Organogenesis (ORGO) 10-K 9 Mar 20 2019 FY Annual report Financial data

Cover Page

Cover Page - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Feb. 28, 2020	Jun. 28, 2019
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	FY
Entity Registrant Name	Organogenesis Holdings Inc.
Entity Central Index Key	0001661181
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Public Float			$ 48.4
Trading Symbol	ORGO
Entity Shell Company	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Small Business	true
Entity Address, State or Province	MA
Title of 12(b) Security	Class A Common Stock
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		105,356,948

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Current assets:
Cash	$ 60,174	$ 21,291
Restricted cash	196	114
Accounts receivable, net	39,359	34,077
Inventory	22,918	13,321
Prepaid expenses and other current assets	2,953	2,328
Total current assets	125,600	71,131
Property and equipment, net	47,184	39,623
Notes receivable from related parties	556	477
Intangible assets, net	20,797	26,091
Goodwill	25,539	25,539
Net deferred tax assets	127	238
Other assets	884	579
Total assets	220,687	163,678
Current liabilities:
Deferred acquisition consideration	5,000	5,000
Redeemable common stock liability	0	6,762
Current portion of notes payable	0	2,545
Current portion of capital lease obligations	3,057	2,236
Accounts payable	28,387	19,165
Accrued expenses and other current liabilities	23,450	20,388
Total current liabilities	59,894	56,096
Line of credit	33,484	26,484
Notes payable, net of current portion	0	12,578
Term loan	49,634	0
Deferred rent	1,012	130
Capital lease obligations, net of current portion	14,431	15,418
Other liabilities	6,649	5,931
Total liabilities	165,104	116,637
Commitments and contingencies (Note 16)
Stockholders' equity (deficit):
Common stock, $0.0001 par value; 400,000,000 shares authorized; 105,599,434 and 91,261,413 shares issued; 104,870,886 and 91,261,413 shares outstanding at December 31, 2019 and 2018, respectively.	10	9
Additional paid-in capital	226,580	177,272
Accumulated deficit	(171,007)	(130,240)
Total stockholders' equity	55,583	47,041
Total liabilities and stockholders' equity	$ 220,687	$ 163,678

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2019	Dec. 31, 2018
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	400,000,000	400,000,000
Common stock, shares issued	105,599,434	91,261,413
Common stock, shares outstanding	104,870,886	91,261,413

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Statement [Abstract]
Net revenue	$ 260,981	$ 193,449	$ 198,508
Cost of goods sold	75,948	68,808	61,220
Gross profit	185,033	124,641	137,288
Operating expenses:
Selling, general and administrative	199,693	161,961	133,717
Research and development	14,799	10,742	9,065
Write-off of deferred offering costs	0	3,494
Total operating expenses	214,492	176,197	142,782
Loss from operations	(29,459)	(51,556)	(5,494)
Other expense, net:
Interest expense, net	(8,996)	(10,789)	(8,010)
Change in fair value of warrants	0	(469)	(1,037)
Loss on the extinguishment of debt	(1,862)	(2,095)
Other income (expense), net	13	162	(9)
Total other expense, net	(10,845)	(13,191)	(9,056)
Net loss before income taxes	(40,304)	(64,747)	(14,550)
Income tax (expense) benefit	(150)	(84)	7,025
Net loss	(40,454)	(64,831)	(7,525)
Net income attributable to non-controlling interest in affiliates			863
Net loss attributable to Organogenesis Holdings Inc.	(40,454)	(64,831)	(8,388)
Accretion of redeemable common shares			(423)
Non-cash deemed dividend to warrant holders	(645)
Net loss attributed to Organogenesis Holdings Inc. common shareholders	$ (41,099)	$ (64,831)	$ (8,811)
Net loss per share attributable to Organogenesis Holdings Inc. common shareholders—basic and diluted	$ (0.44)	$ (0.94)	$ (0.14)
Weighted average common shares outstanding — basic and diluted	92,840,401	69,318,456	63,876,767

CONSOLIDATED STATEMENTS OF REDE

CONSOLIDATED STATEMENTS OF REDEEMABLE COMMON STOCK AND STOCKHOLDERS' EQUITY (DEFICIT) - USD ($) $ in Thousands	Total	Redeemable Common Stock	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Total Organogenesis Holdings Inc Stockholders' Equity (Deficit)	Non-controlling Interest in Affiliates
Balance at Dec. 31, 2016	$ (15,979)		$ 6	$ 33,563	$ (55,647)	$ (22,078)	$ 6,099
Balance (in shares) at Dec. 31, 2016			63,872,058
Shares issued in connection with NuTech Medical acquisition	10,270	$ 6,339		10,270		10,270
Shares issued in connection with NuTech Medical acquisition (in shares)		728,548	2,914,197
VIE deconsolidation	(9,336)				(1,374)	(1,374)	(7,962)
Extinguishment of subordinated notes - affiliates	4,577			4,577		4,577
Exercise of stock options	221			221		221
Exercise of stock options (in shares)			196,884
Warrants issued in connection with notes payable	959			959		959
Cash contributions from members of affiliates	1,000						1,000
Stock-based compensation expense	919			919		919
Accretion of redeemable common shares	(423)	$ 423		(423)		(423)
Net loss	(7,525)				(8,388)	(8,388)	$ 863
Balance at Dec. 31, 2017	(15,317)	$ 6,762	$ 6	50,086	(65,409)	(15,317)
Balance (in shares) at Dec. 31, 2017		728,548	66,983,139
Exercise of stock options	119			119		119
Exercise of stock options (in shares)			76,654
Stock-based compensation expense	1,075			1,075		1,075
Proceeds from equity financing, net of issuance costs of $270	91,730		$ 2	91,728		91,730
Proceeds from equity financing, net of issuance costs of $270 (in shares)			15,561,473
Recapitalization costs	(11,206)			(11,206)		(11,206)
Exercise of common stock warrants	2,707			2,707		2,707
Exercise of common stock warrants (in shares)			746,475
Issuance of common stock for extinguishment of debt	42,764		$ 1	42,763		42,764
Issuance of common stock for extinguishment of debt (in shares)			6,502,679
Common stock issued in exchange for AHPAC shares (in shares)			1,390,993
Notification of exercise of put option of redeemable common stock		$ (6,762)
Net loss	(64,831)				(64,831)	(64,831)
Balance at Dec. 31, 2018	$ 47,041		$ 9	177,272	(130,240)	47,041
Balance (in shares) at Dec. 31, 2018	91,261,413	728,548	91,261,413
Adoption of ASC 606	$ 332				332	332
Exercise of stock options	$ 269			269		269
Exercise of stock options (in shares)	152,133		152,133
Stock-based compensation expense	$ 936			936		936
Exercise of common stock warrants	628			628		628
Exercise of common stock warrants (in shares)			74,052
Common stock issued in warrant exchange				645	(645)
Common stock issued in warrant exchange (shares)			3,315,232
Redemption of redeemable common stock placed into treasury (in shares)		(728,548)
Shares issued in the underwritten public offering	46,831		$ 1	46,830		46,831
Shares issued in the underwritten public offering (in shares)			10,068,056
Net loss	(40,454)				(40,454)	(40,454)
Balance at Dec. 31, 2019	$ 55,583		$ 10	$ 226,580	$ (171,007)	$ 55,583
Balance (in shares) at Dec. 31, 2019	104,870,886		104,870,886

CONSOLIDATED STATEMENTS OF RE_2

CONSOLIDATED STATEMENTS OF REDEEMABLE COMMON STOCK AND STOCKHOLDERS' EQUITY (DEFICIT) (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Issuance costs	$ 3,510	$ 270

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash flows from operating activities:
Net loss	$ (40,454)	$ (64,831)	$ (7,525)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	3,388	3,309	3,591
Amortization of intangible assets	6,043	3,669	2,037
Non-cash interest expense	243	845	410
Deferred interest expense	1,446	249	233
Deferred rent expense	882	56	70
Deferred tax benefit (expense)	111	186	(7,301)
Loss (gain) on disposal of property and equipment	146	1,209	(8)
Impairment of notes receivable			113
Write-off of deferred offering costs	0	3,494
Provision recorded for sales returns and doubtful accounts	239	1,157	1,166
Provision recorded for inventory reserve	1,297	2,473	3,170
Stock-based compensation	936	1,075	919
Change in fair value of warrant liability	0	469	1,037
Loss of extinguishment of debt	1,862	2,095
Change in fair value of interest rate swap			6
Changes in fair value of forfeiture rights	0	589	(212)
Changes in operating assets and liabilities:
Accounts receivable	(4,691)	(7,110)	(7,010)
Inventory	(11,063)	(1,524)	(1,490)
Prepaid expenses and other current assets	(625)	(1,414)	(2,680)
Accounts payable	4,700	(60)	3,967
Accrued expenses and other current liabilities	2,942	2,354	2,665
Accrued interest - affiliate debt	0	(9,241)	3,190
Other liabilities	(930)	316	159
Net cash used in operating activities	(33,528)	(60,635)	(3,493)
Cash flows from investing activities:
Purchases of property and equipment	(5,984)	(1,857)	(2,426)
Acquisition of intangible asset	(250)
Proceeds from disposal of property and equipment	0	1	8
Acquisition of NuTech Medical, net of cash acquired			(11,790)
VIE deconsolidation			(666)
Net cash used in investing activities	(6,234)	(1,856)	(14,874)
Cash flows from financing activities:
Line of credit borrowings, net	7,000	8,866	12,749
Proceeds from term loan	50,000		0
Proceeds from long-term debt - affiliates	0	15,000
Proceeds from notes payable - master lease			16,000
Proceeds from equity financing	50,340	92,000
Payment of equity issuance costs	(2,973)	(270)
Payment of recapitalization costs	0	(11,206)
Repayment of mortgage notes payables—Real Estate Entities, net			(1,335)
Repayment of debt and debt issuance cost on affiliate debt		(22,680)
Repayment of notes payable	(17,585)	(10)	(6,325)
Principal repayments of capital lease obligations	(1,266)	(104)	(81)
Redemption of redeemable common stock placed into treasury	(6,762)
Proceeds from the exercise of stock options	269	119	221
Proceeds from the exercise of common stock warrants	628
Cash contributions from members of affiliates			1,000
Payments of deferred acquisition consideration			(2,500)
Payment of debt issuance costs	(924)	(177)	(862)
Net cash provided by financing activities	78,727	81,538	18,867
Change in cash and restricted cash	38,965	19,047	500
Cash and restricted cash, beginning of year	21,405	2,358	1,858
Cash and restricted cash, end of year	60,370	21,405	2,358
Supplemental disclosure of cash flow information:
Cash paid for interest	8,148	5,423	6,076
Cash paid for income taxes	49	8	96
Supplemental disclosure of non-cash investing and financing activities:
Fair value of shares issued in connection with investor debt settlement		42,764
Fair value of shares issued in connection with settlement of investor warrants		2,707
Common stock issued in exchange for APHAC shares		1
Notice of put option exercise of redeemable common shares		6,762
Non-cash deemed dividend related to warrant exchange	645
Equity issuance costs included in accounts payable	537
Purchases of property and equipment in accounts payable and accrued expenses	4,014	$ 172	764
Acquisition of intangible assets included in accrued expenses and other liabilities	500
Equipment acquired under capital lease	$ 1,099
Fair value of warrant issued in connection with notes payable			959
Extinguishment of Subordinated Notes - affiliates			4,577
Accretion of redeemable common stock			423
Shares issued in connection with NuTech Medical acquisition			16,609
Deconsolidation of variable interest entities, net of cash			9,052
Issuance of deferred acquisition consideration			7,500
Issuance of contingent consideration forfeiture rights			$ 377

