438	27,950,891
Current Liabilities:
Accounts payable	9,386,531	3,876,760
Accounts payable - related party	1,406,763	250,629
Accrued liabilities	9,595,851	1,921,301
Warrant derivative liability	1,050,351	1,320,371
Current portion of capital lease obligations	35,139	61,970
Current portion of royalty liability	0	1,000,750
Current portion of long-term debt	0	50,671
Total current liabilities	21,474,635	8,482,452
Long-term Liabilities:
Capital lease obligation, less current portion	7,800	11,808
Long-term royalty liability, less current portion	0	6,361,216
Long-term convertible debt	68,000,000	0
Long-term debt, less current portion	44,700,476	20,870,330
Total Liabilities	$ 134,182,911	$ 35,725,806
Commitments and Contingencies
Stockholders' Equity (Deficit)
Preferred stock, $0.000001 par value; 5,000,000 shares authorized; no shares issued and Outstanding	$ 0	$ 0
Common stock, $0.000001 par value; 95,000,000 shares authorized; 11,897,601 shares issued and outstanding as of December 31, 2015 and 6,679,646 shares issued and outstanding as of December 31, 2014	11	7
Additional paid-in capital	81,917,488	63,091,620
Accumulated deficit	(73,040,972)	(70,866,542)
Total Stockholders’ Equity (Deficit)	8,876,527	(7,774,915)
Total Liabilities & Stockholders’ Equity	$ 143,059,438	$ 27,950,891

CONSOLIDATED BALANCE SHEETS _Pa

CONSOLIDATED BALANCE SHEETS [Parenthetical] - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Trade accounts receivable, allowance for doubtful accounts (in dollars)	$ 2,579,634	$ 1,392,989
Preferred stock, par value (in dollars per share)	$ 0.000001	$ 0.000001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.000001	$ 0.000001
Common stock, shares authorized	95,000,000	95,000,000
Common stock, shares issued	11,897,601	6,679,646
Common Stock, shares outstanding	11,897,601	6,679,646

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Revenue
Orthopedic product sales	$ 58,194,249	$ 34,569,160
Other revenue	1,151,468	762,652
Total Revenue	59,345,717	35,331,812
Cost of Sales	20,262,728	13,034,314
Gross Profit	39,082,989	22,297,498
Operating Expenses
General and administrative	12,993,307	8,886,972
Sales and marketing	28,731,184	16,912,865
Research and development	2,546,362	1,443,018
Depreciation and amortization	3,819,588	271,748
Acquisition and integration related expenses (Note 2)	4,935,755	0
Extinguishment of debt	(2,345,019)	0
Impairment of assets	233,748	912,549
Non-cash consulting expense	246,165	135,075
Total Operating Expenses	51,161,090	28,562,227
Loss from Operations	(12,078,101)	(6,264,729)
Other Income (Expense)
Interest expense	(7,733,748)	(5,660,357)
Change in warrant derivative liability	270,020	1,736,053
Non-cash consideration associated stock agreement	(558,185)	0
Other income (expense)	388,176	(318,836)
Total Other Income (Expense)	(7,633,737)	(4,243,140)
Net Loss from Operations Before Benefit (Provision) for Income Taxes	(19,711,838)	(10,507,869)
Benefit (Provision) for Income Taxes
Current	0	0
Deferred	17,537,408	0
Net Loss	$ (2,174,430)	$ (10,507,869)
Net loss per share:
Basic	$ (0.24)	$ (1.76)
Dilutive	$ (0.24)	$ (1.76)
Shares used in the computation:
Basic	9,055,483	5,954,195
Dilutive	9,055,483	5,954,195

Consolidated Statements of Chan

Consolidated Statements of Changes in Stockholders' Equity (Deficit) - USD ($)	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]
Balance at Dec. 31, 2013	$ (3,842,177)	$ 5	$ 56,516,491	$ (60,358,673)
Balance (in shares) at Dec. 31, 2013		5,348,282
Stock-based compensation	935,316	$ 0	935,316	0
Stock-based compensation (in shares)		38,364
Issuance of restricted stock	136,977	$ 0	136,977	0
Issuance of restricted stock (in shares)		0
Net proceeds from the issuance of stock	5,869,635	$ 2	5,869,633	0
Net proceeds from the issuance of stock (in shares)		1,143,000
Issuance of stock related to acquisition	(1,461,796)	$ 0	(1,461,796)	0
Issuance of stock to ROS to amend Credit agreement to borrow additional $4 million	1,094,999	$ 0	1,094,999	0
Issuance of stock to ROS to amend Credit agreement to borrow additional $4 million (in shares)		150,000
Net loss	(10,507,869)	$ 0	0	(10,507,869)
Balance at Dec. 31, 2014	(7,774,915)	$ 7	63,091,620	(70,866,542)
Balance (in shares) at Dec. 31, 2014		6,679,646
Stock-based compensation	569,705	$ 0	569,705	0
Stock-based compensation (in shares)		0
Issuance of restricted stock	120,000	$ 0	120,000	0
Issuance of restricted stock (in shares)		39,312
Issuance of common stock	11,500	$ 0	11,500	0
Issuance of common stock (in shares)		17,564
Net proceeds from the issuance of stock	515,395	$ 0	515,395	0
Net proceeds from the issuance of stock (in shares)		140,053
Issuance of stock related to acquisition	14,934,146	$ 4	14,934,142	0
Issuance of stock related to acquisition		4,242,655
Issuance of stock to Aspire Capital	2,675,126	$ 0	2,675,126	0
Issuance of stock to Aspire Capital (in Shares)		778,371
Net loss	(2,174,430)	$ 0	0	(2,174,430)
Balance at Dec. 31, 2015	$ 8,876,527	$ 11	$ 81,917,488	$ (73,040,972)
Balance (in shares) at Dec. 31, 2015		11,897,601

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Operating activities:
Net loss	$ (2,174,430)	$ (10,507,869)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	4,889,272	952,320
Purchase accounting valuation allowance	(17,537,408)	0
Non-cash interest	4,107,225	814,374
Impairment of Assets	956,395	912,549
(Gain)/Loss on sale of fixed assets	(596,883)	25,269
Amortization of debt discount	707,281	1,632,245
Non-cash consulting expense/stock option expense	836,741	935,316
Provision for losses on accounts receivable and inventory	700,234	647,765
Change in derivative warrant liability	(270,020)	(1,736,053)
Non-cash consideration associated with stock purchase agreement	558,185	0
Extinguishment of debt	(2,345,019)	0
Changes in operating assets and liabilities:
Accounts receivable	(5,512,429)	283,624
Inventories	(545,713)	(17,392)
Prepaid and other assets	(1,044,962)	(455,048)
Accounts payable	644,149	715,706
Accrued liabilities	7,527,514	(1,526,865)
Net cash used in operating activities	(9,099,868)	(7,324,059)
Investing activities:
Acquisition of X-spine Systems, Inc.	(72,975,200)	0
Purchases of property and equipment and intangible assets	(2,263,033)	(299,978)
Proceeds from sale of fixed assets	1,667,195	1,626
Net cash used in investing activities	(73,571,038)	(298,352)
Financing activities:
Proceeds from long-term and convertible debt, net of deferred and financing costs	83,897,361	4,000,000
Net proceeds from equity private placement	515,395	0
Payment of royalty obligation	(542,905)
Payments on long-term debt	(1,325,814)	(653,397)
Payments on capital leases	(101,760)	(171,957)
Proceeds from exercise of options	11,500	0
Net proceeds from issuance of stock	2,116,937	5,869,633
Net cash provided by financing activities	84,570,714	9,044,279
Net change in cash and cash equivalents	1,899,808	1,421,868
Cash and cash equivalents at beginning of period	4,468,208	3,046,340
Cash and cash equivalents at end of period	$ 6,368,016	$ 4,468,208

