PROCEPT BioRobotics (PRCT) 10-Q 2 Nov 23 2023 Q3 Quarterly report Financial data

Cover page

Cover page - shares	9 Months Ended
	Sep. 30, 2023	Oct. 27, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
Document Transition Report	false
Entity File Number	001-40797
Entity Registrant Name	PROCEPT BioRobotics Corporation
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	26-0199180
Entity Address, Address Line One	150 Baytech Drive
Entity Address, City or Town	San Jose
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	95134
City Area Code	650
Local Phone Number	232-7200
Title of 12(b) Security	Common stock, $0.00001 par value per share
Trading Symbol	PRCT
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		50,498,621
Entity Central Index Key	0001588978
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Amendment Flag	false
Document Fiscal Period Focus	Q3

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 287,087	$ 221,859
Restricted cash, current	777	777
Accounts receivable, net	34,622	15,272
Inventory	42,201	28,543
Prepaid expenses and other current assets	3,981	6,175
Total current assets	368,668	272,626
Restricted cash	3,038	3,038
Property and equipment, net	27,032	8,656
Operating lease right-of-use assets, net	20,699	23,481
Intangible assets, net	1,273	1,477
Other assets	415	51
Total assets	421,125	309,329
Current liabilities:
Accounts payable	13,597	9,391
Accrued compensation	13,265	13,447
Deferred revenue, current	5,007	2,855
Operating lease, current	1,702	2,129
Other current liabilities	7,785	7,468
Total current liabilities	41,356	35,290
Long-term debt	51,307	51,213
Operating lease, non-current	26,730	23,975
Loan facility derivative liability	1,859	1,779
Deferred revenue, non-current	517	0
Total liabilities	121,769	112,257
Commitments and contingencies (see Note 12)
Stockholders’ equity:
Preferred stock, $0.00001 par value; Authorized shares: 10,000 at June 30, 2023 and December 31, 2022, Issued and outstanding shares: none at June 30, 2023 and December 31, 2022	0	0
Common stock, $0.00001 par value; Authorized shares: 300,000 at June 30, 2023 and December 31, 2022, Issued and outstanding shares: 45,000 and 44,828 at June 30, 2023 and December 31, 2022, respectively	0	0
Additional paid-in capital	726,428	545,753
Accumulated other comprehensive loss	(6)	(6)
Accumulated deficit	(427,066)	(348,675)
Total stockholders’ equity	299,356	197,072
Total liabilities and stockholders’ equity	$ 421,125	$ 309,329

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets - Parentheticals - $ / shares	Sep. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.00001	$ 0.00001
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.00001	$ 0.00001
Common stock, shares authorized (in shares)	300,000,000	300,000,000
Common stock, shares issued (in shares)	50,473,000	44,828,000
Common stock, shares, outstanding (in shares)	50,473,000	44,828,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Revenue	$ 35,102	$ 20,349	$ 92,610	$ 51,237
Cost of sales	16,228	10,118	42,816	24,828
Gross profit	18,874	10,231	49,794	26,409
Operating expenses:
Research and development	11,600	7,582	33,950	19,299
Selling, general and administrative	32,883	24,754	95,457	62,794
Total operating expenses	44,483	32,336	129,407	82,093
Loss from operations	(25,609)	(22,105)	(79,613)	(55,684)
Interest expense	(1,019)	(1,455)	(2,870)	(4,317)
Interest and other income, net	2,006	947	4,090	1,019
Net loss	$ (24,622)	$ (22,613)	$ (78,393)	$ (58,982)
Net loss per share, basic (in dollars per share)	$ (0.51)	$ (0.51)	$ (1.70)	$ (1.33)
Net loss per share, diluted (in dollars per share)	$ (0.51)	$ (0.51)	$ (1.70)	$ (1.33)
Weighted-average common shares used to compute net loss per share attributable to common shareholders
Basic (in shares)	48,310	44,640	46,131	44,276
Diluted (in shares)	48,310	44,640	46,131	44,276
Other comprehensive loss:
Unrealized gain on cash equivalents	$ 0	$ 185	$ 0	$ 271
Comprehensive loss	$ (24,622)	$ (22,428)	$ (78,393)	$ (58,711)