Nature of Business and Basis of

Nature of Business and Basis of Presentation	12 Months Ended
	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business and Basis of Presentation	1. Nature of Business and Basis of Presentation Organogenesis Holdings Inc. (formerly Avista Healthcare Public Acquisition Corp.) (“ORGO” or the “Company”) is a leading regenerative medicine company focused on the development, manufacture, and commercialization of solutions for the Advanced Wound Care and Surgical & Sports Medicine markets. Several of the existing and pipeline products in the Company’s portfolio have Premarket Application (“PMA”) approval, Business License Applicant (“BLA”) approval or Premarket Notification 510(k) clearance from the United States Food and Drug Administration (“FDA”). The Company’s customers include hospitals, wound care centers, government facilities, ambulatory service centers (ASCs) and physician offices. The Company operates in one operating and reportable segment. Merger with Avista Healthcare Public Acquisition Corp On December 10, 2018, Avista Healthcare Public Acquisition Corp., our predecessor company (“AHPAC”), consummated the previously announced merger (the “Avista Merger”) pursuant to an Agreement and Plan of Merger, dated as of August 17, 2018 (as amended, the “Avista Merger Agreement”), by and among AHPAC, Avista Healthcare Merger Sub, Inc., a Delaware corporation and a direct wholly-owned subsidiary of AHPAC (“Avista Merger Sub”) and Organogenesis Inc., a Delaware corporation (“Organogenesis Inc.”). As a result of the Avista Merger and the other transactions contemplated by the Avista Merger Agreement, Avista Merger Sub merged with and into Organogenesis Inc., with Organogenesis Inc. surviving the Avista Merger and becoming a wholly-owned subsidiary of AHPAC and (ORG O The Avista Merger was accounted for as a reverse merger in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Under this method of accounting, AHPAC was treated as the “acquired” company for accounting purposes. This determination was primarily based on Organogenesis Inc.’s equity holders having a majority of the voting power of the combined company, Organogenesis Inc. comprising the ongoing operations of the combined entity, Organogenesis Inc. comprising a majority of the governing body of the combined company, and Organogenesis Inc.’s senior management comprising the senior management of the combined company. Accordingly, for accounting purposes, the Avista Merger was treated as the equivalent of Organogenesis Inc. issuing stock for the net assets of AHPAC, accompanied by a recapitalization. The net assets of AHPAC were recorded at historical cost, with no goodwill or other intangible assets recorded. Operations prior to the Avista Merger are those of Organogenesis Inc. In accordance with the terms of the Avista Merger Agreement, at the effective time of the Avista Merger, each share of Organogenesis Inc. common stock then issued and outstanding was automatically cancelled, extinguished and converted into the right to receive 2.03 shares of ORGO Class A common stock, par value $0.0001 per share, (after giving effect to the Domestication). 75,073,548 shares of ORGO Class A common stock were issued to the equity holders of Organogenesis Inc. In addition, all outstanding options and warrants (other than warrants that expired, were exercised or were deemed automatically net exercised immediately prior to the Avista Merger) exercisable for common stock in Organogenesis Inc. were exchanged for options and warrants exercisable for ORGO Class A common stock with the same terms and conditions except adjusted by the aforementioned exchange ratio. In connection with the execution of the Avista Merger Agreement and the consummation of the Avista Merger, founders and certain directors of AHPAC, surrendered to AHPAC an aggregate of 6,359,007 founder shares and 16,400,000 private placement warrants. All such founder shares and private placement warrants were cancelled. In addition, an aggregate of 1,390,993 shares of ORGO Class A common stock were issued upon conversion of the remaining outstanding founder shares in accordance with the terms of the Company’s charter in connection with the Avista Merger. In connection with the execution of the Avista Merger Agreement on August 17, 2018, Avista Capital Partners IV, L.P. and Avista Capital Partners IV (Offshore), L.P. (collectively, the “PIPE Investors”) purchased , 6,538,732 shares of ORGO Class A common stock for an aggregate purchase price of $46,000 ( the “Initial Avista Investment”). The Company received the proceeds from the Initial Avista Investment in August 2018. Concurrently with the completion of the Avista Merger, the PIPE Investors also purchased 9,022,741 shares of ORGO Class A common stock and 4,100,000 warrants to purchase one-half Concurrently with the completion of the Avista Merger, the affiliate debt was discharged and terminated (See Note “10. Long-Term Debt—Affiliates”). During the year ended December 31, 2018, the Company recorded $3,072 of transaction expenses related to third party legal and accounting services to consummate the Avista Merger. These costs are incorporated into selling, general and administrative expenses in the Company’s consolidated statement of operations. Additionally, AHPAC incurred $11,206 in transaction costs prior to the Avista Merger that were paid in full by the Company after the consummation of the Avista Merger. Acquisition of Nutech Medical, Inc. On March 18, 2017, the Company purchased Nutech Medical, Inc. (“NuTech Medical”) pursuant to an Agreement of Plan of Merger (“NuTech Merger Agreement”) for an aggregate consideration of $12,000 in cash at closing we we the one-year period For the restricted shares of Class A common stock which we Liquidity and Financial Conditions In accordance with ASC 205-40, 205-40”), , $50,340 in 2019 Credit Agreement (see Note “11. Line of Credit and Notes Payable”), will be sufficient to fund its operating expenses, capital expenditure requirements and debt service payments for at least 12 months beyond the filing date of this annual report. The Company expects to continue investing in product development, sales and marketing and customer support for its products. The Company may seek to raise additional funding through public and/or private equity financings, debt financings or other strategic transactions. There can be no assurance that the Company will be able to obtain additional debt or equity financing on terms acceptable to the Company, on a timely basis or at all. The failure of the Company to obtain sufficient funds on acceptable terms when needed could have a material adverse effect on the Company’s business, results of operations, and financial condition. The accompanying consolidated financial statements do not include any adjustments that might result from the outcome of this uncertainty. Accordingly, the consolidated financial statements have been prepared on a basis that assumes the Company will continue as a going concern and which contemplates the realization of assets and satisfaction of liabilities and commitments in the ordinary course of business.