Business Description and Summar

Business Description and Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business Description and Summary of Significant Accounting Policies	(1) Business Description and Summary of Significant Accounting Policies Business Description The accompanying consolidated financial statements include the accounts of Xtant Medical Holdings, Inc. (“Xtant”), formerly known as Bacterin International Holdings, Inc., a Delaware corporation, and its wholly owned subsidiaries, Bacterin International, Inc., (“Bacterin”) a Nevada corporation and X-Spine Systems, Inc. (“X-spine”), an Ohio corporation, (Xtant, Bacterin and X-spine are jointly referred to herein as the “Company”). All intercompany balances and transactions have been eliminated in consolidation. Xtant develops, manufactures and markets regenerative orthopedic products for domestic and international markets and fixation devices. Xtant products serve the combined specialized needs of orthopedic and neurological surgeons, including orthobiologics for the promotion of bone healing, implants and instrumentation for the treatment of spinal disease, tissue grafts for the treatment of orthopedic disorders to promote healing following spine, cranial and foot surgeries and the development, manufacturing and sale of medical devices for use in orthopedic spinal surgeries. The On July 31, 2015, Xtant acquired all of the outstanding capital stock of X-spine Systems, Inc. for approximately $ 60 13 4.24 Bacterin International Holdings, Inc. changed its name to Xtant Medical Holdings, Inc. On August 6, 2015 Xtant formed a new wholly owned subsidiary, Xtant Medical, Inc., a Delaware corporation to facilitate the integration of Bacterin and X-spine. The markets in which the Company competes are highly competitive and rapidly changing. Significant technological advances, changes in customer requirements, or the emergence of competitive products with new capabilities or technologies could adversely affect the Company ’ Xtant completed a 1:10 reverse split In August 2014, Xtant offered 1,143,000 5.70 571,500 valued at $ 1,461,796 7.12 6.5 5.9 We entered into a Common Stock Purchase Agreement on March 16, 2015, as amended and restated on April 17, 2015 (the “Purchase Agreement”), with Aspire Capital Fund, LLC (“Aspire Capital”), which provides that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital is committed to purchase up to an aggregate of $ 10.0 207,182 750,000 154,189 3.62 558,185 417,000 1,366,941 During the third quarter of 2015, we issued 140,053 515,395 The Company’s accounts receivable are due from a variety of health care organizations and distributors throughout the world. Approximately 95 98 In 2015, Xtant purchased from Norwood Medical approximately 12 its operating products Year Ended 2015 2014 United States $ 56,750,372 $ 34,643,571 Rest of World 2,595,345 688,241 $ 59,345,717 $ 35,331,812 The preparation of the financial statements requires management of the Company to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the period. Significant estimates include the carrying amount of property and equipment, goodwill, and intangible assets and liabilities; valuation allowances for trade receivables, inventory valuation, and deferred income tax assets and liabilities; valuation of the warrant derivative liability; inventory reserve; royalty liability; and estimates for the fair value of stock options grants and other equity awards upon which the Company determines stock-based compensation expense. Actual results could differ from those estimates. Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity date of three months or less to be cash equivalents. Cash equivalents are recorded at cost, which approximates market value. At times the Company maintains deposits in financial institutions in excess of federally insured limits. Accounts Receivable Accounts receivable represents amounts due from customers for which revenue has been recognized. Normal terms on trade accounts receivable are net 30 days and some customers are offered discounts for early pay. The Company performs credit evaluations when considered necessary, but generally does not require collateral to extend credit. The allowance for doubtful accounts is the Company’s best estimate of the amount of probable credit losses in the Company’s existing receivables. The Company determines the allowance based on factors such as historical collection experience, customer’s current creditworthiness, customer concentration, age of accounts receivable balance, general economic conditions that may affect a customer’s ability to pay and management judgment. Actual customer collections could differ from estimates. Account balances are charged to the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. Provisions to the allowance for doubtful accounts are charged to expense. The Company does not have any off-balance sheet credit exposure related to its customers. Inventories Inventories are stated at the lower of cost or market. Cost is determined using the specific identification method and includes materials, labor and overhead. The Company calculates an inventory reserve for estimated obsolescence or excess inventory based on historical usage and sales, as well as assumptions about future demand for its products. These estimates for excess and obsolete inventory are reviewed and updated on a quarterly basis. Increases in the inventory reserves result in a corresponding expense, which is recorded to cost of tissue and medical devices sales. Inventories where the sales cycle is estimated to be beyond twelve months are classified as Non-current inventories. Property and Equipment Property and equipment are stated at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the assets, generally three seven Other Assets Other Assets consist of the short-term and the long-term portion of prepaid expenses, security deposits, the capitalized portion of debt related issuance costs and kits that are used in the implantation of certain biologic products. The items are stated at cost and in the case of debt related issuance costs and kits are amortized on a straight line basis over their estimated useful lives. Long-Lived Assets Long-lived assets, including intangible assets, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the estimated fair value of the assets. See Note 5, “Impairment of Assets” below. Goodwill represents the excess of costs over fair value of assets of businesses acquired. Goodwill and intangible assets acquired in a purchase business combination and determined to have indefinite useful lives are not amortized, instead are tested for impairment at least annually and whenever events or circumstances indicate the carrying amount of the asset may not be recoverable. In its evaluation of goodwill, the Company performs an assessment of qualitative factors to determine if it is more-likely-than-not that goodwill might be impaired and whether it is necessary to perform the two-step goodwill impairment. The Company conducts its annual impairment test on December 31 of each year. Revenue is recognized when all of the following criteria are met: a) the Company has entered into a legally binding agreement with the customer; b) the products or services have been delivered; c) the Company’s fee for providing the products and services is fixed or determinable; and d) collection of the Company’s fee is probable. The Company’s policy is to record revenue net of any applicable sales, use, or excise taxes. If an arrangement includes a right of acceptance or a right to cancel, revenue is recognized when acceptance is received or the right to cancel has expired. The Company ships to certain customers under consignment arrangements whereby the Company’s product is stored by the customer. The customer is required to report the use to the Company and upon such notice, the Company invoices the customer and revenue is recognized when above criteria have been met. The Company expenses advertising costs as incurred. The Company had advertising expense of $ 224,297 34,970 Research and development costs, which are principally related to internal costs for the development of new devices and biologics and processes are expensed as incurred. Net Loss Per Share Basic net income (loss) per share is computed by dividing net income (loss) by the weighted average number of common shares outstanding. Shares issued during the period and shares reacquired during the period are weighted for the portion of the period that they were outstanding. Diluted net income (loss) per share is computed in a manner consistent with that of basic earnings per share while giving effect to all potentially dilutive common shares outstanding during the period, which include the assumed exercise of stock options and warrants using the treasury stock method. Diluted net loss per share was the same as basic net loss per share for the years ended December 31, 2015 and 2014, as shares issuable upon the exercise of stock options and warrants were anti-dilutive as a result of the net losses incurred for those periods. Dilutive earnings per share are not reported as their effects of including 1,942,647 2,350,656 The carrying values of financial instruments, including trade accounts receivable, accounts payable, other accrued expenses and long-term debt, approximate their fair values based on terms and related interest rates. The Company follows a framework for measuring fair value. The framework provides a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). The three levels of the fair value hierarchy are described below: Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets. Level 2: Inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument. Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement. A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. During the years ended December 31, 2015 and 2014, there was no reclassification in financial assets or liabilities between Level 1, 2 or 3 categories. The following table sets forth by level, within the fair value hierarchy, our liabilities as of December 31, 2015 and December 31, 2014 that are measured at fair value on a recurring basis: Warrant derivative liability As of As of Level 1 - - Level 2 - - Level 3 $ 1,050,351 $ 1,320,371 The valuation technique used to measure fair value of the warrant liability is based on a lattice model and significant assumptions and inputs determined by us (See Note 11, “Warrants” below). Level 3 Changes Warrant derivative liability Balance at January 1, 2015 $ 1,320,371 Gain recognized in earnings (270,020) Balance at December 31 , 2015 $ 1,050,351 During the year ended December 31, 2015, the Company did not change any of the valuation techniques used to measure its liabilities at fair value. In May 2014, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers. The new standard was originally effective for reporting periods beginning after December 15, 2016 and early adoption was not permitted. On August 12, 2015, the FASB approved a one year delay of the effective date to reporting periods beginning after December 15, 2017, while permitting companies to voluntarily adopt the new standard as of the original effective date. The comprehensive new standard will supersede existing revenue recognition guidance and require revenue to be recognized when promised goods or services are transferred to customers in amounts that reflect the consideration to which the company expects to be entitled in exchange for those goods or services. Adoption of the new rules could affect the timing of revenue recognition for certain transactions. The guidance permits two implementation approaches, one requiring retrospective application of the new standard with restatement of prior years and one requiring prospective application of the new standard with disclosure of results under old standards. The Company is currently evaluating when to adopt the new standard, the impacts of adoption and the implementation approach to be used. In April 2015, the FASB issued ASU 2015-3, to simplify the presentation of debt issuance costs. This update requires that debt issuance costs be presented in the balance sheet as a direct deduction from the carrying amount of the associated debt liability, consistent with the required presentation for debt discounts. This update is effective for interim and annual periods beginning after December 15, 2015. ASU 2015-3 is not expected to have a material impact. In February 2016, the FASB issued Accounting Standards Update No. 2016-02, Leases (Topic 842)

Business Combination

Business Combination	12 Months Ended
	Dec. 31, 2015
Business Combinations [Abstract]
Business Combination	(2) Business Combination On July 31, 2015 (the “Acquisition Date”), the Company completed its acquisition of 100% of the outstanding common stock of X-spine, pursuant to a Stock Purchase Agreement (the “Purchase Agreement”). X-spine was engaged in the development, manufacturing and sale of medical devices for use in orthopedic spinal surgeries. The primary reasons for the X-spine acquisition are to combine the Company’s product lines into regenerative orthopedic product lines, leverage customer call points, expand sales and marketing coverage, increase revenue, and drive operating efficiencies. Under the terms of the Purchase Agreement, the Company paid the former X-spine stockholders consideration of approximately $ 60 4.24 13 The cash consideration was financed in part using the net proceeds from the Company’s offering of $ 68 6 The Company accounted for the acquisition as a business combination and recorded the assets acquired, liabilities assumed, and the estimated future obligations at their respective fair values as of the Acquisition Date. The assets acquired and liabilities assumed were recorded as of the Acquisition Date at their respective fair values and consolidated with those of the Company. The reported consolidated balance sheet of the Company after completion of the acquisition reflects these fair values. The results of X-spine operations from the Acquisition Date contributed $ 288,824 components of the aggregate preliminary purchase price for the acquisition were as follows: Cash $ 73,033,018 Fair value of Xtant shares 14,934,146 Total purchase price $ 87,967,164 Net Assets Acquired Allocation of Amortization Accounts receivable $ 5,989,904 Inventories 13,132,697 Prepaids and other current assets 208,116 Property and equipment, net 7,409,667 Cash 57,818 Total tangible assets acquired 26,798,202 Less: liabilities assumed 23,559,164 Net tangible assets less liabilities $ 3,239,038 Intangible assets: Technology 28,698,700 10 Customer relationships 9,911,000 14 Tradename 4,543,300 10 Non-compete agreements 40,500 3 Goodwill 41,534,626 Total purchase price $ 87,967,164 The assets acquired and liabilities assumed were recorded at their estimated fair values as of the Acquisition Date. We determined the fair value of the inventory based on its estimated selling price less cost to sell and normal profit margin. The fair value of the technology and tradename intangible assets were determined based upon a “relief from royalty” approach. The “relief from royalty” method is based on the premise that a third party would be willing to pay a royalty to use these assets owned by the subject company. The projected royalties are converted into their present value equivalents through the application of a risk adjusted discount rate. The customer relationships were valued based on an “excess earnings method.” The “excess earnings method” measures the historical customer churn analysis and discussions with management extended until excess earning cash flow approximates zero. The non-compete agreements were valued based on a “with and without” approach. The “with and without” method measures an asset value by estimating the difference in cash flows generated by the business with the asset in-use versus without the asset. The difference in cash flows is attributable to incremental earnings or cost savings associated with the asset. These fair value measurements are based on significant unobservable inputs, based on management’s estimates and assumptions. The fair value of the identifiable assets, including the intangible assets noted above, may be impacted by the Company’s evaluation of deferred taxes as further discussed below and possibly by future factors that may or may not impact the fair value of the identifiable assets, including the intangible assets noted above. The Company recorded the excess of the aggregate purchase price over the estimated fair values of the identifiable assets acquired as goodwill, which is not deductible for tax purposes. Goodwill is primarily attributable to the benefits the Company expects to realize by expanding its product offerings and addressable markets, thereby contributing to an expanded revenue base. The Company will also increase the size of its sales organization, while realizing cost synergies associated with eliminating redundant positions, primarily in selling, general and administrative functions. The assets and liabilities assumed in the acquisition have been included in the Company’s consolidated balance sheet as of December 31, 2015. The results of X-spine operations were included in the Company’s consolidated financial statements from the Acquisition Date. The Company’s management reviews financial results and manages the business on an aggregate basis. Therefore, financial results are reported in a single operating segment (See Note 17, “Segment and Geographic Information” below). Acquisition Costs Acquisition-related expenses were $ 4.9 Taxes The Company did not acquire X-spine’s net operating loss carryforwards for federal tax purposes because X-spine was an S-corporation tax filer prior to the acquisition and any carryforwards were taken by the former shareholders of X-spine in their federal tax filings. The Company has evaluated the realizability of the net deferred tax assets acquired net of the deferred tax liabilities that arose from the recording of intangible assets as part of the purchase price allocation (See Note 13, “Income Taxes” below). Given its significant prior accumulated tax losses, the Company does not expect to incur U.S. federal tax expense in the year ended December 31, 2015 or the foreseeable future. The Company does, however, expect to incur state tax expense during 2015. Unaudited Supplemental Pro Forma Financial Information The unaudited pro forma results presented below include the combined results of both entities as if the acquisition had been consummated as of January 1, 2014. Certain pro forma adjustments have been made to reflect the impact of the purchase transaction, primarily consisting of amortization of intangible assets with determinable lives and interest expense on long-term debt. In addition, certain historical expenses, such as warrant expense and interest expense associated with debt that was immediately repaid, were eliminated from these pro-forma results. The pro forma information does not necessarily reflect the actual results of operations had the acquisition been consummated at the beginning of the fiscal reporting period indicated nor is it indicative of future operating results. The pro forma information does not include any adjustment for potential revenue enhancements, cost synergies or other operating efficiencies that could result from the acquisition. Year Ended December 31, 2015 2014 Revenue $ 86,517,599 $ 77,651,056 Net loss $ (5,845,125) $ (15,565,081)

Equity

Equity	12 Months Ended
	Dec. 31, 2015
Equity [Abstract]
Equity	(3) Equity During the first quarter of 2014, the Company issued 150,000 4 In August 2014, the Company offered 1,143,000 5.70 571,500 7.12 6.5 5.9 The warrants have a five year term and expire on August 6, 2019. We entered into a Common Stock Purchase Agreement on March 16, 2015, as amended and restated April 17, 2015, with Aspire Capital which provides that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital is committed to purchase up to an aggregate of $ 10.0 207,182 750,000 154,189 558,185 417,000 1,366,941 Under the Common Stock Purchase Agreement, we have the right, at our sole discretion, to present Aspire Capital with purchase notices, directing Aspire Capital (as principal) to purchase up to 50,000 500,000 ⋅ the lowest sale price of our common stock on the purchase date; or ⋅ the arithmetic average of the three lowest closing sale prices for our common stock during the ten consecutive trading days ending on the trading day immediately preceding the purchase date. In addition, we also have the right to present Aspire Capital with volume-weighted average price purchase notices directing Aspire Capital to purchase an amount of our common stock equal to up to 30 The Purchase Agreement may be terminated by us at any time, at our discretion, without any penalty or cost to us. The Purchase Agreement also provides for customary events of default, upon the occurrence of which Aspire Capital may terminate the Purchase Agreement. Aspire Capital has agreed that neither it nor any of its agents, representatives or affiliates shall engage in any direct or indirect short-selling or hedging of our common stock during any time prior to the termination of the Purchase Agreement. Any proceeds we receive under the Purchase Agreement are expected to be used for working capital and general corporate purposes. On July 31, 2015, the Company acquired all of the outstanding capital stock of X-spine for approximately $ 60 13 4,242,655 Related to the acquisition, on October 8, 2015 the Company granted 78,510 3.19 250,447 On September 4, 2015, the Company sold an aggregate of 140,053 515,395