Condensed Consolidated Statem_2

Condensed Consolidated Statements Of Stockholders’ Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Gain (Loss)	Accumulated Deficit
Balance at the beginning of the period (in shares) at Dec. 31, 2021		43,676
Balance at the beginning of the period at Dec. 31, 2021	$ 267,091	$ 0	$ 528,666	$ (54)	$ (261,521)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under stock plans (in shares)		401
Issuance of common stock under stock plans	1,291		1,291
Stock-based compensation expense	1,552		1,552
Unrealized gain (loss) on cash equivalents	1			1
Net loss	(17,185)				(17,185)
Balance at the end of the period (in shares) at Mar. 31, 2022		44,077
Balance at the end of the period at Mar. 31, 2022	252,750	$ 0	531,509	(53)	(278,706)
Balance at the beginning of the period (in shares) at Dec. 31, 2021		43,676
Balance at the beginning of the period at Dec. 31, 2021	267,091	$ 0	528,666	(54)	(261,521)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	(58,982)
Balance at the end of the period (in shares) at Sep. 30, 2022		44,714
Balance at the end of the period at Sep. 30, 2022	220,762	$ 0	541,048	217	(320,503)
Balance at the beginning of the period (in shares) at Mar. 31, 2022		44,077
Balance at the beginning of the period at Mar. 31, 2022	252,750	$ 0	531,509	(53)	(278,706)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under stock plans (in shares)		461
Issuance of common stock under stock plans	2,861		2,861
Stock-based compensation expense	2,676		2,676
Unrealized gain (loss) on cash equivalents	85			85
Net loss	(19,184)				(19,184)
Balance at the end of the period (in shares) at Jun. 30, 2022		44,538
Balance at the end of the period at Jun. 30, 2022	239,188	$ 0	537,046	32	(297,890)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under stock plans (in shares)		176
Issuance of common stock under stock plans	777		777
Stock-based compensation expense	3,225		3,225
Unrealized gain (loss) on cash equivalents	185			185
Net loss	(22,613)				(22,613)
Balance at the end of the period (in shares) at Sep. 30, 2022		44,714
Balance at the end of the period at Sep. 30, 2022	$ 220,762	$ 0	541,048	217	(320,503)
Balance at the beginning of the period (in shares) at Dec. 31, 2022	44,828	44,828
Balance at the beginning of the period at Dec. 31, 2022	$ 197,072	$ 0	545,753	(6)	(348,675)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under stock plans (in shares)		181
Issuance of common stock under stock plans	380		380
Stock-based compensation expense	4,137		4,137
Unrealized gain (loss) on cash equivalents	21			21
Net loss	(28,484)				(28,484)
Balance at the end of the period (in shares) at Mar. 31, 2023		45,009
Balance at the end of the period at Mar. 31, 2023	$ 173,126	$ 0	550,270	15	(377,159)
Balance at the beginning of the period (in shares) at Dec. 31, 2022	44,828	44,828
Balance at the beginning of the period at Dec. 31, 2022	$ 197,072	$ 0	545,753	(6)	(348,675)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	$ (78,393)
Balance at the end of the period (in shares) at Sep. 30, 2023	50,473	50,473
Balance at the end of the period at Sep. 30, 2023	$ 299,356	$ 0	726,428	(6)	(427,066)
Balance at the beginning of the period (in shares) at Mar. 31, 2023		45,009
Balance at the beginning of the period at Mar. 31, 2023	173,126	$ 0	550,270	15	(377,159)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under stock plans (in shares)		262
Issuance of common stock under stock plans	2,430		2,430
Stock-based compensation expense	5,652		5,652
Unrealized gain (loss) on cash equivalents	(21)			(21)
Net loss	(25,285)				(25,285)
Balance at the end of the period (in shares) at Jun. 30, 2023		45,271
Balance at the end of the period at Jun. 30, 2023	155,902	$ 0	558,352	(6)	(402,444)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under stock plans (in shares)		117
Issuance of common stock under stock plans	414		414
Stock issuance costs	10,795
Issuance of common stock, net of issuance costs (in shares)		5,085
Issuance of common stock, net of issuance costs of $10,795	161,705		161,705
Stock-based compensation expense	5,957		5,957
Net loss	$ (24,622)				(24,622)
Balance at the end of the period (in shares) at Sep. 30, 2023	50,473	50,473
Balance at the end of the period at Sep. 30, 2023	$ 299,356	$ 0	$ 726,428	$ (6)	$ (427,066)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash flows from operating activities:
Net loss	$ (78,393)	$ (58,982)
Adjustments to reconcile net loss to cash used in operating activities:
Depreciation and amortization	2,489	2,178
Stock-based compensation expense	14,153	7,452
Change in fair value in derivative liability	80	113
Non-cash lease adjustment	123	645
Inventory write-down	995	87
Changes in operating assets and liabilities:
Accounts receivable, net	(19,349)	(8,375)
Inventory	(12,937)	(9,502)
Prepaid expenses and other current assets	2,194	(2)
Other assets	(365)	(202)
Accounts payable	(87)	4,243
Accrued compensation	(182)	3,810
Accrued interest expense	93	688
Deferred revenue	2,668	1,318
Reimbursements for leasehold improvements from operating leases	4,989	0
Other liabilities	319	1,321
Net cash used in operating activities	(83,210)	(55,208)
Cash flows from investing activities:
Purchases of property and equipment	(16,491)	(1,787)
Net cash used in investing activities	(16,491)	(1,787)
Cash flows from financing activities:
Proceeds from the issuance of common stock, net of issuance costs	161,705	0
Proceeds from issuance of common stock under employee stock purchase plan	1,717	1,289
Proceeds from issuance of common stock from the exercise of stock options	1,507	3,641
Net cash provided by financing activities	164,929	4,930
Net increase (decrease) in cash, cash equivalents and restricted cash	65,228	(52,065)
Beginning of the period	225,674	305,096
End of the period	290,902	253,031
Reconciliation of cash, cash equivalents and restricted cash to balance sheets:
Cash and cash equivalents	287,087	249,217
Restricted cash	3,815	3,814
Cash, cash equivalents and restricted cash in balance sheets	290,902	253,031
Supplemental cash flow information
Interest paid	3,052	3,573
Non-cash investing and financing activities
Transfer of evaluation units from inventory to property and equipment, net	(123)	203
Property and equipment included in accounts payable and other current liabilities	7,837	200
Right-of-use-assets obtained in exchange for operating lease liabilities	$ 0	$ 22,668

Organization

Organization	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Organization	Organization Description of Business PROCEPT BioRobotics Corporation (the “Company”) is a surgical robotics company focused on advancing patient care by developing transformative solutions in urology. It develops, manufactures and sells the AquaBeam Robotic System, an advanced, image-guided, surgical robotic system for use in minimally invasive urologic surgery, with an initial focus on treating benign prostatic hyperplasia, or BPH. BPH is the most common prostate disease and impacts approximately 40 million men in the United States. The AquaBeam Robotic System employs a single-use disposable handpiece to deliver the Company’s proprietary Aquablation therapy, which combines real-time, multi-dimensional imaging, personalized treatment planning, automated robotics and heat-free waterjet ablation for targeted and rapid removal of prostate tissue. The Company received U.S. Food and Drug Administration clearance in December 2017 to market its AquaBeam Robotic System pursuant to a de novo classification.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles, or U.S. GAAP, and pursuant to the rules and regulations of the United States Securities and Exchange Commission, or SEC. These condensed consolidated financial statements include the accounts of the Company and its consolidated subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. Unaudited Interim Financial Statements The accompanying balance sheet as of September 30, 2023, the statements of operations and comprehensive loss for the three and nine months ended September 30, 2023 and 2022, and cash flows for the nine months ended September 30, 2023 and 2022, and the statements of stockholders’ equity as of September 30, 2023 and 2022, are unaudited. The financial data and other information disclosed in these notes to the financial statements related to September 30, 2023, and the three and nine months ended September 30, 2023 and 2022, are also unaudited. The accompanying balance sheet as of December 31, 2022 have been derived from the audited consolidated financial statements included in the Company’s Annual Report on Form 10-K (“Annual Report”) filed with the Securities and Exchange Commission. The unaudited interim financial statements have been prepared on the same basis as the annual financial statements and, in the opinion of management, reflect all adjustments, which include only normal recurring adjustments, necessary to a fair statement of the Company’s financial position as of September 30, 2023, and the results of its operations and cash flows for the three and nine months ended September 30, 2023 and 2022. The results for the three and nine months ended September 30, 2023, are not necessarily indicative of results to be expected for the year ending December 31, 2023, or for any other interim period or for any future year and should be read in conjunction with the annual consolidated financial statements included in the Company’s Annual Report. Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts and disclosures reported in the condensed consolidated financial statements. Management uses significant judgment when making estimates related to its stock-based compensation expense, right-of-use lease asset, lease liability, loan facility derivative liability, as well as certain accrued liabilities. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities. Actual results could differ from those estimates. Recently Issued Accounting Pronouncements No new accounting pronouncements recently issued are expected to have a material impact on the condensed consolidated financial statements.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements The following is a summary of assets and liabilities measured at fair value on a recurring basis (in thousands): September 30, 2023 Level 1 Level 2 Level 3 Total Cash and cash equivalents: Cash $ 9,303 $ — $ — $ 9,303 Cash equivalents 277,784 — — $ 277,784 Total cash and cash equivalents $ 287,087 $ — $ — $ 287,087 Loan facility derivative liability $ — $ — $ 1,859 $ 1,859 December 31, 2022 Level 1 Level 2 Level 3 Total Cash and cash equivalents: Cash $ 8,870 $ — $ — $ 8,870 Cash equivalents 212,989 — — 212,989 Total cash and cash equivalents $ 221,859 $ — $ — $ 221,859 Loan facility derivative liability $ — $ — $ 1,779 $ 1,779 Cash equivalents consist primarily of money market deposit funds and U.S. treasury bills. There were no transfers in and out of Level 3 during the three and nine months ended September 30, 2023 and year ended December 31, 2022. The following table sets forth a summary of the changes in the estimated fair value of the Company’s loan facility derivative liability, classified as Level 3 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Beginning of the period $ 1,832 $ 1,570 $ 1,779 $ 1,496 Change in fair value 27 39 80 113 End of the period $ 1,859 $ 1,609 $ 1,859 $ 1,609