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Significant Accounting Policies Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported results of operations during the reporting period. Actual results and outcomes may differ significantly from those estimates and assumptions. Principles of Consolidation The consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc., and its wholly-owned subsidiaries, Organogenesis Inc. and the wholly-owned subsidiaries of Organogenesis Inc., including Organogenesis GmbH (a Switzerland corporation) and Prime Merger Sub, LLC. For periods prior to the closing of the Avista Merger on December 10, 2018, the notes to the consolidated financial statements have been updated to give effect to the Avista Merger. Dan Road Associates, LLC, 85 Dan Road Associates, LLC and Canton 65 Dan Road Associates, LLC (each a “Real Estate Entity,” collectively the “Real Estate Entities”) were variable interest entities requiring consolidation through the deconsolidation date of June 1, 2017. The Real Estate Entities were deconsolidated and the financial statements as of June 1, 2017 derecognized all assets and liabilities of the Real Estate Entities. Refer to Note “4. Real Estate Entities” to the consolidated financial statements in Part II, Item 8 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2018. The results of operations for the years ended December 31, 2017 include the operations of the Real Estate Entities through the date of deconsolidation . The consolidated balance sheet as of December 31, 2019 and 2018, and the results of operations for the years ended December 31, 2019 and 2018, do not include the accounts of the Real Estate Entities. All intercompany balances and transactions have been eliminated in consolidation. Segment Reporting Operating segments are defined as components of an enterprise about which discrete financial information is available that is evaluated regularly by the chief operating decision maker, or decision making group, in making decisions on how to allocate resources and assess performance for the organization. The Company’s chief operating decision maker is the Chief Executive Officer. The Company’s chief operating decision maker reviews consolidated operating results to make decisions about allocating resources and assessing performance for the entire Company. Accordingly, the Company has determined that it has a single operating segment—regenerative medicine. The Company manages its operations as a single operating segment for the purposes of assessing performance and making operating decisions. The Company’s portfolio includes regenerative medicine products in various stages, ranging from preclinical to late stage development, and commercialized advanced wound care and surgical and sports medicine products which support healing across a wide variety of wound types at many different types of facilities. Cash and Cash Equivalents The Company primarily maintains its cash in bank deposit accounts in the United States which, at times, may exceed the federally insured limits. The Company has not experienced losses in such accounts and believes it is not exposed to significant credit risk on cash. The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. Restricted Cash The Company had restricted cash of $ 196 Accounts Receivable Accounts receivable are stated at invoice value less estimated allowances for sales returns and doubtful accounts. The Company estimates the allowance for sales returns based on a historical percentage of returns over a twelve-month trailing average of sales. The Company continually monitors customer payments and maintains a reserve for estimated losses resulting from its customers’ inability to make required payments. The Company considers factors when estimating the allowance for doubtful accounts such as historical experience, credit quality, age of the accounts receivable balances, geography-related risks and economic conditions that may affect a customer’s ability to pay. In cases where there are circumstances that may impair a specific customer’s ability to meet its financial obligations, a specific allowance is recorded against amounts due, thereby reducing the net recognized receivable to the amount reasonably believed to be collectible. Accounts receivables are written off when deemed uncollectible. Recoveries of accounts receivables previously written off are recorded when received. Inventories Inventories are stated at the lower of cost (determined under the first-in first-out The Company regularly reviews inventory quantities on hand and records a provision to write down excess and obsolete inventory to its estimated net realizable value based upon management’s assumptions of future material usage, yields and obsolescence, which are a result of future demand and market conditions and the effective life of certain inventory items. The Company also tests other components of its inventory for future growth projections. The Company determines the average yield of the component and compares it to projected revenue to ensure it is properly reserved. Property and Equipment, Net Property and equipment are recorded at cost and depreciated over the estimated useful lives of the respective assets on a straight-line basis. As of December 31, 2019 and 2018, the Company’s property and equipment consisted of leasehold improvements, furniture and computers, and equipment. Property and equipment estimated useful lives are as follows: Leasehold improvements Lesser of the life of the lease or the Furniture and computers 3 - Equipment 5 - Upon retirement or sale, the cost of assets disposed of s Goodwill Goodwill represents the excess of the purchase price of an acquired business over the fair value of the identifiable assets acquired and liabilities assumed. Goodwill is not amortized, but is tested for impairment at least annually (as of December 31), or more frequently if events or circumstances indicate the carrying value may no longer be recoverable and that an impairment loss may have occurred. Circumstances that could trigger an impairment test include, but are not limited to, a significant adverse change in the business climate or legal factors, an adverse action or assessment by a regulator, or unanticipated competition. The Company operates as one segment, which is considered to be the sole reporting unit, and therefore goodwill is tested for impairment at the consolidated level. In accordance with ASC Topic 350, Intangibles—Goodwill and Other , There was no impairment of goodwill recorded Intangible Assets Subject to Amortization Intangible assets include intellectual property either owned by the Company or for which the Company has a license. Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired and reported net of accumulated amortization, separately from goodwill. Intangible assets with finite lives are amortized over their estimated useful lives. Intangible assets include developed technology and patents, trade names, trademarks, independent sales agency networks and non-compete Trade names and trademarks 10 - 12 years Developed technology 10 - 12 years Independent sales agency network 3 years Non-compete 5 years Impairment of Long-Lived Assets Long-lived assets consist primarily of property and equipment and intangible assets. The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. Factors that the Company considers in deciding when to perform an impairment review include, but not limited to, significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets. When such an event occurs, the Company determines whether there has been impairment by comparing the anticipated undiscounted future net cash flows to the related asset group’s carrying value. If an asset is determined to be impaired, the asset is written down to fair value, which is determined based either on discounted cash flows or appraised value, depending on the nature of the asset. The Company did not record any impairment o f Deferred Offering Costs The Company capitalizes certain legal, professional accounting and other third-party fees that are directly associated with in-process The Company did not record any deferred offering costs in the consolidated balance sheets as of December 31, 2019 and 2018. During the year ended December 31, 2019, the Company recorded $3,510 of equity issuance costs to the additional paid-in Underwritten Public Offering ” paid-in Warrant Liability In connection with the issuance of the 2016 Loans, the Company issued to the loan holders warrants to purchase shares of Class A common stock. The Company classifie d balance sheet because each warrant provided for down-round protection which would cause the exercise price of the warrants to be adjusted if future equity issuances were below the current exercise price of the warrants. The price of the warrant was also subject to adjustment any time the price of another equity-linked instrument changed. The warrant liability was initially recorded at fair value upon issuance and was subsequently remeasured to fair value at each reporting date until the warrants were net exercised in December 2018 in connection with the Avista Merger. Changes in the fair value of the warrant liability were recognized as a component of other income (expense), net in the consolidated statements of operations. The Company had no warrant liability as of December 31, 2019 and 2018. Revenue Recognition Adoption of ASC Topic 606, Revenue from Contracts with Customers (“ASC 606”) The Company adopted ASC 606 on January 1, 2019, using the modified retrospective method for all contracts not completed as of the date of adoption. The reported results for the year ended December 31, 2019 reflect the application of ASC 606 guidance while the reported results for the years ended December 31, 2018 and 2017 were prepared under the guidance of ASC Topic 605, Revenue Recognition Historically, for certain customers, products were shipped in advance of the receipt of a purchase order and the Company recognized revenue on these products only upon receipt of the purchase order which is when the transaction price was deemed fixed and determinable. As control of these products has transferred upon use of the product in a procedure, the recognition of revenue is accelerated to the procedure date under ASC 606. The adoption of ASC 606 did not have a material impact on the Company’s consolidated financial position, results of operations, equity or cash flows as of the adoption date or for the year ended December 31, 2019. Product Revenue The Company generates revenue through the sale of Advanced Wound Care and Surgical & Sports Medicine products. There is a single performance obligation in all of the Company’s contracts, which is the Company’s promise to transfer the Company’s product to customers based on specific payment and shipping terms in the arrangement. The entire transaction price is allocated to this single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s product which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract. Reserves for Variable Consideratio n Revenues from product sales are recorded net of reserves for variable consideration which includes but is not limited to product return, discounts, rebates and group purchasing organization (“GPO”) fees that are offered within contracts between the Company and its customers relating to the Company’s sales of its products. These reserves are based on the amounts earned or to be claimed by its customers on the related sales and are recorded as a reduction of accounts receivable or an establishment of a liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract and is included in the net sales price to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately paid may differ from the Company’s estimates. If actual results vary from the Company’s estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Product Returns Consistent with industry practice, the Company generally offers customers a limited right of return for product purchased. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return reserves using its historical return rates as well as factors that it becomes aware of that it believes could significantly impact its expected returns, including product recalls, pricing changes, or change in reimbursement rates. The Company does not record an asset for the returned product as the product is discarded upon receipt. Rebates and Allowances The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts, resulting in a reduction of revenue and the establishment of a liability that is included in accrued expenses in the accompanying consolidated balance sheets in the period the related product revenue is recognized. GPO Fees The Company pays fees to GPOs for administrative services that the GPOs perform in connection with the purchases of the product by the GPO members. These fees are based on a contractually-determined percentage of the Company’s applicable sales. The Company classifies these GPO fees as a reduction of revenue based on the substance of the relationship of all parties involved in the transaction. For the years ended December 31, 2019, 2018 and 2017, the Company recorded GPO fees of $3,096, $1,923 Other Revenue Policies Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue. Applying the practical expedient in paragraph ASC 606-10-32-18, Applying the practical expedient in ASC 340-40-25-4, Applying the practical expedient in ASC 606-10-25-18B, Disaggregation of Revenue The following table sets forth revenue by product category: Year Ended December 31, 2019 2018 2017 Advanced Wound Care revenue $ 220,744 $ 164,332 $ 178,896 Surgical and Sports Medicine revenue 40,237 29,117 19,612 Total revenue $ 260,981 $ 193,449 $ 198,508 For the years ended December 31, 2019, 2018 and 2017, net PuraPly revenue totaled $126,812 , $69,773 and $109,085, respectively. For all periods presented, net revenue generated outside the US represented less than 1% of total net revenue. Stock-Based Compensation The Company measures stock-based awards granted based on the fair value of the awards on the date of grant and recognizes compensation expense for those awards over the requisite service period, which is generally the vesting period of the respective award. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Generally, the Company issues stock-based awards with only service-based vesting conditions and records the expense for these awards using the straight-line method. The Company has not issued any stock-based awards with performance-based vesting conditions. The Company recognizes stock-based compensation expense within the consolidated financial statements for all share-based payments based upon the estimated grant-date fair value for the awards expected to ultimately vest. The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company has been a public company for a short period of time, has limited public float and lacks company-specific historical and implied volatility information for its stock. Therefore, it estimates its expected stock price volatility based on the historical volatility of publicly traded peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The expected term of the Company’s stock options has been determined utilizing the “simplified” method for awards that qualify as “plain-vanilla” options. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is based on the fact that the Company has never paid cash dividends on its Class A common stock and does not expect to pay any cash dividends in the foreseeable future. Advertising Advertising costs are expensed as incurred and are included in selling, general and administrative expense in the consolidated statements of operations. Advertising costs were approximately $ 1,059, $773, and $947 f Research and Development Costs Research and development expenses include personnel costs for the Company’s research and development personnel, investments in improvements to manufacturing processes, enhancements to the Company’s currently available products, and additional investments in the product and platform development pipeline. Research and development expenses also include expenses for clinical trials. The Company expenses research and development costs as incurred. Foreign Currency The Company’s functional currency, including the Company’s Swiss subsidiary, Organogenesis GmbH, is the U.S. dollar. Foreign currency gains and losses resulting from re-measurement of as non-operating income Income Taxes The Company accounts for income taxes using the asset and liability method which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the consolidated financial statements or in the Company’s tax returns. Deferred tax assets and liabilities are determined on the basis of the differences between the consolidated financial statement and the tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company annually assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. Potential for recovery of deferred tax assets is evaluated by estimating the future taxable profits expected and considering prudent and feasible tax planning strategies. The Company accounts for uncertain income tax positions recognized in the consolidated financial statements by applying a two-step more-likely-than-not Fair Value of Financial Instruments Certain assets and liabilities of the Company are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable: • Level 1—Quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data. • Level 3—Unobservable inputs that are supported by little or no market activity that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques. The carrying values of accounts receivable, inventory, prepaid expenses and other current assets, accounts payable and accrued expenses approximate their fair values due to the short-term nature of these assets and liabilities. The fair value of the redeemable common stock liability was carried at fair value, determined according to Level 3 inputs in the fair value hierarchy described above (see Note “3. Fair Value Measurement of Financial Instruments”). The carrying values of outstanding borrowings under the Company’s debt arrangements (see Notes “10. Long-Term Debt—Affiliates” and “11. Line of Credit and Notes Payable”) approximate their fair values as determined based on a discounted cash flow model, which represents a Level 3 measurement. Net Loss per Share The Company follows the two-class two-class two-class Basic net income (loss) per share attributable to common stockholders is computed by dividing the net income (loss) attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net income (loss) attributable to common stockholders is computed by adjusting net income (loss) attributable to common stockholders to reallocate undistributed earnings based on the potential impact of dilutive securities. Diluted net income (loss) per share attributable to common stockholders is computed by dividing the diluted net income (loss) attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period, including potential dilutive common shares. For purpose of this calculation, outstanding stock options, warrants to purchase shares of common stock and unvested restricted stock are considered potential dilutive common shares. Emerging Growth Company Section 102 (b) (1) of the JOBS Act exempts emerging growth companies from being required to comply with new or revised financial accounting standards until private companies (that is, those that have not had a Securities Act registration statement declared effective or do not have a class of securities registered under the Securities Exchange Act of 1934 , as amended (the ”Exchange Act”) are required to comply with the new or revised financial accounting standards. The JOBS Act provides that a company can elect to opt out of the extended transition period and comply with the requirements that apply to non-emerging growth companies but any such election to opt out is irrevocable. The Company has elected not to opt out of such extended transition period which means that when a standard is issued or revised and it has different application dates for public or private companies, the Company, as an emerging growth company, can adopt the new or revised standard at the time private companies adopt the new or revised standard. For example, the Company will adopt ASU 2016-02 , Leases (Topic 842) on January 1 , 2021 and ASU 2016-13 , Financial Instruments—Credit Losses (Topic 326) on January 1 , 2023 . As a result, the Company’s financial statements may not be comparable to other public companies. The Company may take advantage of these exemptions up until the last day of the fiscal year following October 14 , 2021 , the fifth anniversary of its IPO, or such earlier time that it is no longer an emerging growth company. It would cease to be an emerging growth company if the Company has more than $ billion in annual revenue, the Company has more than $ .0 million in market value of its stock held by non-affiliates or the Company issues more than $ billion of non-convertible debt securities over a three-year period. Reclassification of Prior Period Balances Reclassifications have been made to prior period amounts to conform to the current-year presentation of the reporting of deferred interest and principal on outstanding capital lease obligations and unpaid operating and common area maintenance costs as long-term liabilities on the consolidated balance sheets. The deferred interest and unpaid operating and common area maintenance costs were previously reported as accrued expenses on the consolidated balance sheets and the deferred principal on the capital lease obligations were recorded as part of the current portion of capital lease obligations on the consolidated balance sheet. These reclassifications have no effect on the reported net loss or equity for the years ended December 31, 2018 and 2017. Reclassification has been made to prior period amounts reported in the cash flows from operating activities section of the consolidated cash flow statements to conform to the current year presentation. The provision recorded for inventory reserve has been reduced by amounts not related to excess and obsolete inventory and change in inventory has been increased by a corresponding amount. The reclassification has no effect on the reported balance sheet as of December 31, 2018 or net loss or equity or total operating, investing or financing cash flows for the years ended December 31, 2018 and 2017. Recently Adopted Accounting Pronouncements In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers (Topic 606) 2014-09”). 2018-07, Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting Topic 718, Compensation—Stock Compensation Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) 2016-02”), 2018-10, 2016-02, 2018-11, 2016-02, 2019-01, 2016-02 right-of-use In June 2016, the FASB issued ASU 2016-13 , Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments 2016-13”). 2016-13, 2018-19, Codification Improvements to Topic 326, Financial Instruments- Credit Losses 2019-04, Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments 2019-05, Financial Instruments—Credit Losses (Topic 326)—Targeted Transition Relief 2019-11, Codification Improvements to Topic 326, Financial Instruments—Credit Losses 2016-13 2016-13 2016-13