Inventories

Inventories	12 Months Ended
	Dec. 31, 2015
Inventory Disclosure [Abstract]
Inventories	(4) Inventories December 31, December 31, 2015 2014 Current inventories Raw materials $ 4,860,914 $ 3,836,635 Work in process 2,720,707 2,484,635 Finished goods 18,289,674 5,163,458 25,871,295 11,484,728 Reserve for obsolescence (3,186,579) (1,926,080) Current inventories, total 22,684,716 9,558,648 Non-current inventories Finished goods 2,021,077 2,860,248 Reserve for obsolescence (413,162) (925,990) Non-current inventories, total 1,607,915 1,934,258 Total inventories $ 24,292,631 $ 11,492,906

Impairment of Assets

Impairment of Assets	12 Months Ended
	Dec. 31, 2015
Impairment or Disposal of Tangible Assets Disclosure [Abstract]
Impairment of Assets	(5) Impairment of Assets During the fourth quarter of 2014, management decided to dispose of a group of components because of a shift in strategy for the Company. The component groups consisted of the inventory and fixed assets associated with the Device Coatings and Cranial Maxillofacial Fixation (CMF) lines of business. Sales for these product lines represented less than 1 1 80,042 832,507 912,549 0 The sale of the CMF inventory occurred during the first quarter of 2015 and did not result in any tangible payment to the Company. The sale of the Device Coatings line of business occurred in the third quarter of 2015. The terms of the sale called for cash consideration to the Company of approximately $ 250,000 100,000 51,476 During the third quarter of 2015, Intangible Assets were reviewed and found to be impaired. The impact, net of amortization, was $ 285,224

Property and Equipment, Net

Property and Equipment, Net	12 Months Ended
	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	(6) Property and Equipment, Net December 31, December 31, 2015 2014 Buildings $ - $ 1,657,579 Equipment 5,368,567 4,724,608 Computer equipment 348,404 225,009 Computer software 503,587 345,039 Furniture and fixtures 174,215 153,834 Leasehold improvements 2,661,802 2,380,617 Vehicles 10,000 41,099 Surgical instruments 8,175,578 - Total cost 17,242,153 9,527,785 Less: accumulated depreciation (5,425,524) (4,873,258) $ 11,816,629 $ 4,654,527 The Company provides surgical instruments to surgeons to use during surgical procedures. Instruments are classified as non-current assets and are recorded as property, plant and equipment. Instruments are carried at cost and are held at book value (cost less accumulated depreciation). Depreciation is calculated using the straight-line method using a five year useful life. The Company leases certain equipment under capital leases. For financial reporting purposes, minimum lease payments relating to the assets have been capitalized. As of December 31, 2015, the Company has recorded $ 349,162 147,980 Maintenance and repairs expense for the year ended 2015 and 2014 was $ 366,323 293,707 676,540 570,726

Intangible Assets

Intangible Assets	12 Months Ended
	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	(7) Intangible Assets Intangible assets consist of various patents with regards to processes for its products and intangible assets associated with the acquisition of X-spine. December 31, December 31, Patents 564,717 1,036,580 Acquisition related intangibles: Technology 28,698,700 - Customer relationships 9,911,000 - Tradename 4,543,300 - Non-compete 40,500 - Accumulated amortization (3,520,928) (381,090) Net carrying value $ 40,237,289 $ 655,490 Aggregate amortization expense: $ 3,438,596 $ 77,022 2016 $ 4,481,492 2017 4,641,781 2018 4,656,956 2019 4,547,754 2020 4,462,079 Thereafter 17,447,227 Total $ 40,237,289

Accrued Liabilities

Accrued Liabilities	12 Months Ended
	Dec. 31, 2015
Payables and Accruals [Abstract]
Accrued Liabilities	(8) Accrued Liabilities December 31, December 31, 2015 2014 Accrued stock compensation $ 147,037 $ - Wages/commissions payable 3,994,714 1,434,743 Accrued integration expense 646,860 - Accrued interest payable 1,716,167 - Other accrued expenses 3,969,684 486,558 $ 10,474,462 $ 1,921,301

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2015
Debt Disclosure [Abstract]
Long-term Debt	(9) Long-Term Debt On March 6, 2014, we entered into a Sixth Amendment to our Credit Agreement with ROS whereby we borrowed an additional $ 4.0 150,000 On July 31, 2015, concurrent with the acquisition of X-spine, we completed an offering of $ 65.0 6.00 52.0 3 The Notes bear interest at a rate equal to 6.00 July 15, 2021 At any time prior to the close of business on the second business day immediately preceding the maturity date, holders may convert their Notes into shares of Xtant common stock (together with cash in lieu of fractional shares) at an initial conversion rate of 257.5163 1,000 3.88 · the issuance of certain share and cash dividends on our common stock; · the issuance of certain rights or warrants; · certain subdivisions and combinations of our capital stock; · certain distributions of capital stock, indebtedness or assets; and · certain tender or exchange offers. We will not adjust the conversion rate for other events, such as for an issuance of our common stock for cash or in connection with an acquisition that may dilute our common stock thereby adversely affecting its market price. In addition, Xtant will, in certain circumstances, increase the conversion rate for holders who convert their Notes in connection with a “make-whole fundamental change” (as defined in the Indenture). No sinking fund is provided for the Notes. Xtant may not redeem the Notes at its option prior to their maturity. If a “fundamental change” (as defined in the Indenture) occurs, holders will have the right, at their option, to require us to repurchase their Notes at a cash price equal to 100 The Notes are Xtant’s senior, unsecured obligations, rank equal in right of payment with its existing and future unsecured indebtedness that is not junior to the Notes, are senior in right of payment to any of its existing and future indebtedness that is expressly subordinated to the Notes, and are effectively subordinated to its existing and future secured indebtedness to the extent of the value of the collateral securing such indebtedness. The Notes are structurally subordinated to all existing and future indebtedness and other liabilities, including trade payables, and (to the extent Xtant is not a holder thereof) preferred equity, if any, of its subsidiaries. Amended and Restated Credit Agreement On July 31, 2015, we refinanced approximately $24 million in existing term loans and borrowed an additional $ 18 July 31, 2020 We accounted for the Notes and for the New Facility with ROS in accordance with ASC Subtopic 470-50, Debt Modifications and Extinguishments, and ASC Subtopic 470-60, Troubled Debt Restructurings by Debtors. Based on the facts and circumstances surrounding the changes to the loan and applying the calculation methodology per the above mentioned ASC Subtopics, the Company recognized a gain from the extinguishment of debt of $ 2,345,019 In addition, the Company calculated a fair value of the New Facility on a non-recurring basis by taking the five year cash flow and discounting it at a market interest rate. There was no significant difference between the calculated value and the stated value of the New Facility. Approximately $ 4.8 2.2 $ 2.5 Prior to the issuance of the New Facility, the Company was required to pay a 7.4 12.3 2.3 December 31, December 31, Loan payable to ROS Acquisition Offshore (See details above) $ 42,000,000 $ 24,000,000 Adjustment fee was payable to ROS Acquisition Offshore, due in August 2019 - 700,000 6% convertible senior unsecured notes due 2021 (See details above) 68,000,000 PIK Interest payable to ROS 2,700,476 6.00% loan payable to Valley Bank of Belgrade secured by a building that was sold and leased back in the fourth quarter of 2015 - 1,325,814 112,700,476 26,025,814 Less: current portion - (50,671) Debt discount - (5,104,813) Long-term debt $ 112,700,476 $ 20,870,330 2016 $ - 2017 - 2018 - 2019 - 2020 44,700,476 Thereafter 68,000,000 Total $ 112,700,476

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	(10) Stock-Based Compensation The Amended and Restated Xtant Medical Equity Incentive Plan (“the Plan”) provides for stock awards, including options and performance stock awards, to be granted to employees, consultants, independent contractors, officers and directors. The purpose of the Plan is to enable us to attract, retain and motivate key employees, directors and, on occasion, independent consultants, by providing them with stock options and restricted stock grants. Stock options granted under the Plan may be either incentive stock options to employees, as defined in Section 422A of the Internal Revenue Code of 1986, or non-qualified stock options. The Plan is administered by the compensation committee of our Board of Directors. Stock options granted under the Plan are generally not transferable, vest in installments over the requisite service period and are exercisable during the stated contractual term of the option only by such optionee. The exercise price of all incentive stock options granted under the Plan must be at least equal to the fair market value of the shares of common stock on the date of the grant. 1,400,000 470,000 Stock compensation expense recognized in the statement of operations for the year ended December 31, 2015 and 2014 is based on awards ultimately expected to vest and reflects an estimate of awards that will be forfeited. ASC 718 requires forfeitures to be estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Year Ended Year Ended December 31, 2015 December 31, 2014 Risk-free interest rate 1.75 % 1.92 % Expected volatility 80 % 57 % Expected term 6.3 Years 5.4 Years Expected forfeiture rate 20 % 20 % Dividend yield 0 % 0 % In July 2014, the Company granted the President of Bacterin an option to purchase 55,000 200,000 2015 2014 Weighted Weighted Weighted Average Weighted Average Average Value at Average Value at Shares Price Date Shares Price Date Outstanding at January 1 695,336 $ 11.09 $ 5.35 758,328 $ 14.90 $ 8.60 Granted 45,000 4.00 2.81 169,300 5.78 2.65 Exercised (11,500) 1.00 2.96 (6,666) 10.00 0.04 Cancelled or expired (64,755) 12.58 6.31 (225,626) 11.38 6.07 Outstanding at December 31 664,081 $ 10.64 $ 5.32 695,336 $ 11.09 $ 5.35 Exercisable at December 31 381,988 $ 13.65 $ 6.50 311,080 $ 15.25 $ 7.35 The aggregate intrinsic value of options outstanding as of December 31, 2015 was zero because the closing price of the stock at year end was less than the strike price of all options outstanding. As of December 31, 2015, there were 282,093 3.72 699,000 From time to time we may grant stock options and stock grants to consultants. We account for consultant stock options in accordance with ASC 505-50. Consulting expense for the grant of stock options to consultants is determined based on the estimated fair value of the stock options at the measurement date as defined in ASC 505-50 and is recognized over the vesting period. The Company recognized expenses for the year ended December 31, 2015 and 2014 of $ 246,165 135,075 , as Non-cash consulting expense Total share based compensation recognized for employees, directors and consultants was $ 569,705 935,316 On November 10, 2014, the Company granted 39,312 4.07 160,000 Non-cash consulting On July 1, 2015, the Company granted 58,820 3.40 200,000 100,000 On October 8, 2015 the Company granted 78,510 3.19 250,447 25,045 Also, On October 8, 2015, the Company granted 20,000 3.19 65,550 5,296