Inventory

Inventory	9 Months Ended
	Sep. 30, 2023
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consists of the following (in thousands): September 30, December 31, 2023 2022 Raw materials $ 16,610 $ 12,417 Work-in-process 1,259 1,738 Finished goods 24,332 14,388 Total inventory $ 42,201 $ 28,543

Fixed Assets

Fixed Assets	9 Months Ended
	Sep. 30, 2023
Property, Plant and Equipment [Abstract]
Fixed Assets	Fixed Assets Fixed assets consists of the following (in thousands): September 30, December 31, 2023 2022 Laboratory, manufacturing and computer equipment, and furniture and fixtures $ 9,837 $ 3,260 Rental equipment 1,425 1,313 Leasehold improvements 17,555 4,941 Evaluation units 2,475 2,475 Construction in progress 6,947 5,671 Total property and equipment 38,239 17,660 Less: accumulated depreciation and amortization (11,207) (9,004) Total property and equipment, net $ 27,032 $ 8,656

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt In October 2022, the Company entered into a loan and security agreement (“the Loan Agreement”) with Canadian Imperial Bank of Commerce, or CIBC. The Agreement provides for a senior secured term loan facility in the aggregate principal amount of $52.0 million (the "Term Loan Facility") which was borrowed in full. Proceeds from the Term Loan Facility were used to repay and terminate the Company's previous loan facility, transaction fees, and related expenses. The Term Loan Facility is scheduled to mature on the fifth anniversary of the closing date (the “Maturity Date”). The Agreement provides for interest-only payments on the Term Loan Facility for the first thirty-six months following the Maturity Date (the “Initial Interest-Only Period”). The Initial Interest-Only Period will be extended to an additional twelve months if the Company achieves either (i) $200.0 million or greater in revenue in any twelve-month period or (ii) $0 or greater in EBITDA (as defined in the Loan Agreement) in any six-month period. Thereafter, amortization payments on the Term Loan Facility will be payable monthly until the Maturity Date in monthly installments equal to 20% of the then outstanding principal amount of the Term Loan Facility divided by 12 plus any accrued and unpaid interest. The Company has the option to prepay the Term Loan Facility without any prepayment charge or fee. The loan borrowed under the Term Loan Facility bears interest at an annual rate equal to the secured overnight financing rate or SOFR (calculated based on an adjustment of .10%, .15% and .25%, respectively, for one-month, three-month or six-month term SOFR as of a specified date, subject to a floor of 1.5%) plus an applicable margin of 2.25%.

Stockholders_ Equity

Stockholders’ Equity	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Stockholders' Equity	Stockholders’ EquityIn August 2023, the Company completed an underwritten public offering in which 5,085,494 shares of common stock, including 663,325 shares sold pursuant to the underwriters’ exercise of their option to purchase additional shares, were sold at a public offering price of $33.92 per share. Net proceeds from the public offering, after deducting underwriting discounts, commissions and offering expenses, were approximately $161.7 million.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation Stock Options The Company had 5.3 million shares available for grant as of September 30, 2023 under the 2021 Equity Incentive Award Plan. A summary of the Company’s stock option activity and related information are as follows (shares in thousands): Nine Months Ended September 30, 2023 Number of Shares Weighted-Average Exercise Price Outstanding, beginning of period 5,353 $ 6.93 Granted 398 36.83 Exercised (323) 4.67 Forfeited (14) 11.01 Outstanding, end of period 5,414 9.26 Vested and expected to vest 5,414 9.26 Exercisable 3,961 6.50 As of September 30, 2023 and December 31, 2022, the aggregate pre-tax intrinsic value of options outstanding and exercisable was $106.8 million and $126.3 million, respectively, and the aggregate pre-tax intrinsic value of options outstanding were $130.0 million and $185.3 million, respectively. The aggregate pre-tax intrinsic value of options exercised was $8.9 million and $27.9 million during the nine months ended September 30, 2023 and 2022, respectively. As of September 30, 2023, there was a total of $12.4 million of unrecognized stock-based compensation expense related to stock options. The fair value of the options granted to employees or directors was estimated as of the grant date using the Black-Scholes model assuming the weighted-average assumptions listed in the following table: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Expected life (years) 0.0 0.0 6.0 5.9 Expected volatility — % — % 57 % 55 % Risk-free interest rate — % — % 4.0 % 2.5 % Expected dividend rate — % — % — % — % Weighted-average fair value $ — $ — $ 21.02 $ 19.15 Restricted Stock Units A summary of the Company’s restricted stock unit or RSU activity and related information are as follows (shares in thousands): Nine Months Ended September 30, 2023 Number of Shares Weighted Average Grant Date Fair Value Outstanding, beginning of period 742 $ 36.35 Awarded 1,031 36.54 Forfeited (86) 35.00 Vested (169) 35.87 Outstanding, end of period 1,518 36.61 As of September 30, 2023, there was a total of $47.5 million of unrecognized stock-based compensation expense related to RSUs. Employee Stock Purchase Plan As of September 30, 2023, there was approximately $1.2 million of unrecognized cost related to the Company’s Employee Stock Purchase Plan, or ESPP. This cost is expected to be recognized over a weighted average period of 0.4 years. As of September 30, 2023, a total of 1.1 million shares were available for issuance under the ESPP. The fair value of the awards granted under the ESPP for the nine months ended September 30, 2023 to employees was estimated as of the grant date using the Black-Scholes model assuming the weighted-average assumptions listed in the following table: Nine Months Ended September 30, 2023 Expected life (years) 0.8 Expected volatility 55 % Risk-free interest rate 5.0 % Expected dividend rate — % Weighted-average fair value $ 11.28 Total stock-based compensation recognized, before taxes, are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Cost of sales $ 660 337 $ 1,730 712 Research and development 1,375 678 3,506 1,531 Sales, general and administrative 3,922 2,210 10,509 5,209 Stock-based compensation capitalized in inventory (631) — (1,592) — Total stock-based compensation $ 5,326 $ 3,225 $ 14,153 $ 7,452