Fair Value Measurement of Finan

Fair Value Measurement of Financial Instruments	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value Measurement of Financial Instruments	3. Fair Value Measurement of Financial Instrument s The following table presents information about the Company’s financial assets and liabilities measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values as of December 31, 2018. The redeemable common stock liability was settled in March 2019 as described below. Fair Value Measurements as of December 31, 2018 Using: Level 1 Level 2 Level 3 Total Liabilities: Redeemable common stock liability $ — $ — $ 6,762 $ 6,762 $ — $ — $ 6,762 $ 6,762 Redeemable Common Stock On March 24, 2017, the Company issued 728,548 shares of Class A common stock in connection with the NuTech Medical acquisition (see Note “1. Nature of Business and Basis of Presentation”), which were recorded at their fair value of $8.70 per share. These shares included a put right allowing the holder to put the shares back to the Company at an agreed-upon exercise price of $9.28 per share on March 24, 2019. The Company also had the right to call the shares at an agreed-upon exercise price of $ 9.28 9.28 we

Accounts receivable, net

Accounts receivable, net	12 Months Ended
	Dec. 31, 2019
Receivables [Abstract]
Accounts receivable, net	4. Accounts receivable, net Accounts receivable consisted of the following: December 31, 2019 2018 Accounts receivable $ 42,408 $ 37,497 Less—allowance for sales returns and doubtful accounts (3,049 ) (3,420 ) $ 39,359 $ 34,077 The Company’s allowance for sales returns and doubtful accounts was comprised of the following: Balance as of December 31, 2017 $ 3,225 Additions 1,157 Write-offs (962 ) Balance as of December 31, 2018 $ 3,420 Additions 239 Write-offs (610 ) Balance as of December 31, 2019 $ 3,049

Inventories

Inventories	12 Months Ended
	Dec. 31, 2019
Inventory Disclosure [Abstract]
Inventories	5. Inventories Inventories, net of related reserves, consisted of the following: December 31, 201 9 2018 Raw materials $ 9,178 $ 4,711 Work in process 781 1,759 Finished goods 12,959 6,851 $ 22,918 $ 13,321 Raw materials include various components used in the Company’s manufacturing process. The Company’s excess and obsolete inventory review process includes analysis of sales forecasts and historical sales as compared to inventory, and working with operations to maximize recovery of excess inventory. During the years ended December 31, 2019, 2018 and 2017, the Company charged $ 1,297, $2,473, and $3,170, respectively, for inventory excess and obsolescence to cost of goods sold within the consolidated statements of operations. As of December 31, 2019 and 2018, the Company recorded a reserve for excess and obsolete inventory of $ 1,417

Prepaid Expenses and Other Curr

Prepaid Expenses and Other Current Assets	12 Months Ended
	Dec. 31, 2019
Payables and Accruals [Abstract]
Prepaid Expenses and Other Current Assets	6. Prepaid Expenses and Other Current Assets Prepaid expenses and other current assets consisted of the following: December 31, 2019 2018 Prepaid subscriptions $ 1,041 $ 594 Prepaid inventory testing 291 116 Prepaid conferences and marketing expenses 925 392 Prepaid insurance 472 223 Prepaid deposits 87 764 Other 137 239 $ 2,953 $ 2,328 Prepaid deposits are deposits held by vendors which are expected to be released within twelve months and therefore they are properly recorded as current assets.