Warrants

Warrants	12 Months Ended
	Dec. 31, 2015
Warrants and Rights Note Disclosure [Abstract]
Warrants	(11) Warrants Weighted Common Average Stock Exercise Warrants Price Outstanding as of January 1, 2014 1,087,820 $ 16.20 Issued 571,500 7.12 Expired (4,000) 20.00 Outstanding at January 1, 2015 1,655,320 $ 13.06 Issued - - Expired (376,754) 22.87 Outstanding at December 31, 2015 1,278,566 $ 8.45 We utilize a lattice model to determine the fair market value of the warrants accounted for as liabilities. The valuation model accommodates the probability of exercise price adjustment features as outlined in the warrant agreements. We recorded an unrealized gain of $ 270,020 Year Ended December 31, 2015 2014 Value of underlying common stock (per share) $ 2.80 $ 3.03 Risk free interest rate 1.02 % 0.80 % Expected term 4.08 years 5.00 years Volatility 79 % 75 % Dividend yield 0 % 0 % 2015 2014 Balance at January 1, 1,171,692 600,192 Derivative warrants issued - 571,500 Derivative warrants exercised - - Expired (46,573) - Balance at December 31, 1,125,119 1,171,692

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	(12) Commitments and Contingencies Operating Leases We lease four office facilities under non-cancelable operating lease agreements with expiration dates in 2016, 2019, 2023 and 2025. We have the option to extend the four leases for up to another ten year term and for one facility, and we have the right of first refusal on any sale. We lease additional office space under a month-to-month arrangement. On October 23, 2015, the Company entered into a sale-leaseback transaction for the property located at 664 Cruiser Lane, Belgrade, Montana, 59714 which formerly secured the 6 2016 $ 775,141 2017 451,327 2018 462,678 2019 348,141 2020 342,638 Thereafter 1,386,653 Total $ 3,766,578 Rent expense was $ 544,000 365,000 Indemnifications Our arrangements generally include limited warranties and certain provisions for indemnifying customers against liabilities if our products or services infringe a third-party’s intellectual property rights. To date, we have not incurred any material costs as a result of such warranties or indemnification provisions and have not accrued any liabilities related to such obligations in the accompanying financial statements. We have also agreed to indemnify our directors and executive officers for costs associated with any fees, expenses, judgments, fines and settlement amounts incurred by any of these persons in any action or proceeding to which any of those persons is, or is threatened to be, made a party by reason of the person’s service as a director or officer, including any action by us, arising out of that person’s services as our director or officer or that person’s services provided to any other company or enterprise at our request. Litigation On March 17, 2014, a complaint was served on the Company in the following state court action in the District Court for the County of Arapahoe, State of Colorado: Robert Taggart v. Guy Cook, Bacterin International, Inc., a Nevada Corporation and Bacterin International Holdings, Inc., a Delaware corporation, Civil Action No. 14CV30401. The complaint involves claims under an employment agreement between plaintiff and the Company seeking commissions on Company sales, a commission on funds obtained by the Company as a result of a reverse merger and vesting of certain stock options. Plaintiff seeks damages in excess of $ 5 We are also engaged in ordinary routine litigation incidental to our business, including product liability disputes.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income Taxes	(13) Income Taxes The Company’s provision for income taxes differs from applying the statutory U.S. federal income tax rate to income before taxes. The primary difference results from providing for state income taxes and from deducting certain expenses for financial statement purposes but not for federal income tax purposes. Year Ended December 31, 2015 2014 United States $ (19,711,838) $ (10,507,869) $ (19,711,838) $ (10,507,869) Year Ended December 31, 2015 2014 Current: Federal $ - $ - State - - Total current - - Deferred: Federal (15,117,246) - State (2,420,162) - Total deferred (17,537,408) - $ (17,537,408) $ - 35 Year Ended December 31, 2015 2014 Statutory Federal tax rate $ (6,898,830) $ (3,677,754) Valuation allowance 7,089,311 4,909,776 State income taxes, net of Federal benefit (1,104,199) (368,826) Purchase accounting valuation reversal (17,537,408) - Change in state income tax rate (1,277,303) 277,076 Provision to return adjustment - (505,423) Change in Warrant Derivative Liability (109,633) (668,554) Other deferred tax adjustment 581,444 - Acquisition expenses 527,646 - Non-cash interest 1,096,446 - Other 1,762 - Nondeductible meals, entertainment and other expense 93,356 33,705 $ (17,537,408) $ - At December 31, 2015 2014 Deferred tax assets: Current deferred tax assets Accrued liability for vacation $ 139,162 $ 102,643 Accrued commissions and bonuses/compensation 1,369,265 - Accrued contingencies 142,107 - Bad debt reserve 1,047,382 536,440 Charitable contributions carryforward 38,283 33,124 Inventory reserve 1,461,566 1,098,333 Reserve - assets held for sale - 351,423 Net operating loss carryovers 22,698,555 18,200,823 Stock warrants 139,056 131,891 Stock option compensation 2,058,631 1,594,460 Goodwill amortization - 82,212 Debt discount and waiver amortization 1,577,347 1,076,926 Depreciation - 244,004 Amortization - 30,290 Other 47,593 - Total non-current deferred tax assets 30,718,947 23,482,569 Valuation allowance (13,065,176) (23,482,569) Net non-current deferred tax assets 17,653,771 - Deferred tax liabilities: Depreciation (1,566,381) - Amortization (16,087,390) - Total deferred tax liabilities (17,653,771) - Net deferred tax assets $ - $ - The ultimate realization of deferred tax assets is dependent upon the existence, or generation, of taxable income in the periods when those temporary differences and net operating loss carryovers are deductible. Management considers the scheduled reversal of deferred tax liabilities, taxes paid in carryover years, projected future taxable income, available tax planning strategies, and other factors in making this assessment. Based on available evidence, management does not believe it is more likely than not that all of the deferred tax assets will be realized. Accordingly, the Company has established a valuation allowance equal to the net realizable deferred tax assets. The valuation allowance decreased by $ 10,417,393 4,909,776 During 2015, the Company acquired intangible assets of $ 43,193,500 17,537,408 At December 31, 2015 and 2014, the Company had total domestic Federal and state net operating loss carryovers of approximately $ 55,905,000 47,263,000 Federal net operating loss carryovers expire at various dates between 2025 and 2035, while state net operating loss carryovers expire between 2025 and 2035. Under the Tax Reform Act of 1986, as amended, the amounts of and benefits from net operating loss carryovers and research and development credits may be impaired or limited in certain circumstances. Events which cause limitations in the amount of net operating losses that the Company may utilize in any one year include, but are not limited to, a cumulative ownership change of more than 50%, as defined, over a three year period. The 2012 through 2014 tax years remain open to examination by the Internal Revenue Service and the 2010 to 2014 tax years remain open to the Montana Department of Revenue and various other state tax agencies. These taxing authorities have the authority to examine those tax years until the applicable statute of limitations expire. The Company did not recognize any interest or penalties related to income taxes for the years ended December 31, 2015 and 2014. At December 31, 2015 the Company early adopted Accounting Standards Update (ASU) No. 2015-17, “Balance Sheet Classification of Deferred Taxes” (Topic 740), which provides for a simplified reporting and balance sheet classification of current and non-current deferred tax assets and liabilities. The adopted ASU requires all deferred tax assets and liabilities, and the related valuation allowance, be presented as non-current on the balance sheet. Accordingly, the 2015 and 2014 deferred tax assets and liabilities have been reclassified to conform to the ASU’s required presentation. No change in any prior year net deferred tax accounts was reported as all prior year deferred tax accounts have been fully reserved.

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2015
Compensation and Retirement Disclosure [Abstract]
Employee Benefit Plans	(14) Employee Benefit Plans Bacterin X-Spine Matching 2% None Contribution Limit Enrollment Period Four times a year

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow Information	12 Months Ended
	Dec. 31, 2015
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow Information	(15) Supplemental Disclosure of Cash Flow Information Year Ended December 31, 2015 2014 Supplemental disclosure of cash flow information Cash paid during the period for: Interest $ 2,279,919 $ 3,192,854 Non-cash activities: Issuance of warrants related to stock issuance - 1,461,796 Issuance of shares related to debt issuance $ - $ 1,094,999 Issuance of shares for non-cash consulting expense $ - $ 81,924 Issuance of restricted stock to employees $ - $ 136,977 Issuance of shares in conjunction with the acquisition of X-spine $ 14,934,146 $ - Issuance of capital leases $ 70,921 $ -

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2015
Related Party Transactions [Abstract]
Related Party Transactions	(16) Related Party Transactions Darrel Holmes, our former Chief Operating Officer, and Mitchell Godfrey, a former director, serve on the board of American Donor Services Inc. (“ADS”), and Mr. Godfrey also serves as secretary and treasurer for ADS. Mssrs. Godfrey and Holmes each receive $ 5,000 1,853,457 2,406,926 Certain of X-spine’s former shareholders, now own over 10% of our common stock as of the Acquisition Date, and have owned a controlling interest of X-spine’s largest supplier, Norwood Tool Company d/b/a Norwood Medical. In 2015, Xtant purchased from 12 its operating products (See ITEM 1A. RISK FACTORS - Trends, Risks and Uncertainties Related to Our Business, “the business acquired from X-spine depends, in part, on a relationship with a key supplier, which is a related party” above). Unless delegated to the Compensation Committee by the Board of Directors, the Audit Committee or the disinterested members of the full Board of Directors reviews and approves all related party transactions.

Segment and Geographic Informat

Segment and Geographic Information	12 Months Ended
	Dec. 31, 2015
Segment Reporting [Abstract]
Segment and Geographic Information	(17) Segment and Geographic Information The Company’s management reviews financial results and manages the business on an aggregate basis. Therefore, financial results are reported in a single operating segment: the development, manufacture and marketing of regenerative medical products and devices. The Company attributes revenues to geographic areas based on the location of the customer. Total revenue by major geographic area is reported in

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2015
Subsequent Events [Abstract]
Subsequent Events	(18) Subsequent Events As previously disclosed in a Form 8-K filed with the SEC on January 22, 2016, effective January 8, 2016, Robert Di Silvio ceased to be President and a named executive officer of the Company; however, Mr. Di Silvio will continue to work with the Company as a consultant. In connection with the restructuring of the Company following the acquisition of X-Spine, effective February 24, 2016, Darrel Holmes ceased serving as our Chief Operating Officer. Going forward, Mr. Holmes will continue to serve as the Chief Operating Officer of Bacterin, but will no longer be a named executive officer of the Company.