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Net Loss Per Share	Net Loss Per Share Net loss per share was determined as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net loss $ (24,622) $ (22,613) $ (78,393) $ (58,982) Weighted-average common stock outstanding 48,310 44,640 46,131 44,276 Net loss per share, basic and diluted $ (0.51) $ (0.51) $ (1.70) $ (1.33) The following potentially dilutive securities outstanding have been excluded from the computations of weighted-average shares outstanding because such securities have an antidilutive impact due to losses reported (in common stock equivalent shares, in thousands): September 30, 2023 2022 Stock options 5,414 5,417 Restricted stock units 1,518 636 Employee stock purchase plan 177 61 Total 7,109 6,114

Revenue

Revenue	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue	Revenue The following table presents revenue disaggregated by type and geography (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. System sales and rentals $ 13,467 $ 9,811 $ 37,065 $ 26,081 Handpieces and other consumables 17,047 8,015 42,418 18,182 Service 1,811 812 4,545 1,741 Total U.S. revenue 32,325 18,638 84,028 46,004 Outside of U.S. System sales and rentals 828 743 3,896 2,353 Handpieces and other consumables 1,651 791 3,826 2,369 Service 298 177 860 511 Total outside of U.S. revenue 2,777 1,711 8,582 5,233 Total revenue $ 35,102 $ 20,349 $ 92,610 $ 51,237

Segment, Geographical, and Cust

Segment, Geographical, and Customer Concentration	9 Months Ended
	Sep. 30, 2023
Segment Reporting [Abstract]
Segment, Geographical, and Customer Concentration	Segment, Geographical, and Customer Concentration The Company operates as a single operating segment. The Company’s chief operating decision maker, its Chief Executive Officer, reviews financial information on an aggregate basis for the purposes of allocating resources and evaluating financial performance. The Company’s long-lived assets are primarily based in the United States. No customers accounted for more than 10% of revenue during the three and nine months ended September 30, 2023 and 2022. No customers accounted for more than 10% of accounts receivable at September 30, 2023 and December 31, 2022. The Company’s revenue by geographical location is as follows: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. 92 % 92 % 91 % 90 % Outside the U.S. 8 % 8 % 9 % 10 %
Segment, Geographical, and Customer Concentration	Segment, Geographical, and Customer Concentration The Company operates as a single operating segment. The Company’s chief operating decision maker, its Chief Executive Officer, reviews financial information on an aggregate basis for the purposes of allocating resources and evaluating financial performance. The Company’s long-lived assets are primarily based in the United States. No customers accounted for more than 10% of revenue during the three and nine months ended September 30, 2023 and 2022. No customers accounted for more than 10% of accounts receivable at September 30, 2023 and December 31, 2022. The Company’s revenue by geographical location is as follows: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. 92 % 92 % 91 % 90 % Outside the U.S. 8 % 8 % 9 % 10 %