Property and Equipment, Net

Property and Equipment, Net	12 Months Ended
	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	7. Property and Equipment, Net Property and equipment consisted of the following: December 31, 2019 2018 Leasehold improvements $ 36,344 $ 34,345 Furniture, computers and equipment 46,430 44,752 82,774 79,097 Accumulated depreciation and amortization (65,812 ) (62,435 ) Construction in progress 30,222 22,961 $ 47,184 $ 39,623 Depreciation expense was $ 3,388 , $3,309, and $3,591 for the years ended December 31, 2019, 2018 and 2017, respectively. As of December 31, 2019 and 2018, the Company had $21,689 of buildings under capital leases recorded within leasehold improvements. As of December 31, 2019 and 2018, the Company had $ 13,777 a building under a capital lease and, more recently, improvements at the Company’s leased facilities in Canton and Norwood, Massachusetts.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	8. Goodwill and Intangible Assets During 2017, the Company recorded $19,446 of goodwill associated with the acquisition of NuTech Medical (see Note “1. Nature of Business and Basis of Presentation”). Goodwill was $25,539 as of December 31, 2019 and 2018 . In April 2019, the Company purchased $750 of intangible assets know-how Identifiable intangible assets consisted of the following as of December 31, 2019: Original Accumulated Net Book Developed technology $ 30,570 $ (11,266 ) $ 19,304 Trade names and trademarks 2,000 (650 ) 1,350 Independent sales agency network 4,500 (4,500 ) — Non-compete 260 (117 ) 143 Total $ 37,330 $ (16,533 ) $ 20,797 Identifiable intangible assets consisted of the following as of December 31, 2018: Original Accumulated Net Book Developed technology $ 29,820 $ (8,454 ) $ 21,366 Trade names and trademarks 2,000 (413 ) 1,587 Independent sales agency network 4,500 (1,569 ) 2,931 Non-compete 260 (53 ) 207 Total $ 36,580 $ (10,489 ) $ 26,091 Amortization of intangible assets, calculated on a straight-line basis or using an s 6,043 20 20 $ 3,267 202 1 3,332 202 2 3,322 202 3 3,358 202 4 1,842 Thereafter 5,676 Total $ 20,797

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	12 Months Ended
	Dec. 31, 2019
Payables and Accruals [Abstract]
Accrued Expenses	9. Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of the foll o December 31, 2019 2018 Accrued personnel costs $ 17,640 $ 15,218 Other 5,810 5,170 $ 23,450 $ 20,388

Long-Term Debt-Affiliates

Long-Term Debt-Affiliates	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Long-Term Debt - Affiliates	10. Long-Term Debt—Affiliates Historically, the Company has taken loans from its affiliates and entities controlled by its affiliates. More recent loans include the the Company’s external indebtedness (see Note “11. Line of Credit and Notes Payable”). These loans from affiliates had a balance of $56,642 as of December 31, 2017. They were settled in conjunction with the Avista Merger in 2018 as described below. Interest expense for the affiliate debt totaled $3,892 and $3,189 for the years ended December 31, 2018 and 2017. In 2017, the holders of the affiliate debt entered into new 2017 and Master Lease Agreement (see Note “11. Line of Credit and Notes Payable”). the maturity date of the affiliate loans resulting from additional paid-in capital Concurrently with the consummation of the Avista Merger, outstanding principal of $45,746 related to the affiliate debt was converted into 6,502,679 shares of ORGO Class A common stock, and the Company made a cash payment to such creditors equal to $35,641, including $22,000 of principal and $13,641 of accrued interest and accrued affiliate loan fees as of and through the closing date of the Avista Merger. Following the consummation of the se , write-off

Line of Credit and Notes Payabl

Line of Credit and Notes Payable	12 Months Ended
	Dec. 31, 2019
Line of Credit Facility [Abstract]
Line of Credit and Notes Payable	11. Line of Credit and Notes Payable December 31, 2019 2018 Line of credit $ 33,484 $ 26,484 Term loan 50,000 — Less debt discount and debt issuance cost (366 ) — L — — Term loan, net of debt discount and debt issuance cost $ 49,634 $ — Notes payable — 15,885 Less debt discount and debt issuance cost — (762 ) L — (2,545 ) Notes payable, net of debt discount and debt issuance cost $ — $ 12,578 2019 In March 2019, the Company and its subsidiaries, Organogenesis Inc. and Prime Merger Sub, LLC (collectively, and jointly and severally, “Borrower”), and Silicon Valley Bank (“SVB”), as Administrative Agent, Issuing Lender and Swingline Lender, and the several other lenders thereto (the “Lenders”) entered into a Credit Agreement, as amended (the “2019 Credit Agreement”), pr o of $100,000. The Term Loan Facility is structured in three tranches, as follows: (i) the first tranche of $40,000 was made available to Borrower and fully funded on March 14, 2019; (ii) the second tranche of $10,000 was made available to Borrower and fully funded in 2019 is 2019 2019 thirty-six Borrower’s final payment on the Term Loan Facility, due on the Term Loan Maturity Date, will include all outstanding principal and accrued and unpaid interest under the Term Loan Facility, plus a final payment (the “Final Payment”) equal to the original aggregate principal amount of the Term Loan Facility multiplied by 6.25%. Borrower may prepay the Term Loan Facility, subject to paying the Prepayment Premium (described below) and the Final Payment. The Prepayment Premium is equal to 3.00% of the outstanding principal amount of the Term Loan Facility if the prepayment occurs on or prior to the one year anniversary of the closing, 2.00% of the outstanding principal amount of the Term Loan Facility if the prepayment occurs after such one year anniversary and prior to the second anniversary of the closing, and 1.00% of the outstanding principal amount of the Term Loan Facility if the prepayment occurs after the two year anniversary but prior to the three year anniversary of the closing, and 0% thereafter. Once repaid, amounts borrowed under the Term Loan Facility may not be re-borrowed. The Revolving Facility is equal to the lesser of $40,000 and the amount determined by the Borrowing Base, which is defined as a percentage of the Company’s book value of qualifying finished goods inventory and eligible accounts receivable. The interest rate for advances under the Revolving Facility is a floating per annum interest rate equal to the Wall Street Journal Prime Rate. In the event that the aggregate amount of interest earned by the Lenders from the Revolving Facility in any given month is less than the interest that would have been earned if Borrower had average outstanding advances in an amount equal to 25% of the then-available Revolving Commitments (as defined in the 2019 2019 minus Borrower may elect to reduce or terminate the Revolving Facility in its entirety at any time by repaying all outstanding principal, unpaid accrued interest and a reduction or termination fee equal to 4.00% of the aggregate Revolving Commitments so reduced or terminated if the reduction or termination occurs on or prior to the one year anniversary of the closing, 3.00% of the aggregate Revolving Commitments so reduced or terminated if the reduction or termination occurs after such one year anniversary and prior to the second anniversary of the closing, and 2.00% of the aggregate Revolving Commitments so reduced or terminated if the reduction or termination occurs after the two year anniversary but prior to the three year anniversary of the closing, and $0 thereafter. Under the 2019 2019 by March 31 As of December 31, 2019, the Company was in compliance with the financial covenants under the 2019 s dr aw in As of December 31, 2019, the Company had outstanding borrowings of $50,000 under the Term Loan Facility and $33,484 under the Revolving Facility with up to $6,516 (subject to the Borrowing Base) available for future revolving borrowings. The Company accrues for the Final Payment over the term of the Term Loan Facility through a charge to the interest expense. The related liability of $681 as of December 31, 2019, was included in the other liabilities in the consolidated balance sheets. The Company incurred costs of $554 in connection with the Term Loan Facility, of which $462 wa Future payments of Term Loan Facility, as of December 31, 2019, are as follows for the calendar years ended December 31: 2020 $ — 202 1 13,889 202 2 16,666 202 3 16,667 2024 2,778 Total $ 50,000 2017 On March 21, 2017, the Company entered into a credit agreement (the “ 2017 sub-facility sub-facility sub-facilities 2 017 2017 l On March 14, 2019, $26,541, representing all outstanding unpaid principal and accrued interest relating to the revolving borrowing due under the 2017 2019 Master Lease Agreement On April 28, 2017, the Company entered into the Master Lease Agreement (the “ML Agreement”) with Eastward Fund Management LLC that allowed the Company to borrow up to $20,000 on or prior to June 30, 2018. Of the allowable amount, the Company borrowed a total of $16,000. If the Company elected to prepay the loan or terminated the loan early within the first 24 months, the Company was required to pay an additional 3% of the outstanding principal and any accrued and unpaid interest and fees. This prepayment fee decreased to 2% after the first 24 months. A final payment fee of 6.5% multiplied by the principal amount of the borrowings under the ML Agreement was due upon the earlier to occur of the first day of the final payment term month or prepayment of all outstanding principal. In March 2019, upon entering into the 2019 2019 In connection with the ML Agreement, the Company issued a warrant to purchase 473,011 shares of Class A common stock at $2.53 per share as a pre-condition for wa .