Business Description and Summ25

Business Description and Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Reverse Stock Split	Reverse Stock Split Xtant completed a 1:10 reverse split
Public Offering	Public Offering In August 2014, Xtant offered 1,143,000 5.70 571,500 valued at $ 1,461,796 7.12 6.5 5.9
Aspire Capital Transaction	Aspire Capital Transaction We entered into a Common Stock Purchase Agreement on March 16, 2015, as amended and restated on April 17, 2015 (the “Purchase Agreement”), with Aspire Capital Fund, LLC (“Aspire Capital”), which provides that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital is committed to purchase up to an aggregate of $ 10.0 207,182 750,000 154,189 3.62 558,185 417,000 1,366,941
Private Placement Offering	Private Placement Offering During the third quarter of 2015, we issued 140,053 515,395
Concentrations and Credit Risk	The Company’s accounts receivable are due from a variety of health care organizations and distributors throughout the world. Approximately 95 98 In 2015, Xtant purchased from Norwood Medical approximately 12 its operating products Year Ended 2015 2014 United States $ 56,750,372 $ 34,643,571 Rest of World 2,595,345 688,241 $ 59,345,717 $ 35,331,812
Use of Estimates	Use of Estimates The preparation of the financial statements requires management of the Company to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the period. Significant estimates include the carrying amount of property and equipment, goodwill, and intangible assets and liabilities; valuation allowances for trade receivables, inventory valuation, and deferred income tax assets and liabilities; valuation of the warrant derivative liability; inventory reserve; royalty liability; and estimates for the fair value of stock options grants and other equity awards upon which the Company determines stock-based compensation expense. Actual results could differ from those estimates.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity date of three months or less to be cash equivalents. Cash equivalents are recorded at cost, which approximates market value. At times the Company maintains deposits in financial institutions in excess of federally insured limits.
Accounts Receivable	Accounts Receivable Accounts receivable represents amounts due from customers for which revenue has been recognized. Normal terms on trade accounts receivable are net 30 days and some customers are offered discounts for early pay. The Company performs credit evaluations when considered necessary, but generally does not require collateral to extend credit. The allowance for doubtful accounts is the Company’s best estimate of the amount of probable credit losses in the Company’s existing receivables. The Company determines the allowance based on factors such as historical collection experience, customer’s current creditworthiness, customer concentration, age of accounts receivable balance, general economic conditions that may affect a customer’s ability to pay and management judgment. Actual customer collections could differ from estimates. Account balances are charged to the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. Provisions to the allowance for doubtful accounts are charged to expense. The Company does not have any off-balance sheet credit exposure related to its customers.
Inventories	Inventories Inventories are stated at the lower of cost or market. Cost is determined using the specific identification method and includes materials, labor and overhead. The Company calculates an inventory reserve for estimated obsolescence or excess inventory based on historical usage and sales, as well as assumptions about future demand for its products. These estimates for excess and obsolete inventory are reviewed and updated on a quarterly basis. Increases in the inventory reserves result in a corresponding expense, which is recorded to cost of tissue and medical devices sales. Inventories where the sales cycle is estimated to be beyond twelve months are classified as Non-current inventories.
Property and Equipment	Property and Equipment Property and equipment are stated at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the assets, generally three seven
Other Assets	Other Assets Other Assets consist of the short-term and the long-term portion of prepaid expenses, security deposits, the capitalized portion of debt related issuance costs and kits that are used in the implantation of certain biologic products. The items are stated at cost and in the case of debt related issuance costs and kits are amortized on a straight line basis over their estimated useful lives.
Long-Lived Assets	Long-Lived Assets Long-lived assets, including intangible assets, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the estimated fair value of the assets. See Note 5, “Impairment of Assets” below.
Goodwill	Goodwill Goodwill represents the excess of costs over fair value of assets of businesses acquired. Goodwill and intangible assets acquired in a purchase business combination and determined to have indefinite useful lives are not amortized, instead are tested for impairment at least annually and whenever events or circumstances indicate the carrying amount of the asset may not be recoverable. In its evaluation of goodwill, the Company performs an assessment of qualitative factors to determine if it is more-likely-than-not that goodwill might be impaired and whether it is necessary to perform the two-step goodwill impairment. The Company conducts its annual impairment test on December 31 of each year.
Revenue Recognition	Revenue Recognition Revenue is recognized when all of the following criteria are met: a) the Company has entered into a legally binding agreement with the customer; b) the products or services have been delivered; c) the Company’s fee for providing the products and services is fixed or determinable; and d) collection of the Company’s fee is probable. The Company’s policy is to record revenue net of any applicable sales, use, or excise taxes. If an arrangement includes a right of acceptance or a right to cancel, revenue is recognized when acceptance is received or the right to cancel has expired. The Company ships to certain customers under consignment arrangements whereby the Company’s product is stored by the customer. The customer is required to report the use to the Company and upon such notice, the Company invoices the customer and revenue is recognized when above criteria have been met.
Advertising Costs	The Company expenses advertising costs as incurred. The Company had advertising expense of $ 224,297 34,970
Research and Development	Research and Development Research and development costs, which are principally related to internal costs for the development of new devices and biologics and processes are expensed as incurred.
Net Loss Per Share	Net Loss Per Share Basic net income (loss) per share is computed by dividing net income (loss) by the weighted average number of common shares outstanding. Shares issued during the period and shares reacquired during the period are weighted for the portion of the period that they were outstanding. Diluted net income (loss) per share is computed in a manner consistent with that of basic earnings per share while giving effect to all potentially dilutive common shares outstanding during the period, which include the assumed exercise of stock options and warrants using the treasury stock method. Diluted net loss per share was the same as basic net loss per share for the years ended December 31, 2015 and 2014, as shares issuable upon the exercise of stock options and warrants were anti-dilutive as a result of the net losses incurred for those periods. Dilutive earnings per share are not reported as their effects of including 1,942,647 2,350,656
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying values of financial instruments, including trade accounts receivable, accounts payable, other accrued expenses and long-term debt, approximate their fair values based on terms and related interest rates. The Company follows a framework for measuring fair value. The framework provides a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). The three levels of the fair value hierarchy are described below: Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets. Level 2: Inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument. Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement. A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. During the years ended December 31, 2015 and 2014, there was no reclassification in financial assets or liabilities between Level 1, 2 or 3 categories. The following table sets forth by level, within the fair value hierarchy, our liabilities as of December 31, 2015 and December 31, 2014 that are measured at fair value on a recurring basis: Warrant derivative liability As of As of Level 1 - - Level 2 - - Level 3 $ 1,050,351 $ 1,320,371 The valuation technique used to measure fair value of the warrant liability is based on a lattice model and significant assumptions and inputs determined by us (See Note 11, “Warrants” below). Level 3 Changes Warrant derivative liability Balance at January 1, 2015 $ 1,320,371 Gain recognized in earnings (270,020) Balance at December 31 , 2015 $ 1,050,351 During the year ended December 31, 2015, the Company did not change any of the valuation techniques used to measure its liabilities at fair value.
Recent Accounting Pronouncements	In May 2014, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers. The new standard was originally effective for reporting periods beginning after December 15, 2016 and early adoption was not permitted. On August 12, 2015, the FASB approved a one year delay of the effective date to reporting periods beginning after December 15, 2017, while permitting companies to voluntarily adopt the new standard as of the original effective date. The comprehensive new standard will supersede existing revenue recognition guidance and require revenue to be recognized when promised goods or services are transferred to customers in amounts that reflect the consideration to which the company expects to be entitled in exchange for those goods or services. Adoption of the new rules could affect the timing of revenue recognition for certain transactions. The guidance permits two implementation approaches, one requiring retrospective application of the new standard with restatement of prior years and one requiring prospective application of the new standard with disclosure of results under old standards. The Company is currently evaluating when to adopt the new standard, the impacts of adoption and the implementation approach to be used. In April 2015, the FASB issued ASU 2015-3, to simplify the presentation of debt issuance costs. This update requires that debt issuance costs be presented in the balance sheet as a direct deduction from the carrying amount of the associated debt liability, consistent with the required presentation for debt discounts. This update is effective for interim and annual periods beginning after December 15, 2015. ASU 2015-3 is not expected to have a material impact. In February 2016, the FASB issued Accounting Standards Update No. 2016-02, Leases (Topic 842)

Business Description and Summ26

Business Description and Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Revenues by Geographic Region	Revenue by geographical region is as follows: Year Ended 2015 2014 United States $ 56,750,372 $ 34,643,571 Rest of World 2,595,345 688,241 $ 59,345,717 $ 35,331,812
Schedule of Assets and Liabilities Measured on Recurring Basis	Warrant derivative liability As of As of Level 1 - - Level 2 - - Level 3 $ 1,050,351 $ 1,320,371
Schedule of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	The following is a reconciliation of the beginning and ending balances for liabilities measured at fair value on a recurring basis using significant unobservable inputs (Level 3) during the year ended December 31, 2015: Warrant derivative liability Balance at January 1, 2015 $ 1,320,371 Gain recognized in earnings (270,020) Balance at December 31 , 2015 $ 1,050,351

Business Combination (Tables)

Business Combination (Tables)	12 Months Ended
	Dec. 31, 2015
Business Combinations [Abstract]
Schedule of Business Combinations Purchase Price Allocation	components of the aggregate preliminary purchase price for the acquisition were as follows: Cash $ 73,033,018 Fair value of Xtant shares 14,934,146 Total purchase price $ 87,967,164
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The transaction has been accounted for using the acquisition method of accounting, which requires that assets acquired and liabilities assumed be recognized at their fair values as of the Acquisition Date. The following table summarizes the allocation of assets acquired and liabilities assumed as of the Acquisition Date: Allocation of Amortization Accounts receivable $ 5,989,904 Inventories 13,132,697 Prepaids and other current assets 208,116 Property and equipment, net 7,409,667 Cash 57,818 Total tangible assets acquired 26,798,202 Less: liabilities assumed 23,559,164 Net tangible assets less liabilities $ 3,239,038 Intangible assets: Technology 28,698,700 10 Customer relationships 9,911,000 14 Tradename 4,543,300 10 Non-compete agreements 40,500 3 Goodwill 41,534,626 Total purchase price $ 87,967,164
Business Acquisition, Pro Forma Information	Year Ended December 31, 2015 2014 Revenue $ 86,517,599 $ 77,651,056 Net loss $ (5,845,125) $ (15,565,081)

Inventories (Tables)

Inventories (Tables)	12 Months Ended
	Dec. 31, 2015
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories consist of the following: December 31, December 31, 2015 2014 Current inventories Raw materials $ 4,860,914 $ 3,836,635 Work in process 2,720,707 2,484,635 Finished goods 18,289,674 5,163,458 25,871,295 11,484,728 Reserve for obsolescence (3,186,579) (1,926,080) Current inventories, total 22,684,716 9,558,648 Non-current inventories Finished goods 2,021,077 2,860,248 Reserve for obsolescence (413,162) (925,990) Non-current inventories, total 1,607,915 1,934,258 Total inventories $ 24,292,631 $ 11,492,906

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	12 Months Ended
	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment, Net	Property and equipment, net are as follows: December 31, December 31, 2015 2014 Buildings $ - $ 1,657,579 Equipment 5,368,567 4,724,608 Computer equipment 348,404 225,009 Computer software 503,587 345,039 Furniture and fixtures 174,215 153,834 Leasehold improvements 2,661,802 2,380,617 Vehicles 10,000 41,099 Surgical instruments 8,175,578 - Total cost 17,242,153 9,527,785 Less: accumulated depreciation (5,425,524) (4,873,258) $ 11,816,629 $ 4,654,527

Intangible Assets (Tables)

Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets	The following table sets forth information regarding intangible assets: December 31, December 31, Patents 564,717 1,036,580 Acquisition related intangibles: Technology 28,698,700 - Customer relationships 9,911,000 - Tradename 4,543,300 - Non-compete 40,500 - Accumulated amortization (3,520,928) (381,090) Net carrying value $ 40,237,289 $ 655,490 Aggregate amortization expense: $ 3,438,596 $ 77,022
Schedule of Estimated Amortization Expense for Intangible Assets	The following is a summary of estimated future amortization expense for intangible assets as of December 31, 2015: 2016 $ 4,481,492 2017 4,641,781 2018 4,656,956 2019 4,547,754 2020 4,462,079 Thereafter 17,447,227 Total $ 40,237,289

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	12 Months Ended
	Dec. 31, 2015
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	December 31, December 31, 2015 2014 Accrued stock compensation $ 147,037 $ - Wages/commissions payable 3,994,714 1,434,743 Accrued integration expense 646,860 - Accrued interest payable 1,716,167 - Other accrued expenses 3,969,684 486,558 $ 10,474,462 $ 1,921,301