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Guarantees and Indemnifications In the normal course of business, the Company enters into agreements that contain a variety of representations and provide for general indemnification. The Company’s exposure under these agreements is unknown because it involves claims that may be made against the Company in the future. To date, the Company has not paid any material claims or been required to defend any action related to its indemnification obligations. As of September 30, 2023 and December 31, 2022, the Company does not have any material indemnification claims that were probable or reasonably possible and consequently has not recorded related liabilities. Facility Lease In July 2013, the Company entered into a lease agreement for its previous facility located in Redwood City, California. In 2018, the Company expanded the lease space and extended the lease agreement through October 2023. In January 2023, the Company entered into an amendment to this lease that provided that the lease of 19,807 square feet of office space would terminate on October 29, 2023, and lease of the remaining 23,638 square feet is extended to terminate no later than January 31, 2024 unless the Company provides notice it will not utilize such extension. The Company provided the notice of intent to not extend the term of the lease. Therefore, the lease will terminate on October 29, 2023. In December 2021, the Company entered into a lease for two existing buildings, comprising approximately 158,221 square feet of space, located in San Jose, California. The lease commenced in July 2022, and will continue for 122 months following thereafter, with two five years options to extend the term of the lease. Rent expense recognized under the lease, including additional rent charges for utilities, parking, maintenance, and real estate taxes, was $2.6 million and $1.9 million for the three months ended September 30, 2023 and 2022, respectively, and $6.6 million and $3.3 million for the nine months ended September 30, 2023 and 2022, respectively. As of September 30, 2023 Minimum Lease Payments Debt Repayments Total 2023 $ 1,262 $ — $ 1,262 2024 4,183 — 4,183 2025 4,297 4,333 8,630 2026 4,426 26,000 30,426 2027 4,808 21,667 26,475 Thereafter 27,250 — 27,250 Total minimum payments 46,226 52,000 98,226 Less: amount representing interest/unamortized debt discount (17,794) (693) (18,487) Present value of future payments 28,432 51,307 79,739 Less: current portion (1,702) — (1,702) Non-current portion $ 26,730 $ 51,307 $ 78,037
Commitments and Contingencies	Commitments and Contingencies Guarantees and Indemnifications In the normal course of business, the Company enters into agreements that contain a variety of representations and provide for general indemnification. The Company’s exposure under these agreements is unknown because it involves claims that may be made against the Company in the future. To date, the Company has not paid any material claims or been required to defend any action related to its indemnification obligations. As of September 30, 2023 and December 31, 2022, the Company does not have any material indemnification claims that were probable or reasonably possible and consequently has not recorded related liabilities. Facility Lease In July 2013, the Company entered into a lease agreement for its previous facility located in Redwood City, California. In 2018, the Company expanded the lease space and extended the lease agreement through October 2023. In January 2023, the Company entered into an amendment to this lease that provided that the lease of 19,807 square feet of office space would terminate on October 29, 2023, and lease of the remaining 23,638 square feet is extended to terminate no later than January 31, 2024 unless the Company provides notice it will not utilize such extension. The Company provided the notice of intent to not extend the term of the lease. Therefore, the lease will terminate on October 29, 2023. In December 2021, the Company entered into a lease for two existing buildings, comprising approximately 158,221 square feet of space, located in San Jose, California. The lease commenced in July 2022, and will continue for 122 months following thereafter, with two five years options to extend the term of the lease. Rent expense recognized under the lease, including additional rent charges for utilities, parking, maintenance, and real estate taxes, was $2.6 million and $1.9 million for the three months ended September 30, 2023 and 2022, respectively, and $6.6 million and $3.3 million for the nine months ended September 30, 2023 and 2022, respectively. As of September 30, 2023 Minimum Lease Payments Debt Repayments Total 2023 $ 1,262 $ — $ 1,262 2024 4,183 — 4,183 2025 4,297 4,333 8,630 2026 4,426 26,000 30,426 2027 4,808 21,667 26,475 Thereafter 27,250 — 27,250 Total minimum payments 46,226 52,000 98,226 Less: amount representing interest/unamortized debt discount (17,794) (693) (18,487) Present value of future payments 28,432 51,307 79,739 Less: current portion (1,702) — (1,702) Non-current portion $ 26,730 $ 51,307 $ 78,037

Defined Contribution Plan

Defined Contribution Plan	9 Months Ended
	Sep. 30, 2023
Retirement Benefits [Abstract]
Defined Contribution Plan	Defined Contribution PlanThe Company has a defined contribution retirement savings plan under Section 401(k) of the Internal Revenue Code. This plan allows eligible employees to defer a portion of their annual compensation on a pre-tax basis. Employer contributions were $0.4 million and $0 for the three months ended September 30, 2023 and 2022, and $1.2 million and $0 for the nine months ended September 30, 2023.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net loss	$ (24,622)	$ (25,285)	$ (28,484)	$ (22,613)	$ (19,184)	$ (17,185)	$ (78,393)	$ (58,982)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles, or U.S. GAAP, and pursuant to the rules and regulations of the United States Securities and Exchange Commission, or SEC. These condensed consolidated financial statements include the accounts of the Company and its consolidated subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation.
Use of Estimates	Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts and disclosures reported in the condensed consolidated financial statements. Management uses significant judgment when making estimates related to its stock-based compensation expense, right-of-use lease asset, lease liability, loan facility derivative liability, as well as certain accrued liabilities. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities. Actual results could differ from those estimates.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements No new accounting pronouncements recently issued are expected to have a material impact on the condensed consolidated financial statements.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	The following is a summary of assets and liabilities measured at fair value on a recurring basis (in thousands): September 30, 2023 Level 1 Level 2 Level 3 Total Cash and cash equivalents: Cash $ 9,303 $ — $ — $ 9,303 Cash equivalents 277,784 — — $ 277,784 Total cash and cash equivalents $ 287,087 $ — $ — $ 287,087 Loan facility derivative liability $ — $ — $ 1,859 $ 1,859 December 31, 2022 Level 1 Level 2 Level 3 Total Cash and cash equivalents: Cash $ 8,870 $ — $ — $ 8,870 Cash equivalents 212,989 — — 212,989 Total cash and cash equivalents $ 221,859 $ — $ — $ 221,859 Loan facility derivative liability $ — $ — $ 1,779 $ 1,779
Schedule of Derivative Liabilities at Fair Value	The following table sets forth a summary of the changes in the estimated fair value of the Company’s loan facility derivative liability, classified as Level 3 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Beginning of the period $ 1,832 $ 1,570 $ 1,779 $ 1,496 Change in fair value 27 39 80 113 End of the period $ 1,859 $ 1,609 $ 1,859 $ 1,609

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2023
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consists of the following (in thousands): September 30, December 31, 2023 2022 Raw materials $ 16,610 $ 12,417 Work-in-process 1,259 1,738 Finished goods 24,332 14,388 Total inventory $ 42,201 $ 28,543

Fixed Assets (Tables)

Fixed Assets (Tables)	9 Months Ended
	Sep. 30, 2023
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment, Net	Fixed assets consists of the following (in thousands): September 30, December 31, 2023 2022 Laboratory, manufacturing and computer equipment, and furniture and fixtures $ 9,837 $ 3,260 Rental equipment 1,425 1,313 Leasehold improvements 17,555 4,941 Evaluation units 2,475 2,475 Construction in progress 6,947 5,671 Total property and equipment 38,239 17,660 Less: accumulated depreciation and amortization (11,207) (9,004) Total property and equipment, net $ 27,032 $ 8,656