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2019
Equity [Abstract]
Stockholders' Equity	12. Stockholders’ Equity As of December 31, 2019, the Company’s certificate of incorporation, as amended and restated, authorized the Company to issue 400,000,000 shares of $0.0001 par value Class A common stock; 20,000,000 shares of $0.0001 par value Class B common stock; and 1,000,000 shares of $0.0001 par value preferred stock. 105,599,434 shares of Class A common stock were issued and 104,870,886 shares were outstanding as of December 31, 2019. The issued shares include 728,548 shares that were reacquired in connection with the redemption of redeemable shares in March 2019. See Note “3. Fair Value Measurement of Financial Instruments”. Each share of Class A common stock entitles the holder to one vote on all matters submitted to the stockholders for a vote. Class A common stockholders are entitled to receive dividends, as may be declared by the Board of Directors. Through December 31, 2019, no cash dividends have been declared or paid. At December 31, 2019 and 2018, the Company has reserved the following shares of Class A common stock for future issuance: December 31, December 31, Shares reserved for issuance for outstanding options 6,503,646 6,590,195 Shares reserved for issuance for future option grant 9,008,996 9,108,996 Shares reserved for issuance under the warrants — 17,732,700 Total shares of authorized common stock reserved for future issuance 15,512,642 33,431,891 Avista Merger In connection with the Avista Merger in 2018 (see Note “1. Nature of Business and Basis of Presentation”), founders and certain directors of AHPAC, surrendered to AHPAC an aggregate of 6,359,007 founder shares and 16,400,000 private placement warrants. All such founder shares and private placement warrants were cancelled. The remaining outstanding founder shares were converted into 1,390,993 shares of Class A common stock pursuant to the Company’s charter in connection with the Avista Merger. In addition, the Company issued to the PIPE Investors 15,561,473 shares of Class A common stock and 4,100,000 warrants to purchase one-half In connection with the Avista Merger on December 10, 2018, the Company also converted a portion of the affiliate debt into 6,502,679 shares of Class A common stock. Following the Avista Merger on December 10, 2018, 31,000,000 Public Warrants (defined below) to purchase one half of one share of Class A common stock at an exercise price of $11.50 per share remained outstanding. The warrants were classified as equity and recorded to additional paid-in-capital. Warrant Exchange and Warrant Exercise As of December 31, 2018, the outstanding warrants to purchase shares of Class A common stock consisted of the following: December 31, 2018 Date Exercisable Number of Number of Exercise Exercisable Classification Expiration November 3, 2010 109,620 109,620 $ 3.95 Common Stock Equity Later of 8/31/2019 or upon repayment of the notes payable August 31, 2013 36,540 36,540 $ 3.95 Common Stock Equity Later of 8/31/2019 or upon repayment of the notes payable August 31, 2015 36,540 36,540 $ 3.95 Common Stock Equity Later of 8/31/2019 or upon repayment of the notes payable December 10, 2018 4,100,000 2,050,000 $ 11.50 Common Stock Equity December 10, 2023 December 10, 2018 31,000,000 15,500,000 $ 11.50 Common Stock Equity December 10, 2023 35,282,700 17,732,700 On July 22, 2019, the Company made an exchange offer (the “Exchange Offer”) to all holders of the Company’s 30 ,8 90,748 On August 19, 2019, the Company executed an amendment to the warrant agreement, dated October 10, 2016, governing its outstanding Public Warrants to provide the Company with the right to require the Public Warrants holders to exchange one share of their Public Warrant for 0.0855 shares of the Company’s Class A common stock. Pursuant to the amendment, the Company issued 80,451 additional shares in exchange for all remaining untendered Public Warrants. Pursuant to the terms of the Company’s previously announced Warrant Exchange Agreement dated July 12, 2019 with the PIPE Investors, the Company issued an aggregate of 389,501 shares of Class A common stock, to the PIPE Investors, at the same exchange ratio offered to the Public Warrant holders in the Exchange Offer, in exchange for an aggregate of 4,100,000 private placement warrants. On August 13, 2019, the Company’s prior lenders net exercised outstanding warrants to purchase an aggregate of 182,700 shares of the Company’s Class A common stock at an exercise price of $3.95 per share. The Company issued an aggregate of 19,426 shares of common stock in connection with this net exercise. As a result of these transactions, the Company issued an aggregate of 3,334,658 shares of common stock, representing approximately 3% of the total Class A common stock outstanding after such issuances. In addition, in the first quarter of 2019, the Company issued 54,626 shares of common stock in connection with some Public Warrant holders’ exercise of Public Warrants and received cash proceeds of $628. As of December 31, 2019, no warrants were outstanding. As the fair value of the warrants exchanged in the warrant exchange transactions immediately prior to the exchanges was less than the fair value of the common stock issued, the Company recorded a non-cash 645 Underwritten Public Offering On November 21, 2019, the Company entered into an underwriting agreement, with Credit Suisse Securities (USA) LLC and SVB Leerink, as representatives of the underwriters, with respect to a public offering (the “Underwritten Public Offering”) of 9,000,000 shares of the Company’s Class A common stock, par value $0.0001 per share, at a price per share to the public of $5.00, less underwriting discounts and commissions. The Company also granted the underwriters an option to purchase up to an additional 1,350,000 shares of common stock within thirty days after November 21, 2019 at the public offering price, less underwriting discounts and commissions to cover any over-allotments made by the underwriters in the sale and distribution of the Company’s common stock. In Connection with the Underwritten Public Offering, the Company entered into a fee letter agreement (the “Letter Agreement”) with Avista Capital Partners IV, L.P. (“Avista IV”), Avista Capital Partners (Offshore) IV, L.P. (“Avista IV Offshore” and together with Avista IV, the “Avista Funds”) and Avista Capital Holdings, L.P., an affiliate of the Avista Funds (the “Management Company”), pursuant to which the Company agreed to pay the Management Company a fee in consideration for certain services rendered in connection with the Avista Funds’ purchase of the Company’s Class A common stock in the Underwritten Public Offering. The fee paid to the Management Company was equal to the fee paid to the underwriters on a per-share The Underwritten Public Offering closed on November 26, 2019. On December 6, 2019, the underwriters partially exercised their option to purchase up to 1,350,000 additionaly shares of common stock by purchasing an additional 1,068,056 shares of common stock. In connection with this offering, the Company issued a total of 10,068,056 shares with gross proceeds of $50,340 and net proceeds of $46,830 after deducting underwriter discounts, payment to the Management Company and other offering expenses in the amount of $3,510 which were recorded to additional paid-in

Equity Incentive Plan Share-Bas

Equity Incentive Plan Share-Based Compensation	12 Months Ended
	Dec. 31, 2019
Share-based Payment Arrangement [Abstract]
Equity Incentive Plan Share-Based Compensation	13. Equity Incentive Plan Share-Based Compensation 2018 Stock Incentive Plan On November 28, 2018, the Board of Directors of the Company adopted, and on December 10, 2018, the Company’s stockholders approved, the Organogenesis 2018 Equity and Incentive Plan (the “2018 Plan”). The purposes of the 2018 Plan are to provide long-term incentives and rewards to the Company’s employees, officers, directors and other key persons (including consultants), to attract and retain persons with the requisite experience and ability, and to more closely align the interests of such employees, officers, directors and other key persons with the interests of the Company’s stockholders. The 2018 Plan authorizes the Company’s Board of Directors or a committee of not less than two independent directors (in either case, the “Administrator”) to grant the following types of awards: non-statutory As of December 31, 2019, a total of 9,198,996 shares of Class A common stock have been authorized to be issued under the 2018 Plan (subject to adjustment in the case of any stock dividend, stock split, reverse stock split, or similar change in capitalization of the Company). As of December 31, 2019, options to purchase 190,000 shares of Class A common stock were outstanding under the 2018 Plan. 2003 Stock Incentive Plan The Organogenesis 2003 Stock Incentive Plan (the “2003 Plan”), provides for the Company to issue restricted stock awards, or to grant incentive stock options or non-statutory non-statutory B D As of the closing of the Avista Merger on December 10, 2018, a total of 7,176,715 shares of Class A common stock were issuable upon exercise of outstanding options under the 2003 Plan. Effective as of the closing of the Avista Merger on December 10, 2018, no additional awards may be made under the 2003 Plan and as a result (i) any shares in respect of stock options that are expired or terminated under the 2003 Plan without having been fully exercised will not be available for future awards; (ii) any shares in respect of restricted stock that are forfeited to, or otherwise repurchased by the Company, will not be available for future awards; and (iii) any shares of common stock that are tendered to the Company by a participant to exercise an award will not be available for future awards. Following the closing of the Avista Merger, the 2003 Plan is administered by the Company’s B D Stock Option The Company measures the compensation cost of employee or consultant services received in exchange for an award of equity instruments based on the grant-date fair value of the award. That cost is recognized over the period during which an employee or consultant is required to provide service in exchange for the award. During the years ended December 31, 2019, 2018 and 2017, the Company recorded stock-based compensation expense of $936, $1,075, and $919, respectively, within selling, general and administrative expenses on the consolidated statements of operations. Stock options awarded under the 2018 Plan and the 2003 Plan expire 10 years after the grant date and typically vest over four or five years. The stock options granted during the years ended December 31, 2019 and 2018 were 100,000 and 248,567, respectively. The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods were as follows, presented on a weighted-average basis: Year Ended 2019 2018 Risk-free interest rate 2.24 % 2.73 % Expected term (in years) 6.50 5.89 Expected volatility 42.7 % 42.0 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 7.08 $ 5.99 Underlying stock price $ 7.08 $ 5.82 These assumptions resulted in an estimated weighted-average grant-date fair value per share of stock options granted during the years ended December 31, 2019 and 2018 of $ and $ , respectively. The following table summarizes the Company’s stock option activity since December 31, 2018: Number of Weighted Weighted Aggregate (in years) Outstanding as of December 31, 2018 7,266,185 $ 1.92 5.89 $ 33,909 Granted 100,000 7.08 Cancelled / forfeited (34,416 ) 4.10 Exercised (152,133 ) 1.76 715 Outstanding as of December 31, 2019 7,179,636 1.98 5.06 20,799 Options exercisable as of December 31, 2019 6,195,889 1.64 4.60 19,767 Options vested or expected to vest as of December 31, 2019 6,984,130 $ 1.92 4.98 $ 20,603 The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the fair value of the Company’s Class A common stock for those stock options that have exercise prices lower than the fair value of the Company’s Class A common stock. The total fair value of options vested during the years ended December 31, 2019 and 2018 was $1,079 and $963, respectively. As of December 31, 2019, the total unrecognized stock compensation expense was $1,252 and is expected to be recognized over a weighted-average period of 2.34 years. As of December 31, 2019, there were partial recourse notes outstanding totaling $635. These notes were taken by a former executive to exercise his stock options (see Note “17. Related Parties Transactions”) and the notes a outstanding for accounting purposes and the additional paid-in capital associated with these shares were deducted from equity in prior periods.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	14. Income Taxes The components of the income tax provision (benefit) consisted of the following for the years ended December 31, 2019, 2018 and 2017: Year Ended 201 9 201 8 201 7 (Benefit from) provision for income taxes: Current tax expense ( benefit Federal $ (105 ) $ (212 ) $ — State 116 101 214 Foreign 28 9 62 Total current tax expense (benefit) 39 (102 ) 276 Deferred tax expense (benefit) Federal 105 212 (6,401 ) State — — (900 ) Foreign 6 (26 ) — Total deferred tax expense (benefit) 111 186 (7,301 ) Total income tax expense (benefit) $ 150 $ 84 $ (7,025 ) As of December 31, 2019, the Company had available for the reduction of future years’ federal taxable income, net operating loss carry-forwards of approximately $173,843. Of these carry-forwards, $114,467 will expire from the year ended December 31, 2020 through 2037 and $59,376 can be carried forward indefinitely. The Company had state net operating loss carry-forwards of approximately $73,278 expiring from the year ended December 31, 2020 through 2039. At December 31, 2019, the Company had available for the reduction of future years’ federal taxable income, research and development credits of approximately $919 expiring between December 31, 20 20 Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2019 and 2018 are as follows: December 31, 201 9 201 8 Net operating loss carryforwards Federal $ 36,511 $ 34,707 State 4,075 3,208 Foreign 21 26 Other 11,858 12,219 Stock-based compensation 633 29 Fresh start and intangible assets acquired 1,280 (2,765 ) Net deferred tax assets before valuation allowance 54,378 47,424 Valuation allowance (54,251 ) (47,186 ) Net deferred tax assets $ 127 $ 238 A s of $ 54,251 and $47,186 , respectively. In 201 9, A s of are s of remaining prepaid expenses and other current assets, which represents the amount of refundable AMT credit the Company will claim with the 2019 tax return. Additionally, the Company’s subsidiary in Switzerland is carrying a deferred tax asset of approximately $21 The Company has not recorded withholding taxes on the undistributed earnings of its Swiss subsidiary because it is the Company’s intent to reinvest such earnings indefinitely. Ownership changes, as defined in the Internal Revenue Code, may limit the amount of net operating losses and research and development tax credit carryforwards that can be utilized annually to offset future taxable income. Subsequent ownership changes could further affect the limitation in future years. The differences between income taxes expected at the U.S. federal statutory income tax rate of 21 % December 31, 201 9 201 8 201 7 U.S. federal statutory income tax rate 21.0 % 21.0 % 35.0 % Tax reform act — % — % (134.4 ) % Federal valuation allowance (17.6 )% (18.4 )% 147.5 % State valuation allowance (3.9 )% (3.9 )% 3.0 % State and local 3.5 % 3.5 % 2.3 % Nondeductible expenses (1.4 )% (2.3 )% (6.8 )% Noncontrolling interest — % — % 2.2 % Uncertain tax position reserves (0.1 ) % (0.1 ) % (0.5 ) % Research and development credits (1.9 )% — % — % Effective income tax rate (0.4 )% (0.2 )% 48.3 % The Company recognizes the tax benefit from an uncertain tax position only if it is more-likely-than-not which have been subject to a full valuation allowance. The net decrease primarily relates to the expiration of the carryforward period for certain Federal R&D credits previously included as an unrecognized tax benefit. A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below: Year Ended 201 9 201 8 201 7 Gross balance at beginning of year $ 3,286 $ 3,486 $ 3,663 Additions based on tax positions related to the current period 133 157 231 Reductions for tax positions of prior years (801 ) (357 ) (408 ) Gross balance at end of year $ 2,618 $ 3,286 $ 3,486 The Company files income tax returns in the U.S. federal and state jurisdictions and Switzerland. With limited exceptions, the Company is no longer subject to federal, state, local or foreign examinations for years prior to December 31, 2015. However, carryforward attributes that were generated prior to December 31, 2015 may still be adjusted upon examination by state or local tax authorities if they either have been or will be used in a future period. The Company recognizes interest and penalty related expense s