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2015
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt consists of the following: December 31, December 31, Loan payable to ROS Acquisition Offshore (See details above) $ 42,000,000 $ 24,000,000 Adjustment fee was payable to ROS Acquisition Offshore, due in August 2019 - 700,000 6% convertible senior unsecured notes due 2021 (See details above) 68,000,000 PIK Interest payable to ROS 2,700,476 6.00% loan payable to Valley Bank of Belgrade secured by a building that was sold and leased back in the fourth quarter of 2015 - 1,325,814 112,700,476 26,025,814 Less: current portion - (50,671) Debt discount - (5,104,813) Long-term debt $ 112,700,476 $ 20,870,330
Schedule of Maturities of Long-term Debt	The following is a summary of maturities due on the debt as of December 31, 2015: 2016 $ - 2017 - 2018 - 2019 - 2020 44,700,476 Thereafter 68,000,000 Total $ 112,700,476

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	The estimated fair value of stock options granted is done using the Black-Scholes-Merton method applied to individual grants. Key assumptions used to estimate the fair value of stock awards are as follows: Year Ended Year Ended December 31, 2015 December 31, 2014 Risk-free interest rate 1.75 % 1.92 % Expected volatility 80 % 57 % Expected term 6.3 Years 5.4 Years Expected forfeiture rate 20 % 20 % Dividend yield 0 % 0 %
Schedule of Share-based Compensation, Stock Options, Activity	Stock option activity, including options granted under the Plan and the Non-Plan Grants, was as follows: 2015 2014 Weighted Weighted Weighted Average Weighted Average Average Value at Average Value at Shares Price Date Shares Price Date Outstanding at January 1 695,336 $ 11.09 $ 5.35 758,328 $ 14.90 $ 8.60 Granted 45,000 4.00 2.81 169,300 5.78 2.65 Exercised (11,500) 1.00 2.96 (6,666) 10.00 0.04 Cancelled or expired (64,755) 12.58 6.31 (225,626) 11.38 6.07 Outstanding at December 31 664,081 $ 10.64 $ 5.32 695,336 $ 11.09 $ 5.35 Exercisable at December 31 381,988 $ 13.65 $ 6.50 311,080 $ 15.25 $ 7.35

Warrants (Tables)

Warrants (Tables)	12 Months Ended
	Dec. 31, 2015
Warrants and Rights Note Disclosure [Abstract]
Schedule of Warrant Activity	The following table summarizes our warrant activities for the period ended December 31, 2015: Weighted Common Average Stock Exercise Warrants Price Outstanding as of January 1, 2014 1,087,820 $ 16.20 Issued 571,500 7.12 Expired (4,000) 20.00 Outstanding at January 1, 2015 1,655,320 $ 13.06 Issued - - Expired (376,754) 22.87 Outstanding at December 31, 2015 1,278,566 $ 8.45
Schedule of Warrant Valuation Assumptions	The estimated fair value was derived using the lattice model with the following weighted-average assumptions: Year Ended December 31, 2015 2014 Value of underlying common stock (per share) $ 2.80 $ 3.03 Risk free interest rate 1.02 % 0.80 % Expected term 4.08 years 5.00 years Volatility 79 % 75 % Dividend yield 0 % 0 %
Schedule of Warrants Activities Used In Derivative Liability	The following table summarizes our activities related to warrants accounted for as a derivative liability for the year ended December 31, 2015 and 2014: 2015 2014 Balance at January 1, 1,171,692 600,192 Derivative warrants issued - 571,500 Derivative warrants exercised - - Expired (46,573) - Balance at December 31, 1,125,119 1,171,692

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Schedule of Future Minimum Rental Payments for Operating Leases	Future minimum payments for the next five years and thereafter as of December 31, 2015, under these leases, are as follows: 2016 $ 775,141 2017 451,327 2018 462,678 2019 348,141 2020 342,638 Thereafter 1,386,653 Total $ 3,766,578

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income Loss Before Provision For Income Taxes	Year Ended December 31, 2015 2014 United States $ (19,711,838) $ (10,507,869) $ (19,711,838) $ (10,507,869)
Schedule of Components of Income Tax Expense (Benefit)	The components of the income tax provision are as follows: Year Ended December 31, 2015 2014 Current: Federal $ - $ - State - - Total current - - Deferred: Federal (15,117,246) - State (2,420,162) - Total deferred (17,537,408) - $ (17,537,408) $ -
Schedule of Effective Income Tax Rate Reconciliation	The reconciliation of income tax attributable to operations computed at the U.S. Federal statutory income tax rate of 35 Year Ended December 31, 2015 2014 Statutory Federal tax rate $ (6,898,830) $ (3,677,754) Valuation allowance 7,089,311 4,909,776 State income taxes, net of Federal benefit (1,104,199) (368,826) Purchase accounting valuation reversal (17,537,408) - Change in state income tax rate (1,277,303) 277,076 Provision to return adjustment - (505,423) Change in Warrant Derivative Liability (109,633) (668,554) Other deferred tax adjustment 581,444 - Acquisition expenses 527,646 - Non-cash interest 1,096,446 - Other 1,762 - Nondeductible meals, entertainment and other expense 93,356 33,705 $ (17,537,408) $ -
Schedule of Deferred Tax Assets and Liabilities	At December 31, 2015 2014 Deferred tax assets: Current deferred tax assets Accrued liability for vacation $ 139,162 $ 102,643 Accrued commissions and bonuses/compensation 1,369,265 - Accrued contingencies 142,107 - Bad debt reserve 1,047,382 536,440 Charitable contributions carryforward 38,283 33,124 Inventory reserve 1,461,566 1,098,333 Reserve - assets held for sale - 351,423 Net operating loss carryovers 22,698,555 18,200,823 Stock warrants 139,056 131,891 Stock option compensation 2,058,631 1,594,460 Goodwill amortization - 82,212 Debt discount and waiver amortization 1,577,347 1,076,926 Depreciation - 244,004 Amortization - 30,290 Other 47,593 - Total non-current deferred tax assets 30,718,947 23,482,569 Valuation allowance (13,065,176) (23,482,569) Net non-current deferred tax assets 17,653,771 - Deferred tax liabilities: Depreciation (1,566,381) - Amortization (16,087,390) - Total deferred tax liabilities (17,653,771) - Net deferred tax assets $ - $ -

Employee Benefit Plans (Tables)

Employee Benefit Plans (Tables)	12 Months Ended
	Dec. 31, 2015
Compensation and Retirement Disclosure [Abstract]
Schedule of Defined Benefit Plans Disclosures [Table Text Block]	Xtant currently has two 401(k) retirement plans for its employees. Under both plans, the employee becomes qualified after six months of employment. The Company is in the process of integrating the two plans. Terms for the two plans are as follows: Bacterin X-Spine Matching 2% None Contribution Limit Enrollment Period Four times a year

Supplemental Disclosure of Ca38

Supplemental Disclosure of Cash Flow Information (Tables)	12 Months Ended
	Dec. 31, 2015
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow Information	Supplemental cash flow information is as follows: Year Ended December 31, 2015 2014 Supplemental disclosure of cash flow information Cash paid during the period for: Interest $ 2,279,919 $ 3,192,854 Non-cash activities: Issuance of warrants related to stock issuance - 1,461,796 Issuance of shares related to debt issuance $ - $ 1,094,999 Issuance of shares for non-cash consulting expense $ - $ 81,924 Issuance of restricted stock to employees $ - $ 136,977 Issuance of shares in conjunction with the acquisition of X-spine $ 14,934,146 $ - Issuance of capital leases $ 70,921 $ -

Business Description and Summ39

Business Description and Summary of Significant Accounting Policies (Details) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total Revenues	$ 59,345,717	$ 35,331,812
US [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total Revenues	56,750,372	34,643,571
Rest Of World [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total Revenues	$ 2,595,345	$ 688,241

Business Description and Summ40

Business Description and Summary of Significant Accounting Policies (Details 1) - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	$ 1,050,351	$ 1,320,371
Fair Value, Inputs, Level 1 [Member] | Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	0	0
Fair Value, Inputs, Level 2 [Member] | Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	0	0
Fair Value, Inputs, Level 3 [Member] | Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	$ 1,050,351	$ 1,320,371

Business Description and Summ41

Business Description and Summary of Significant Accounting Policies (Details 2)	12 Months Ended
	Dec. 31, 2015USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Balance at January 1, 2015	$ 1,320,371
Gain recognized in earnings	(270,020)
Balance at December 31 , 2015	$ 1,050,351

Business Description and Summ42

Business Description and Summary of Significant Accounting Policies (Details Textual) - USD ($)	Sep. 04, 2015	Aug. 06, 2014	Jul. 31, 2015	Jul. 28, 2014	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2015	Dec. 31, 2014	Mar. 16, 2015	Dec. 31, 2013
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Advertising Expense							$ 224,297	$ 34,970
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount							1,942,647	2,350,656
Royalty Revenue Description							The Company also receives royalty revenue from third parties related to licensing agreements which represented less than 1% of total revenue for the years ended December 31, 2015 and 2014.
Proceeds From Issuance Or Sale Of Equity Gross		$ 6,500,000
Class of Warrant or Right, Exercise Price of Warrants or Rights							$ 8.45	$ 13.06		$ 16.2
Proceeds from Issuance or Sale of Equity, Total		5,900,000
Stockholders' Equity, Reverse Stock Split				1:10 reverse split
Stock Issued During Period, Value, New Issues							$ 515,395	$ 5,869,635
Other Non Cash Expense Associated With Stock Purchase Agreement							558,185	0
Business Combination, Consideration Transferred			$ 60,000,000
Proceeds from Issuance of Private Placement							515,395	0
Common Stock, Value, Issued		$ 1,461,796					11	$ 7
Debt [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other Payments to Acquire Businesses			$ 13,000,000
Aspire Capital Fund LLC [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Stock Issued During Period, Shares, New Issues					417,000	207,182
Common Stock To Be Issued For Commitment Fee						154,189
Common Stock, Shares Subscribed but Unissued									10,000,000
Stock Issued During Period, Value, New Issues					$ 1,366,941	$ 750,000
Share Price						$ 3.62
Other Non Cash Expense Associated With Stock Purchase Agreement						$ 558,185	$ 558,185
Common Stock [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Stock Issued During Period, Shares, New Issues		1,143,000					140,053	1,143,000
Shares Issued, Price Per Share		$ 5.70
Stock Issued During Period, Value, New Issues							$ 0	$ 2
Business Acquisition Number Of Shares Acquired			4,240,000
Private Placement [Member] | Common Stock [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Stock Issued During Period, Shares, New Issues	140,053
Proceeds from Issuance of Private Placement	$ 515,395
August 2014 Warrants [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights		571,500
Class of Warrant or Right, Exercise Price of Warrants or Rights		$ 7.12
Class Of Warrant Or Right Term							5 years
Sales Revenue, Net [Member] | Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Concentration Risk, Percentage							1.00%	1.00%
Sales Revenue, Net [Member] | One Vendor [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Concentration Risk, Percentage							12.00%
Building [Member] | Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Property, Plant and Equipment, Useful Life							7 years
Computers and Equipment [Member] | Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Property, Plant and Equipment, Useful Life							3 years
Geographic Concentration Risk [Member] | Sales Revenue, Net [Member] | US [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Concentration Risk, Percentage							95.00%	98.00%

Business Combination (Details)

Business Combination (Details)	Dec. 31, 2015USD ($)
Cash	$ 73,033,018
Fair value of Xtant shares	14,934,146
Total purchase price	$ 87,967,164

Business Combination (Details 1

Business Combination (Details 1) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Total tangible assets acquired	$ 26,798,202
Less: liabilities assumed	23,559,164
Net tangible assets less liabilities	3,239,038
Goodwill	41,534,626	$ 0
Total purchase price	87,967,164
Technology-Based Intangible Assets [Member]
Intangible assets	$ 28,698,700
Amortization period (in years)	10 years
Customer Relationships [Member]
Intangible assets	$ 9,911,000
Amortization period (in years)	14 years
Trade Names [Member]
Intangible assets	$ 4,543,300
Amortization period (in years)	10 years
Noncompete Agreements [Member]
Intangible assets	$ 40,500
Amortization period (in years)	3 years
Accounts Receivable [Member]
Total tangible assets acquired	$ 5,989,904
Inventories [Member]
Total tangible assets acquired	13,132,697
Prepaids And Other Current Assets [Member]
Total tangible assets acquired	208,116
Property And Equipment Net [Member]
Total tangible assets acquired	7,409,667
Cash [Member]
Total tangible assets acquired	$ 57,818