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]
Schedule of Stock Option Activity and Related Information	A summary of the Company’s stock option activity and related information are as follows (shares in thousands): Nine Months Ended September 30, 2023 Number of Shares Weighted-Average Exercise Price Outstanding, beginning of period 5,353 $ 6.93 Granted 398 36.83 Exercised (323) 4.67 Forfeited (14) 11.01 Outstanding, end of period 5,414 9.26 Vested and expected to vest 5,414 9.26 Exercisable 3,961 6.50
Schedule of Fair Value Assumptions	The fair value of the options granted to employees or directors was estimated as of the grant date using the Black-Scholes model assuming the weighted-average assumptions listed in the following table: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Expected life (years) 0.0 0.0 6.0 5.9 Expected volatility — % — % 57 % 55 % Risk-free interest rate — % — % 4.0 % 2.5 % Expected dividend rate — % — % — % — % Weighted-average fair value $ — $ — $ 21.02 $ 19.15 The fair value of the awards granted under the ESPP for the nine months ended September 30, 2023 to employees was estimated as of the grant date using the Black-Scholes model assuming the weighted-average assumptions listed in the following table: Nine Months Ended September 30, 2023 Expected life (years) 0.8 Expected volatility 55 % Risk-free interest rate 5.0 % Expected dividend rate — % Weighted-average fair value $ 11.28
Schedule of Restricted Stock Unit Activity	A summary of the Company’s restricted stock unit or RSU activity and related information are as follows (shares in thousands): Nine Months Ended September 30, 2023 Number of Shares Weighted Average Grant Date Fair Value Outstanding, beginning of period 742 $ 36.35 Awarded 1,031 36.54 Forfeited (86) 35.00 Vested (169) 35.87 Outstanding, end of period 1,518 36.61
Schedule of Share-based Payment Arrangement, Expensed and Capitalized, Amount	Total stock-based compensation recognized, before taxes, are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Cost of sales $ 660 337 $ 1,730 712 Research and development 1,375 678 3,506 1,531 Sales, general and administrative 3,922 2,210 10,509 5,209 Stock-based compensation capitalized in inventory (631) — (1,592) — Total stock-based compensation $ 5,326 $ 3,225 $ 14,153 $ 7,452

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Schedule of Earnings Per Share, Basic	Net loss per share was determined as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net loss $ (24,622) $ (22,613) $ (78,393) $ (58,982) Weighted-average common stock outstanding 48,310 44,640 46,131 44,276 Net loss per share, basic and diluted $ (0.51) $ (0.51) $ (1.70) $ (1.33)
Schedule of Earnings Per Share, Diluted	Net loss per share was determined as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net loss $ (24,622) $ (22,613) $ (78,393) $ (58,982) Weighted-average common stock outstanding 48,310 44,640 46,131 44,276 Net loss per share, basic and diluted $ (0.51) $ (0.51) $ (1.70) $ (1.33)
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following potentially dilutive securities outstanding have been excluded from the computations of weighted-average shares outstanding because such securities have an antidilutive impact due to losses reported (in common stock equivalent shares, in thousands): September 30, 2023 2022 Stock options 5,414 5,417 Restricted stock units 1,518 636 Employee stock purchase plan 177 61 Total 7,109 6,114

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Schedule of Revenue from External Customers by Geographic Areas	The following table presents revenue disaggregated by type and geography (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. System sales and rentals $ 13,467 $ 9,811 $ 37,065 $ 26,081 Handpieces and other consumables 17,047 8,015 42,418 18,182 Service 1,811 812 4,545 1,741 Total U.S. revenue 32,325 18,638 84,028 46,004 Outside of U.S. System sales and rentals 828 743 3,896 2,353 Handpieces and other consumables 1,651 791 3,826 2,369 Service 298 177 860 511 Total outside of U.S. revenue 2,777 1,711 8,582 5,233 Total revenue $ 35,102 $ 20,349 $ 92,610 $ 51,237 The Company’s revenue by geographical location is as follows: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. 92 % 92 % 91 % 90 % Outside the U.S. 8 % 8 % 9 % 10 %
Schedule of Revenue from External Customers by Products and Services	The following table presents revenue disaggregated by type and geography (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. System sales and rentals $ 13,467 $ 9,811 $ 37,065 $ 26,081 Handpieces and other consumables 17,047 8,015 42,418 18,182 Service 1,811 812 4,545 1,741 Total U.S. revenue 32,325 18,638 84,028 46,004 Outside of U.S. System sales and rentals 828 743 3,896 2,353 Handpieces and other consumables 1,651 791 3,826 2,369 Service 298 177 860 511 Total outside of U.S. revenue 2,777 1,711 8,582 5,233 Total revenue $ 35,102 $ 20,349 $ 92,610 $ 51,237

Segment, Geographical, and Cu_2

Segment, Geographical, and Customer Concentration (Tables)	9 Months Ended
	Sep. 30, 2023
Segment Reporting [Abstract]
Schedule of Revenue from External Customers by Geographic Areas	The following table presents revenue disaggregated by type and geography (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. System sales and rentals $ 13,467 $ 9,811 $ 37,065 $ 26,081 Handpieces and other consumables 17,047 8,015 42,418 18,182 Service 1,811 812 4,545 1,741 Total U.S. revenue 32,325 18,638 84,028 46,004 Outside of U.S. System sales and rentals 828 743 3,896 2,353 Handpieces and other consumables 1,651 791 3,826 2,369 Service 298 177 860 511 Total outside of U.S. revenue 2,777 1,711 8,582 5,233 Total revenue $ 35,102 $ 20,349 $ 92,610 $ 51,237 The Company’s revenue by geographical location is as follows: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 U.S. 92 % 92 % 91 % 90 % Outside the U.S. 8 % 8 % 9 % 10 %

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Schedule of Future Minimum Lease Payments	As of September 30, 2023 Minimum Lease Payments Debt Repayments Total 2023 $ 1,262 $ — $ 1,262 2024 4,183 — 4,183 2025 4,297 4,333 8,630 2026 4,426 26,000 30,426 2027 4,808 21,667 26,475 Thereafter 27,250 — 27,250 Total minimum payments 46,226 52,000 98,226 Less: amount representing interest/unamortized debt discount (17,794) (693) (18,487) Present value of future payments 28,432 51,307 79,739 Less: current portion (1,702) — (1,702) Non-current portion $ 26,730 $ 51,307 $ 78,037
Schedule of Maturities of Long-term Debt	As of September 30, 2023 Minimum Lease Payments Debt Repayments Total 2023 $ 1,262 $ — $ 1,262 2024 4,183 — 4,183 2025 4,297 4,333 8,630 2026 4,426 26,000 30,426 2027 4,808 21,667 26,475 Thereafter 27,250 — 27,250 Total minimum payments 46,226 52,000 98,226 Less: amount representing interest/unamortized debt discount (17,794) (693) (18,487) Present value of future payments 28,432 51,307 79,739 Less: current portion (1,702) — (1,702) Non-current portion $ 26,730 $ 51,307 $ 78,037

Organization (Details)

Organization (Details) customer in Millions	9 Months Ended
	Sep. 30, 2023 customer
Accounting Policies [Abstract]
Number of men impacted by BPH	40