Net Loss Per Share

Net Loss Per Share	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Net Loss Per Share	15. Net Loss Per Share Basic and diluted net loss per share attributable to Organogenesis Holdings Inc. common shareholders was calculated as follows: Year Ended December 31, 2019 2018 2017 Numerator: Net loss $ (40,454 ) $ (64,831 ) $ (7,525 ) Less: Net income attributable to non-controlling — — 863 Less: Accretion of redeemable common shares — — 423 Less: Non-cash dividend to warrant holders 645 — — Net loss attributable to Organogenesis Holdings Inc. common shareholders $ (41,099 ) $ (64,831 ) $ (8,811 ) Denominator: Weighted average common shares outstanding 92,840,401 69,318,456 63,876,767 Net loss per share $ (0.44 ) $ (0.94 ) $ (0.14 ) The Company’s potentially dilutive securities, which include redeemable common stock and stock options and warrants to purchase shares of Class A common stock, have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. Therefore, the weighted average number of common shares outstanding used to calculate both basic and diluted net loss per share attributable to common stockholders is the same. The Company excluded the following potential shares of Class A common stock, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to Organogenesis Holdings Inc. for the periods indicated because including them would have had an anti-dilutive effect: Year Ended December 31, 2019 2018 2017 Options to purchase common stock 7,179,636 7,266,715 7,150,214 Redeemable common stock — 728,548 728,548 Warrants to purchase common stock — 17,732,700 1,561,485 7,179,636 25,727,963 9,440,247

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies Disclosure	16. Commitments and Contingencies Capital Leases On January 1, 2013, the Company entered into capital lease arrangements with 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC for office and laboratory space in Canton, Massachusetts. 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC are related parties as the owners of these entities are also stockholders of the Company. The leases terminate on December 31, 2022 and each contains a renewal option for a five-year period with the rental rate at the greater of (i) rent for the last year of the prior term, or (ii) the then fair market value. Notice of the exercise of this renewal option is due one year prior to the expiration of the initial term. Aggregate annual lease payments are approximately $4,308 with future rent increases of 10% effective January 1, 2022. The Company records the capital lease asset within property and equipment and the liability is recorded within the capital lease obligations on the consolidated balance sheets. As of December 31, 2019 and 2018, the Company owed an aggregate of $10,336 and $10,293, respectively, of accrued but unpaid lease obligations which include rent in arrears and unpaid operating and common area maintenance costs under the aforementioned leases. The principal portion of rent in arrears on the capital leases totaled $6,321 and $5,265 as of December 31, 2019 and 2018, respectively, and is included in the long-term portion of capital lease obligations. The interest portion of rent in arrears totaled $3,512 and $4,174 as of December 31, 2019 and 2018, respectively, and is included in other liabilities on the consolidated balance sheets. The unpaid operating and common area maintenance costs totaled $503 and $854 as of December 31, 2019 and 2018, respectively, and are included in other liabilities on the consolidated balance sheets. The unpaid lease obligations are subordinated to the 2019 Credit Agreement and will not be paid until the debt under the 2019 Credit Agreement is paid off in 2024 even though the capital leases expire in December 2022. Effective April 1, 2019, the Company agreed to accrue interest on the accrued but unpaid lease obligations at an interest rate equal to the rate charged in the 2019 “11. Line of Credit and Notes Payable”) . The accrued interest is also subordinated to the 2019 Credit Agreement and, as such, is included in other liabilities on the consolidated balance sheet. Interest accrued as of December 31, 2019 totaled $717. In addition to the capital leases with affiliates discussed above, the Company also has certain insignificant capital leases with non-affiliates. Future obligations under capital leases in the aggregate and for the next five years is as follows: 2020 $ 4,791 2021 4,780 2022 4,945 2023 — 20 2 9,834 24,350 Less amount representing interest (6,862 ) Present value of minimum lease payments 17,488 Less current maturities (3,057 ) Long-term portion $ 14,431 Operating Lease The Company leases vehicles for certain employees and has one-year During March 2014, in conjunction with the acquisition of Dermagraft from Shire plc, the Company entered into a rental sublease agreement for certain operating and office space in California. The sublease agreement calls for escalating monthly rental payments and expires in December 2021. In conjunction with the acquisition of NuTech Medical in March 2017, the Company entered into an operating lease with Oxmoor Holdings, LLC, an entity that is affiliated with the former sole shareholder of NuTech Medical, related to the facility at NuTech Medical’s headquarters in Birmingham, Alabama. Under the lease, the Company is required to make monthly rent payments of approximately $21 through the lease termination date on December 31, 2020. The lease was extended in the first quarter of 2020 with the revised termination date on December 31, 2021. In March 2019, the Company entered into an agreement to lease approximately 43,850 square feet of office and laboratory space in Norwood, Massachusetts. Pursuant to the lease agreement, the rent commencement date is ten-year Operating lease expenses were $6,231, $4,628 and $4,205 for the years ended December 31, 2019, 2018 and 2017. Future minimum lease payments due under noncance l 20 20 $ 5,661 202 1 5,077 202 2 2,677 202 3 1,874 202 4 1,224 Thereafter 6,898 $ 23,411 Royalties The Company entered into a license agreement with a university for certain patent rights related to the development, use and production of one of its advanced wound care products. Under this agreement, the Company incurred a royalty based on a percentage of net product sales, for the use of these patents until the patents expired, which was in November 2006. Accrued royalties totaled $1,187 as of December 31, 2019 and 2018 and are classified as part of accrued expenses on the Company’s consolidated balance sheets. There was no royalty expense incurred during the years ended December 31, 2019 , 2018 In October 2017, the Company entered into a license agreement with a third party. Under the license agreement, the Company is required to pay royalties based on a percentage of net sales of the licensed product that occur, after December 31, 2017, through the expiration in October 2026 of the underlying patent, subject to minimum royalty payment provisions. The Company recorded royalty expense $3,778 , , and $3,122 during the years ended December 31, 2019, 2018 and 2017, respectively, within selling, general and administrative expenses on the consolidated statement s As part of the NuTech Medical acquisition (see Note “1. Nature of Business and Basis of Presentation”), the Company inherited certain product development and consulting agreements for ongoing consulting services and royalty payments based on a percentage of net sales on certain products over a period of 15 years from the execution of the agreements. These product development and consulting agreements were cance ll which was paid on February 14, 2020. Legal Matters In conducting its activities, the Company, from time to time, is subject to various claims and also has claims against others. In management’s opinion, the ultimate resolution of such claims would not have a material effect on the financial position, operating results or cash flows of the Company. The Company accrues for these claims when amounts due are probable and estimable. The Company accrued $ 542 . As discussed in Note “1. Nature of Business and Basis of Presentation”, the purchase price for NuTech Medical included $7,500 of future payments issued as deferred acquisition consideration. As of December 31, 2019, the Company has paid $2,500 in deferred acquisition consideration. The amount of the remaining $5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical was previo usly In February 2020, the Company entered into a settlement agreement with the sellers of NuTech Medical and settled the dispute for $4,000 , of which, $2,000 was paid immediately on February 24, 2020 (the “Settlement Date”) and the remaining $2,000 is to be paid in four quarterly installments of $500 each with the first quarterly payment due and payable on the date that is 90 days from the Settlement Date.