Business Combination (Details 2

Business Combination (Details 2) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Revenue	$ 86,517,599	$ 77,651,056
Net loss	$ (5,845,125)	$ (15,565,081)

Business Combination (Details T

Business Combination (Details Textual) - USD ($) shares in Thousands	1 Months Ended		12 Months Ended
	Jul. 31, 2015	Jul. 31, 2014	Dec. 31, 2015	Dec. 31, 2014
Payments to Acquire Businesses, Gross			$ 250,000
Debt Instrument, Face Amount	$ 65,000,000
Net Income (Loss) Attributable to Parent, Total			(2,174,430)	$ (10,507,869)
Business Combination, Acquisition Related Costs			4,900,000
Xspine [Member]
Payments to Acquire Businesses, Gross	60,000,000
Other Payments to Acquire Businesses	13,000,000
Stock Issued During Period, Shares, Acquisitions		4,240
Debt Instrument, Face Amount	$ 68,000,000
Debt Instrument, Interest Rate During Period	6.00%
Net Income (Loss) Attributable to Parent, Total			$ 288,824

Equity (Details Textual)

Equity (Details Textual) - USD ($)	Oct. 08, 2015	Sep. 04, 2015	Aug. 06, 2014	Jul. 31, 2015	Mar. 16, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Schedule of Equity Method Investments [Line Items]
Proceeds from Issuance or Sale of Equity, Total			$ 5,900,000
Proceeds From Issuance Or Sale Of Equity Gross			$ 6,500,000
Class of Warrant or Right, Exercise Price of Warrants or Rights								$ 8.45	$ 13.06	$ 16.2
Stock Issued During Period, Value, New Issues								$ 515,395	$ 5,869,635
Warrant Expiration Period, Description			The warrants have a five year term and expire on August 6, 2019.
Other Non Cash Expense Associated With Stock Purchase Agreement								$ 558,185	$ 0
ROS Acquisition Offshore LP [Member]
Schedule of Equity Method Investments [Line Items]
Proceeds from Lines of Credit							$ 4,000,000
Stock Issued During Period, Shares, Acquisitions							150,000
Restricted Stock [Member]
Schedule of Equity Method Investments [Line Items]
Stock issued (in shares)	78,510
Stock Issued During Period, Price Per Share	$ 3.19
Shares Issued, Price Per Share				$ 3.40
Stock Issued During Period, Value, New Issues	$ 250,447
Common Stock [Member]
Schedule of Equity Method Investments [Line Items]
Stock issued (in shares)			1,143,000					140,053	1,143,000
Shares Issued, Price Per Share			$ 5.70
Stock Issued During Period, Value, New Issues								$ 0	$ 2
Stock Issued During Period, Shares, Acquisitions				4,242,655				4,242,655
August 2014 Warrants [Member]
Schedule of Equity Method Investments [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights			571,500
Class of Warrant or Right, Exercise Price of Warrants or Rights			$ 7.12
Private Placement [Member] | Common Stock [Member]
Schedule of Equity Method Investments [Line Items]
Stock issued (in shares)		140,053
Private Placement [Member] | Common Stock [Member] | Board Of Directors [Member]
Schedule of Equity Method Investments [Line Items]
Stock issued (in shares)		140,053
Stock Issued During Period, Value, New Issues		$ 515,395
Aspire Capital Fund LLC [Member]
Schedule of Equity Method Investments [Line Items]
Stock issued (in shares)						417,000	207,182
Common Stock, Shares Subscribed but Unissued					10,000,000
Stock Issued During Period, Value, New Issues						$ 1,366,941	$ 750,000
Common Stock To Be Issued For Commitment Fee							154,189
Maximum Common Stock To Be Issued Per Trading Day					50,000
Maximum Common Stock Value To Be Issued Per Trading Day					$ 500,000
Maximum Percentage Of Common Stock Weighted Average Price					30.00%
Other Non Cash Expense Associated With Stock Purchase Agreement							$ 558,185	$ 558,185
X Sspine [Member] | Restricted Stock [Member]
Schedule of Equity Method Investments [Line Items]
Stock Issued During Period, Price Per Share	$ 3.19
Stock Issued During Period, Value, New Issues	$ 250,447
X Sspine [Member] | Common Stock [Member]
Schedule of Equity Method Investments [Line Items]
Stock Issued During Period, Value, New Issues				$ 60,000,000
Repayments of Debt				$ 13,000,000

Inventories (Details)

Inventories (Details) - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Current inventories
Raw materials	$ 4,860,914	$ 3,836,635
Work in process	2,720,707	2,484,635
Finished goods	18,289,674	5,163,458
Inventory, Gross	25,871,295	11,484,728
Reserve for obsolescence	(3,186,579)	(1,926,080)
Current inventories, total	22,684,716	9,558,648
Non-current inventories
Finished goods	2,021,077	2,860,248
Reserve for obsolescence	(413,162)	(925,990)
Non-current inventories, total	1,607,915	1,934,258
Total inventories	$ 24,292,631	$ 11,492,906

Impairment of Assets (Details T

Impairment of Assets (Details Textual) - USD ($)	3 Months Ended	12 Months Ended
	Sep. 30, 2015	Dec. 31, 2015	Dec. 31, 2014
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Disposal Group, Including Discontinued Operation, Property, Plant and Equipment			$ 80,042
Disposal Group, Including Discontinued Operation, Inventory			832,507
Disposal Group, Including Discontinued Operation, Assets			0
Asset Impairment Charges		$ 233,748	$ 912,549
Payments to Acquire Businesses, Gross		250,000
Contingent Payment		100,000
Depreciation, Amortization and Accretion, Net, Total	$ 285,224
Gain (Loss) on Sale of Assets and Asset Impairment Charges		$ 51,476
Gross Profit [Member] | Minimum [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Concentration Risk, Percentage		1.00%	1.00%
Sales Revenue, Net [Member] | Minimum [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Concentration Risk, Percentage		1.00%	1.00%

Property and Equipment, Net (De

Property and Equipment, Net (Details) - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Total cost	$ 17,242,153	$ 9,527,785
Less: accumulated depreciation	(5,425,524)	(4,873,258)
Property and equipment, net	11,816,629	4,654,527
Building [Member]
Property, Plant and Equipment [Line Items]
Total cost	0	1,657,579
Equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	5,368,567	4,724,608
Computer equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	348,404	225,009
Computer software[Member]
Property, Plant and Equipment [Line Items]
Total cost	503,587	345,039
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Total cost	174,215	153,834
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Total cost	2,661,802	2,380,617
Vehicles [Member]
Property, Plant and Equipment [Line Items]
Total cost	10,000	41,099
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Total cost	$ 8,175,578	$ 0

Property and Equipment, Net (51

Property and Equipment, Net (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Capital Leased Assets, Gross	$ 349,162
Capital Leases, Lessee Balance Sheet, Assets by Major Class, Accumulated Depreciation	147,980
Cost of Property Repairs and Maintenance	366,323	$ 293,707
Depreciation	$ 676,540	$ 570,726
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Useful Life	5 years

Intangible Assets (Details)

Intangible Assets (Details) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Finite Lived Intangible Assets Future Amortization Expense [Line Items]
Accumulated amortization	$ (3,520,928)	$ (381,090)
Net carrying value	40,237,289	655,490
Aggregate amortization expense:	3,438,596	77,022
Patents [Member]
Finite Lived Intangible Assets Future Amortization Expense [Line Items]
Gross carrying value	564,717	1,036,580
Technology [Member]
Finite Lived Intangible Assets Future Amortization Expense [Line Items]
Gross carrying value	28,698,700	0
Customer relationships [Member]
Finite Lived Intangible Assets Future Amortization Expense [Line Items]
Gross carrying value	9,911,000	0
Tradename [Member]
Finite Lived Intangible Assets Future Amortization Expense [Line Items]
Gross carrying value	4,543,300	0
Non-compete [Member]
Finite Lived Intangible Assets Future Amortization Expense [Line Items]
Gross carrying value	$ 40,500	$ 0

Intangible Assets (Details 1)

Intangible Assets (Details 1) - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Estimated amortization expense:
2,016	$ 4,481,492
2,017	4,641,781
2,018	4,656,956
2,019	4,547,754
2,020	4,462,079
Thereafter	17,447,227
Total	$ 40,237,289	$ 655,490

Accrued Liabilities (Details)

Accrued Liabilities (Details) - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Accrued Liabilities [Line Items]
Accrued stock compensation	$ 147,037	$ 0
Wages/commissions payable	3,994,714	1,434,743
Accrued integration expense	646,860	0
Other accrued expenses	3,969,684	486,558
Accrued interest payable	1,716,167	0
Accrued Liabilities Current	$ 9,595,851	$ 1,921,301

Long-Term Debt (Details)

Long-Term Debt (Details) - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Loan Payable	$ 112,700,476	$ 26,025,814
Less: current portion	0	(50,671)
Debt discount	0	(5,104,813)
Long-term debt	44,700,476	20,870,330
Ros Acquisition Offshore [Member]
Debt Instrument [Line Items]
Loan Payable	42,000,000	24,000,000
Adjustment fee payable to ROS Acquisition Offshore, due in August 2019	0	700,000
Valley Bank Of Belgrade [Member]
Debt Instrument [Line Items]
Loan Payable	0	$ 1,325,814
Convertible Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Loan Payable	68,000,000
Payment in Kind (PIK) Note [Member]
Debt Instrument [Line Items]
Loan Payable	$ 2,700,476

Long-Term Debt (Details 1)

Long-Term Debt (Details 1)	Dec. 31, 2015USD ($)
Schedule of maturities due on debt [Line Items]
2,016	$ 0
2,017	0
2,018	0
2,019	0
2,020	44,700,476
Thereafter	68,000,000
Total	$ 112,700,476

Long-Term Debt (Details Textual

Long-Term Debt (Details Textual) - USD ($)	Aug. 10, 2015	Mar. 06, 2014	Jul. 31, 2015	Dec. 31, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Royalty Expenses Description				royalty of 1.75% on the first $45,000,000 of net sales, plus 1.0% of net sales in excess of $45,000,000.
Royalty Expense				$ 7,400,000
Debt Instrument, Face Amount			$ 65,000,000
Business Acquisition, Percentage of Voting Interests Acquired			100.00%
Business Combination Conjunction Related Expenses			$ 4,800,000
Payments of Debt Issuance Costs			$ 2,200,000
Business Combination Expenses Related To Future Acquisition				2,500,000
Line of Credit Facility, Expiration Date			Jul. 15, 2021
Gains (Losses) on Extinguishment of Debt, Total				2,345,019	$ 0
Extinguishment of Debt, Amount				12,300,000
Xspine [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate During Period			6.00%
New Facility [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Current Borrowing Capacity			$ 18,000,000
Line of Credit Facility, Expiration Date			Jul. 31, 2020
Gains (Losses) on Extinguishment of Debt, Total				$ 2,345,019
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount			$ 52,000,000
Debt Instrument, Interest Rate During Period			6.00%
Debt Instrument Purchase Of Additional Notes	$ 3,000,000
Conversion of Stock, Shares Converted			257.5163
Conversion of Stock, Amount Converted			$ 1,000
Debt Instrument, Convertible, Conversion Price			$ 3.88
Valley Bank Of Belgrade [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate During Period				6.00%
Ros Acquisition Offshore [Member]
Debt Instrument [Line Items]
Debt Conversion, Converted Instrument, Shares Issued		150,000
Proceeds from Lines of Credit		$ 4,000,000