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022	Sep. 30, 2022
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]
Total cash and cash equivalents	$ 287,087	$ 221,859	$ 249,217
Derivative liability, statement of financial position	Loan facility derivative liability	Loan facility derivative liability
Fair Value, Measurements, Recurring
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]
Cash	$ 9,303	$ 8,870
Cash equivalents	277,784	212,989
Total cash and cash equivalents	287,087	221,859
Loan facility derivative liability	1,859	1,779
Level 1 | Fair Value, Measurements, Recurring
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]
Cash	9,303	8,870
Cash equivalents	277,784	212,989
Total cash and cash equivalents	287,087	221,859
Loan facility derivative liability	0	0
Level 2 | Fair Value, Measurements, Recurring
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]
Cash	0	0
Cash equivalents	0	0
Total cash and cash equivalents	0	0
Loan facility derivative liability	0	0
Level 3 | Fair Value, Measurements, Recurring
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]
Cash	0	0
Cash equivalents	0	0
Total cash and cash equivalents	0	0
Loan facility derivative liability	$ 1,859	$ 1,779

Fair Value Measurements - Fai_2

Fair Value Measurements - Fair Value, Inputs, Level 3 - Fair Value, Measurements, Recurring (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Fair value, net derivative asset (liability), recurring basis, unobservable input reconciliation, gain (loss), statement of income or comprehensive income	Change in fair value in derivative liability	Change in fair value in derivative liability	Change in fair value in derivative liability	Change in fair value in derivative liability
Fair Value, Measurements, Recurring
Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Beginning of the period	$ 1,832	$ 1,570	$ 1,779	$ 1,496
Change in fair value	27	39	80	113
End of the period	$ 1,859	$ 1,609	$ 1,859	$ 1,609

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 16,610	$ 12,417
Work-in-process	1,259	1,738
Finished goods	24,332	14,388
Total inventory	$ 42,201	$ 28,543

Fixed Assets (Details)

Fixed Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 38,239	$ 17,660
Less: accumulated depreciation and amortization	(11,207)	(9,004)
Total property and equipment, net	27,032	8,656
Laboratory, manufacturing and computer equipment, and furniture and fixtures
Property, Plant and Equipment [Line Items]
Total property and equipment	9,837	3,260
Rental equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	1,425	1,313
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	17,555	4,941
Evaluation units
Property, Plant and Equipment [Line Items]
Total property and equipment	2,475	2,475
Construction in progress
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 6,947	$ 5,671

Long-Term Debt (Details)

Long-Term Debt (Details) - Canadian Imperial Bank of Commerce - Senior Loans - USD ($)	1 Months Ended	9 Months Ended	12 Months Ended
	Oct. 31, 2022	Jun. 30, 2023	Sep. 30, 2023
Line of Credit Facility [Line Items]
Aggregate principal amount	$ 52,000,000
Debt instrument, covenant compliance interest-only period term	36 months
Debt instrument, covenant compliance interest-only period renewal term	12 months
Debt instrument, covenant compliance, revenue threshold amount			$ 200,000,000
Debt instrument, covenant compliance, EBITDA threshold amount		$ 0
Debt instrument, convertible, threshold percentage of stock price trigger	20%
Deposits	$ 90,000,000
Non-US
Line of Credit Facility [Line Items]
Pledged subsidiary equity interests in Non -US subsidiaries, percent	65%
Secured Overnight Financing Rate One Month Term
Line of Credit Facility [Line Items]
Facility interest, spread on base rate	0.10%
Secured Overnight Financing Rate Three Month Term
Line of Credit Facility [Line Items]
Facility interest, spread on base rate	0.15%
Secured Overnight Financing Rate Six Month Term
Line of Credit Facility [Line Items]
Facility interest, spread on base rate	0.25%
Secured Overnight Financing Rate Floor Rate
Line of Credit Facility [Line Items]
Facility interest, spread on base rate	1.50%
Secured Overnight Financing Rate Margin Rate
Line of Credit Facility [Line Items]
Facility interest, spread on base rate	2.25%

Stockholders_ Equity (Details)

Stockholders’ Equity (Details) $ / shares in Units, $ in Millions	1 Months Ended
	Aug. 31, 2023 USD ($) $ / shares shares
Subsidiary, Sale of Stock [Line Items]
Share price (in dollars per share) | $ / shares	$ 33.92
Public Stock Offering
Subsidiary, Sale of Stock [Line Items]
Sale of stock, number of shares issued in transaction (in shares)	5,085,494
Sale of stock, consideration received on transaction | $	$ 161.7
Over-Allotment Option
Subsidiary, Sale of Stock [Line Items]
Sale of stock, number of shares issued in transaction (in shares)	663,325

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details) - USD ($) $ in Thousands, shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Class of Warrant or Right [Line Items]
Options outstanding and exercisable, aggregate intrinsic value	$ 106,800		$ 106,800		$ 126,300
Options outstanding, aggregate intrinsic value	130,000		130,000		$ 185,300
Options exercised in the period, intrinsic value			8,900	$ 27,900
Unrecognized compensation cost	12,400		12,400
Unrecognized stock-based compensation expense	$ 5,326	$ 3,225	$ 14,153	$ 7,452
Employee stock purchase plan
Class of Warrant or Right [Line Items]
Shares available for grant (in shares)	1.1		1.1
Unrecognized compensation cost	$ 1,200		$ 1,200
2021 Equity Incentive Award Plan
Class of Warrant or Right [Line Items]
Shares available for grant (in shares)	5.3		5.3
Average vesting period for unrecognized compensation cost (in years)			4 months 24 days
Restricted stock units
Class of Warrant or Right [Line Items]
Unrecognized stock-based compensation expense			$ 47,500

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Stock Option Activity (Details) - Stock options - $ / shares shares in Thousands	9 Months Ended
	Sep. 30, 2023
Number of Shares
Balance at the beginning of the period (in shares)	5,353
Granted (in shares)	398
Exercised (in shares)	(323)
Forfeited (in shares)	(14)
Balance at the end of the period (in shares)	5,414
Vested and expected to vest (in shares)	5,414
Exercisable (in shares)	3,961
Weighted-Average Exercise Price
Balance at the beginning of the period (in dollars per share)	$ 6.93
Granted (in dollars per share)	36.83
Exercised (in dollars per share)	4.67
Forfeited (in dollars per share)	11.01
Balance at the end of the period (in dollars per share)	9.26
Vested and expected to vest (in dollars per share)	9.26
Exercisable (in dollars per share)	$ 6.50