Stock-Based Compensation (Detai

Stock-Based Compensation (Details)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Risk-free interest rate	1.75%	1.92%
Expected volatility	80.00%	57.00%
Expected term	6 years 3 months 18 days	5 years 4 months 24 days
Expected forfeiture rate	20.00%	20.00%
Dividend yield	0.00%	0.00%

Stock-Based Compensation (Det59

Stock-Based Compensation (Details 1) - Stock Option - $ / shares	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Schedule of activity under stock option plans [Line Items]
Outstanding at January 1, 2015, Shares	695,336	758,328
Granted, Shares	45,000	169,300
Exercised, Shares	(11,500)	(6,666)
Cancelled or expired, Shares	(64,755)	(225,626)
Outstanding at December 31, Shares	664,081	695,336
Exercisable at December 31, 2015, Shares	381,988	311,080
Outstanding at January 1, 2015, Weighted Average Exercise Price	$ 11.09	$ 14.90
Granted, Weighted Average Exercise Price	4	5.78
Exercised, Weighted Average Exercise Price	1	10
Cancelled or expired, Weighted Average Exercise Price	12.58	11.38
Outstanding at December 31, 2015, Weighted Average Exercise Price	10.64	11.09
Exercisable at December 31, 2015, Weighted Average Exercise Price	13.65	15.25
Outstanding at January 1, 2015, Weighted Average Fair Value At Grant Date	5.35	8.60
Granted, Weighted Average Fair Value At Grant Date	2.81	2.65
Exercised, Weighted Average Fair Value At Grant Date	2.96	0.04
Cancelled or expired, Weighted Average Fair Value At Grant Date	6.31	6.07
Outstanding at December 31, 2015, Weighted Average Fair Value At Grant Date	5.32	5.35
Exercisable at December 31, Weighted Average Fair Value At Grant Date	$ 6.50	$ 7.35

Stock-Based Compensation (Det60

Stock-Based Compensation (Details Textual) - USD ($)	Oct. 08, 2015	Nov. 10, 2014	Jul. 31, 2015	Jul. 31, 2014	Aug. 31, 2013	Dec. 31, 2015	Dec. 31, 2014
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Shares authorized under the Plan						1,400,000
Aggregate intrinsic value of options outstanding						470,000
Allocated Share-based Compensation Expense						$ 569,705	$ 935,316
Stock Issued During Period, Value, New Issues						515,395	5,869,635
Chief Executive Officer [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Options granted					200,000
President [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Options granted				55,000
Employee Stock Option [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Employee Service Share-based Compensation, Nonvested Awards, Total Compensation Cost Not yet Recognized, Stock Options						$ 282,093
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options	$ 65,550
Shares Issued, Price Per Share	$ 3.19
Share-Based Compensation Arrangement By Share-Based Payment Award, Options, Exercisable, Weighted Average Exercise Price						$ 3.72
Employee Service Share-based Compensation, Tax Benefit from Compensation Expense						$ 699,000
Stock Issued During Period, Shares, Restricted Stock Award, Gross	20,000
Restricted Stock [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Allocated Share-based Compensation Expense						246,165	$ 135,075
Share-Based Compensation Arrangement By Share-Based Payment Award, Equity Instruments Other Than Options, Grants In Period		39,312
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options		$ 160,000	$ 200,000			25,045
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Issue Price On Grand Date		$ 4.07
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures, Total			58,820
Shares Issued, Price Per Share			$ 3.40
Stock Issued During Period, Value, New Issues	$ 250,447
Stock Issued During Period, Shares, New Issues	78,510
Stock Issued During Period, Price Per Share	$ 3.19
Restricted Stock [Member] | General and Administrative Expense [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options	$ 5,296					$ 100,000

Warrants (Details)

Warrants (Details) - $ / shares	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Warrant activity [Line Items]
Outstanding	1,655,320	1,087,820
Issued, Shares	0	571,500
Expired, Shares	(376,754)	(4,000)
Outstanding	1,278,566	1,655,320
Outstanding Weighted Average Exercise Price	$ 13.06	$ 16.2
Issued, Weighted Average Exercise Price	0	7.12
Expired, Weighted Average Exercise Price	22.87	20
Outstanding Weighted Average Exercise Price	$ 8.45	$ 13.06

Warrants (Details 1)

Warrants (Details 1) - Warrant [Member] - $ / shares	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Value of underlying common stock (per share)	$ 2.8	$ 3.03
Risk free interest rate	1.02%	0.80%
Expected term	4 years 29 days	5 years
Volatility	79.00%	75.00%
Dividend yield	0.00%	0.00%

Warrants (Details 2)

Warrants (Details 2) - shares	9 Months Ended	12 Months Ended
	Sep. 30, 2014	Dec. 31, 2015	Dec. 31, 2014
Class of Warrant or Right [Line Items]
Outstanding	1,087,820	1,655,320	1,087,820
Derivative warrants issued		0	571,500
Outstanding		1,278,566	1,655,320
Warrant [Member]
Class of Warrant or Right [Line Items]
Outstanding	600,192	1,171,692	600,192
Derivative warrants issued	571,500	0
Derivative warrants exercised	0	0
Expired		(46,573)	0
Outstanding	1,171,692	1,125,119	1,171,692

Warrants (Details Textual)

Warrants (Details Textual)	12 Months Ended
	Dec. 31, 2015USD ($)
Class of Warrant or Right [Line Items]
Unrealized Loss On Warranty Derivative Liability	$ 270,020

Commitments and Contingencies65

Commitments and Contingencies (Details)	Dec. 31, 2015USD ($)
Schedule of future minimum payments by operating lease [Line Items]
2,016	$ 775,141
2,017	451,327
2,018	462,678
2,019	348,141
2,020	342,638
Thereafter	1,386,653
Total	$ 3,766,578

Commitments and Contingencies66

Commitments and Contingencies (Details Textual) - USD ($)	1 Months Ended	12 Months Ended
	Mar. 17, 2014	Dec. 31, 2015	Dec. 31, 2014	Oct. 23, 2015
Schedule of commitment and contingencies [Line Items]
Operating Leases, Rent Expense, Net		$ 544,000	$ 365,000
Loss Contingency, Damages Sought, Value	$ 5,000,000
Loans Payable [Member]
Schedule of commitment and contingencies [Line Items]
Debt Instrument, Interest Rate, Stated Percentage				6.00%

Income Taxes (Details)

Income Taxes (Details) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Line Items]
Net Income	$ (2,174,430)	$ (10,507,869)
Domestic Tax Authority [Member]
Income Tax Disclosure [Line Items]
Net Income	$ (19,711,838)	$ (10,507,869)

Income Taxes (Details 1)

Income Taxes (Details 1) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Current:
Federal	$ 0	$ 0
State	0	0
Total current	0	0
Deferred:
Federal	(15,117,246)	0
State	(2,420,162)	0
Total deferred	(17,537,408)	0
Total Income Tax	$ (17,537,408)	$ 0

Income Taxes (Details 2)

Income Taxes (Details 2) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Line Items]
Statutory Federal tax rate	$ (6,898,830)	$ (3,677,754)
Valuation allowance	7,089,311	4,909,776
State income taxes, net of Federal benefit	(1,104,199)	(368,826)
Purchase accounting valuation reversal	(17,537,408)	0
Change in state income tax rate	(1,277,303)	277,076
Provision to return adjustment	0	(505,423)
Change in Warrant Derivative Liability	(109,633)	(668,554)
Other deferred tax adjustment	581,444	0
Acquisition expenses	527,646	0
Non-cash interest	1,096,446	0
Other	1,762	0
Nondeductible meals, entertainment and other expense	93,356	33,705
Total Income Tax Expense\Benefit	$ (17,537,408)	$ 0

Income Taxes (Details 3)

Income Taxes (Details 3) - USD ($)	Dec. 31, 2015	Dec. 31, 2014
Current deferred tax assets
Accrued liability for vacation	$ 139,162	$ 102,643
Accrued commissions and bonuses/compensation	1,369,265	0
Accrued contingencies	142,107	0
Bad debt reserve	1,047,382	536,440
Charitable contributions carryforward	38,283	33,124
Inventory reserve	1,461,566	1,098,333
Reserve - assets held for sale	0	351,423
Noncurrent deferred tax assets
Net operating loss carryovers	22,698,555	18,200,823
Stock warrants	139,056	131,891
Stock option compensation	2,058,631	1,594,460
Goodwill amortization	0	82,212
Debt discount and waiver amortization	1,577,347	1,076,926
Depreciation	0	244,004
Amortization	0	30,290
Other	47,593	0
Total non-current deferred tax assets	30,718,947	23,482,569
Valuation allowance	(13,065,176)	(23,482,569)
Net non-current deferred tax assets	17,653,771	0
Deferred tax liabilities:
Depreciation	(1,566,381)	0
Amortization	(16,087,390)	0
Total deferred tax liabilities	(17,653,771)	0
Net deferred tax assets	$ 0	$ 0

Income Taxes (Details Textual)

Income Taxes (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Line Items]
Valuation Allowance, Deferred Tax Asset, Change in Amount	$ 10,417,393	$ 4,909,776
Operating Loss Carryforwards	$ 55,905,000	47,263,000
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent	35.00%
Operating Loss Carryforward Expiration Dates1	Federal net operating loss carryovers expire at various dates between 2025 and 2035, while state net operating loss carryovers expire between 2025 and 2035.
Operating Loss Carryforwards, Limitations on Use	Events which cause limitations in the amount of net operating losses that the Company may utilize in any one year include, but are not limited to, a cumulative ownership change of more than 50%, as defined, over a three year period.
Finite-lived Intangible Assets Acquired	$ 43,193,500
Deferred Income Tax Expense (Benefit)	$ 17,537,408	$ 0

Employee Benefit Plans (Details

Employee Benefit Plans (Details)	12 Months Ended
	Dec. 31, 2015
Bacterin Employee [Member]
Defined Benefit Plans and Other Postretirement Benefit Plans Table Text Block [Line Items]
Defined Contribution Plan, Maximum Annual Contributions Per Employee, Percent	2.00%
Defined Benefit Plan Contributions Contribution Limit	$18,000 or the statutorily prescribed limit
Defined Benefit Plan Contributions Enrollment Period	Twice a year
X-Spine Employee [Member]
Defined Benefit Plans and Other Postretirement Benefit Plans Table Text Block [Line Items]
Defined Contribution Plan, Maximum Annual Contributions Per Employee, Percent	0.00%
Defined Benefit Plan Contributions Contribution Limit	$18,000 or $24,000 if over the age of 50
Defined Benefit Plan Contributions Enrollment Period	Four times a year

Supplemental Disclosure of Ca73

Supplemental Disclosure of Cash Flow Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Cash paid during the period for:
Interest	$ 2,279,919	$ 3,192,854
Non-cash activities:
Issuance of warrants related to stock issuance	0	1,461,796
Issuance of shares related to debt issuance	0	1,094,999
Issuance of share for non-cash consulting expense	246,165	135,075
Issuance of restricted stock to employees	0	136,977
Issuance of shares in conjunction with the acquisition of X-spine	14,934,146	0
Issuance of capital leases	$ 70,921	$ 0

Related Party Transactions (Det

Related Party Transactions (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
One Vendor [Member] | Sales Revenue, Net [Member]
Related Party Transaction [Line Items]
Concentration Risk, Percentage	12.00%
Chief Operating Officer [Member]
Related Party Transaction [Line Items]
Amount of related party transaction	$ 5,000
American Donor Services [Member]
Related Party Transaction [Line Items]
Amount of related party transaction	$ 1,853,457	$ 2,406,926