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Fair Value Assumptions (Details) - Stock options - $ / shares	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Share-based Compensation Arrangements
Expected life (years)	0 years	0 years	6 years	5 years 10 months 24 days
Expected volatility	0%	0%	57%	55%
Risk-free interest rate	0%	0%	4%	2.50%
Expected dividend rate	0%	0%	0%	0%
Weighted-average fair value (in dollars per share)	$ 0	$ 0	$ 21.02	$ 19.15
Employee stock purchase plan
Share-based Compensation Arrangements
Expected life (years)			9 months 18 days
Expected volatility			55%
Risk-free interest rate			5%
Expected dividend rate			0%
Weighted-average fair value (in dollars per share)			$ 11.28

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of Restricted Stock Unit Activity (Details) - Restricted stock units shares in Thousands	9 Months Ended
	Sep. 30, 2023 $ / shares shares
Restricted Stock Units
Outstanding, beginning of period (in shares) | shares	742
Award (in shares) | shares	1,031
Forfeited (in shares) | shares	(86)
Vested (in shares) | shares	(169)
Outstanding, end of period (in shares) | shares	1,518
Weighted-Average Fair Value
Outstanding, beginning of period (in dollars per share) | $ / shares	$ 36.35
Awarded (in dollars per share) | $ / shares	36.54
Forfeited (in dollars per shares) | $ / shares	35
Vested (in dollars per shares) | $ / shares	35.87
Outstanding, endof period (in dollars per share) | $ / shares	$ 36.61

Stock-Based Compensation - Sc_4

Stock-Based Compensation - Schedule of Share-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 5,326	$ 3,225	$ 14,153	$ 7,452
Cost of sales
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	660	337	1,730	712
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	1,375	678	3,506	1,531
Sales, general and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation capitalized in inventory	(631)	0	(1,592)	0
Total stock-based compensation	$ 3,922	$ 2,210	$ 10,509	$ 5,209

Net Loss Per Share - Net loss p

Net Loss Per Share - Net loss per share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Equity [Abstract]
Net loss	$ (24,622)	$ (25,285)	$ (28,484)	$ (22,613)	$ (19,184)	$ (17,185)	$ (78,393)	$ (58,982)
Weighted-average common stock outstanding, basic (in shares)	48,310			44,640			46,131	44,276
Weighted-average common stock outstanding, diluted (in shares)	48,310			44,640			46,131	44,276
Net loss per share, basic (in dollars per share)	$ (0.51)			$ (0.51)			$ (1.70)	$ (1.33)
Net loss per share, diluted (in dollars per share)	$ (0.51)			$ (0.51)			$ (1.70)	$ (1.33)

Net Loss Per Share - Potentiall

Net Loss Per Share - Potentially Dilutive Securities (Details) - shares shares in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	7,109	6,114
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	5,414	5,417
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	1,518	636
Employee stock purchase plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	177	61

Revenue (Details)

Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation of Revenue [Line Items]
Revenue	$ 35,102	$ 20,349	$ 92,610	$ 51,237
U.S.
Disaggregation of Revenue [Line Items]
Revenue	32,325	18,638	84,028	46,004
Outside of U.S.
Disaggregation of Revenue [Line Items]
Revenue	2,777	1,711	8,582	5,233
System sales and rentals | U.S.
Disaggregation of Revenue [Line Items]
Revenue	13,467	9,811	37,065	26,081
System sales and rentals | Outside of U.S.
Disaggregation of Revenue [Line Items]
Revenue	828	743	3,896	2,353
Handpieces and other consumables | U.S.
Disaggregation of Revenue [Line Items]
Revenue	17,047	8,015	42,418	18,182
Handpieces and other consumables | Outside of U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,651	791	3,826	2,369
Service | U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,811	812	4,545	1,741
Service | Outside of U.S.
Disaggregation of Revenue [Line Items]
Revenue	$ 298	$ 177	$ 860	$ 511

Segment, Geographical, and Cu_3

Segment, Geographical, and Customer Concentration (Details) - Revenue Benchmark - Geographic Concentration Risk	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
U.S.
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue by significant geographical locations outside the United States, percent	92%	92%	91%	90%
Outside of U.S.
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue by significant geographical locations outside the United States, percent	8%	8%	9%	10%

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) $ in Millions	1 Months Ended	3 Months Ended		9 Months Ended
	Dec. 31, 2021 renewalOption building ft²	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Jan. 31, 2023 building
Other Commitments [Line Items]
Number of renewal options | renewalOption	2
Renewal term (in years)	5 years
Rent expense | $		$ 2.6	$ 1.9	$ 6.6	$ 3.3
Terminated on October 29, 2023
Other Commitments [Line Items]
Number of square feet						19,807
Terminate No Later Than January 31, 2024
Other Commitments [Line Items]
Number of square feet						23,638
Building
Other Commitments [Line Items]
Number of square feet | ft²	158,221
Number of buildings	2
Operating lease term (in years)		122 months		122 months

Commitments and Contingencies_2

Commitments and Contingencies - Future Minimum Lease Payments and Long-Term Debt Maturities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Minimum Lease Payments
2023	$ 1,262
2024	4,183
2025	4,297
2026	4,426
2027	4,808
Thereafter	27,250
Total minimum payments	46,226
Less: amount representing interest/unamortized debt discount	(17,794)
Present value of future payments	28,432
Less: current portion	(1,702)	$ (2,129)
Non-current portion	26,730	23,975
Debt Repayments
2023	0
2024	0
2025	4,333
2026	26,000
2027	21,667
Thereafter	0
Total minimum payments	52,000
Less: amount representing interest/unamortized debt discount	(693)
Present value of future payments	51,307
Less: current portion	0
Non-current portion	51,307	$ 51,213
Total
2023	1,262
2024	4,183
2025	8,630
2026	30,426
2027	26,475
Thereafter	27,250
Total minimum payments	98,226
Less: amount representing interest/unamortized debt discount	(18,487)
Present value of future payments	79,739
Less: current portion	(1,702)
Non-current portion	$ 78,037

Defined Contribution Plan (Deta

Defined Contribution Plan (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Retirement Benefits [Abstract]
Employer contribution amount	$ 0.4	$ 0	$ 1.2	$ 0