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2019
Related Party Transactions [Abstract]
Related Party Transactions	17. Related Parties Transactions Capital lease obligations to affiliates, including unpaid lease obligations, and an operating lease with affiliates are further described in Note “16 Commitments and Contingencies”. Affiliate debts are described in Note “10. Long-Term Debt—Affiliates”. Fee paid to the Avista Funds in connection with the Underwritten Public Offering is described in Note “12. Stockholders’ Equity.” During 2010, the Company’s Board of Directors approved a loan program that permitted the Company to make loans to three executives of the Company (the “Employer Loans”) to (i) provide them with liquidity (“Liquidity Loans”) and (ii) fund the exercise of vested stock options (“Option Loans”). The Employer Loans mature with all principal and accrued interest due on the tenth anniversary of the issuance date of each subject loan, except that in certain circumstances, the Employer Loans may mature earlier. The borrower may prepay all or any portion of his Employer Loan at any time without premium or penalty. Interest on the Employer Loans accrues at various rates ranging from 2.30%—3.86% per annum, compounded annually. The Employer Loans are secured by 1,857,450 and 675,990 shares of the Company’s Class A common stock held by two former executives, respectively. With respect to the Liquidity Loans, the Company has no personal recourse against the borrowers beyond the pledged shares. In connection with the Avista Merger (see Note “1. Nature of Business and Basis of Presentation”), the Company forgave the outstanding aggregate principal balance of $997 and accrued interest of $133 related to the current CEO’s Liquidity Loans immediately prior to consummation of the Avista Merger. As of December 31, 2019 and 2018, Liquidity Loans to two former executives were outstanding with an aggregate principal balance of $2,350 and Option Loans to one former executive were outstanding with an aggregate principal balance of $635 . The principal and part of the interest receivable under the Employer Loans were fully reserved with net interest receivable of $556 and $477 as of December 31, 2019 and 2018, respectively, included in the notes receivable from related parties balance in the consolidated balance sheets. Interest income related to these notes was $78

Employee Benefit Plan

Employee Benefit Plan	12 Months Ended
	Dec. 31, 2019
Retirement Benefits [Abstract]
Employee Benefit Plan	18. Employee Benefit Plan The Company maintains a 401(k) Savings Plan (the “Plan”) for the U.S. employees. Under the Plan, eligible employees may contribute, subject to statutory limitations, a percentage of their salary to the Plan. Contributions made by the Company are made at the discretion of the Board of Directors and vest immediately. During the years ended December 31, 2019, 2018 and 2017, the Company made employer contributions of $2,290 As part of the NuTech Medical acquisition (see Note “1. Nature of Business and Basis of Presentation”), pre-tax non-elective pre-tax

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2019
Subsequent Events [Abstract]
Subsequent Events	19. Subsequent Events The Company has performed an evaluation of subsequent events through the time of filing this Annual Report on Form 10-K In January 2020, the Company cancelled certain product development and consulting agreements inherited from NuTech Medical for total consideration of $1,950 which was paid on February 14, 2020. Refer to Note “16. Commitments and Contingencies”. In February 2020, the Company entered into a settlement agreement with the sellers of NuTech Medical and settled the dispute on the deferred acquisition consideration for $4,000, of which, $2,000 was paid immediately on February 24, 2020 (the “Settlement Date”) and the remaining $2,000 is to be paid in four quarterly installments of $500 each with the first quarterly payment due and payable on the date that is 90 days from the Settlement Date. Refer to Note “16. Commitments and Contingencies”. On March 2, 2020, the Company’s Board of Directors granted 596,000 $2,408 . These restricted stock units will vest over four years with the first tranche vesting on January 15, 2021.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported results of operations during the reporting period. Actual results and outcomes may differ significantly from those estimates and assumptions.
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc., and its wholly-owned subsidiaries, Organogenesis Inc. and the wholly-owned subsidiaries of Organogenesis Inc., including Organogenesis GmbH (a Switzerland corporation) and Prime Merger Sub, LLC. For periods prior to the closing of the Avista Merger on December 10, 2018, the notes to the consolidated financial statements have been updated to give effect to the Avista Merger. Dan Road Associates, LLC, 85 Dan Road Associates, LLC and Canton 65 Dan Road Associates, LLC (each a “Real Estate Entity,” collectively the “Real Estate Entities”) were variable interest entities requiring consolidation through the deconsolidation date of June 1, 2017. The Real Estate Entities were deconsolidated and the financial statements as of June 1, 2017 derecognized all assets and liabilities of the Real Estate Entities. Refer to Note “4. Real Estate Entities” to the consolidated financial statements in Part II, Item 8 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2018. The results of operations for the years ended December 31, 2017 include the operations of the Real Estate Entities through the date of deconsolidation . The consolidated balance sheet as of December 31, 2019 and 2018, and the results of operations for the years ended December 31, 2019 and 2018, do not include the accounts of the Real Estate Entities. All intercompany balances and transactions have been eliminated in consolidation.
Segment Reporting	Segment Reporting Operating segments are defined as components of an enterprise about which discrete financial information is available that is evaluated regularly by the chief operating decision maker, or decision making group, in making decisions on how to allocate resources and assess performance for the organization. The Company’s chief operating decision maker is the Chief Executive Officer. The Company’s chief operating decision maker reviews consolidated operating results to make decisions about allocating resources and assessing performance for the entire Company. Accordingly, the Company has determined that it has a single operating segment—regenerative medicine. The Company manages its operations as a single operating segment for the purposes of assessing performance and making operating decisions. The Company’s portfolio includes regenerative medicine products in various stages, ranging from preclinical to late stage development, and commercialized advanced wound care and surgical and sports medicine products which support healing across a wide variety of wound types at many different types of facilities.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company primarily maintains its cash in bank deposit accounts in the United States which, at times, may exceed the federally insured limits. The Company has not experienced losses in such accounts and believes it is not exposed to significant credit risk on cash. The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents.
Restricted Cash	Restricted Cash The Company had restricted cash of $ 196
Accounts Receivable	Accounts Receivable Accounts receivable are stated at invoice value less estimated allowances for sales returns and doubtful accounts. The Company estimates the allowance for sales returns based on a historical percentage of returns over a twelve-month trailing average of sales. The Company continually monitors customer payments and maintains a reserve for estimated losses resulting from its customers’ inability to make required payments. The Company considers factors when estimating the allowance for doubtful accounts such as historical experience, credit quality, age of the accounts receivable balances, geography-related risks and economic conditions that may affect a customer’s ability to pay. In cases where there are circumstances that may impair a specific customer’s ability to meet its financial obligations, a specific allowance is recorded against amounts due, thereby reducing the net recognized receivable to the amount reasonably believed to be collectible. Accounts receivables are written off when deemed uncollectible. Recoveries of accounts receivables previously written off are recorded when received.
Inventories	Inventories Inventories are stated at the lower of cost (determined under the first-in first-out The Company regularly reviews inventory quantities on hand and records a provision to write down excess and obsolete inventory to its estimated net realizable value based upon management’s assumptions of future material usage, yields and obsolescence, which are a result of future demand and market conditions and the effective life of certain inventory items. The Company also tests other components of its inventory for future growth projections. The Company determines the average yield of the component and compares it to projected revenue to ensure it is properly reserved.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are recorded at cost and depreciated over the estimated useful lives of the respective assets on a straight-line basis. As of December 31, 2019 and 2018, the Company’s property and equipment consisted of leasehold improvements, furniture and computers, and equipment. Property and equipment estimated useful lives are as follows: Leasehold improvements Lesser of the life of the lease or the Furniture and computers 3 - Equipment 5 - Upon retirement or sale, the cost of assets disposed of s
Goodwill	Goodwill Goodwill represents the excess of the purchase price of an acquired business over the fair value of the identifiable assets acquired and liabilities assumed. Goodwill is not amortized, but is tested for impairment at least annually (as of December 31), or more frequently if events or circumstances indicate the carrying value may no longer be recoverable and that an impairment loss may have occurred. Circumstances that could trigger an impairment test include, but are not limited to, a significant adverse change in the business climate or legal factors, an adverse action or assessment by a regulator, or unanticipated competition. The Company operates as one segment, which is considered to be the sole reporting unit, and therefore goodwill is tested for impairment at the consolidated level. In accordance with ASC Topic 350, Intangibles—Goodwill and Other , There was no impairment of goodwill recorded
Intangible Assets Subject to Amortization	Intangible Assets Subject to Amortization Intangible assets include intellectual property either owned by the Company or for which the Company has a license. Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired and reported net of accumulated amortization, separately from goodwill. Intangible assets with finite lives are amortized over their estimated useful lives. Intangible assets include developed technology and patents, trade names, trademarks, independent sales agency networks and non-compete Trade names and trademarks 10 - 12 years Developed technology 10 - 12 years Independent sales agency network 3 years Non-compete 5 years
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets Long-lived assets consist primarily of property and equipment and intangible assets. The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. Factors that the Company considers in deciding when to perform an impairment review include, but not limited to, significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets. When such an event occurs, the Company determines whether there has been impairment by comparing the anticipated undiscounted future net cash flows to the related asset group’s carrying value. If an asset is determined to be impaired, the asset is written down to fair value, which is determined based either on discounted cash flows or appraised value, depending on the nature of the asset. The Company did not record any impairment o f
Deferred Offering Costs	Deferred Offering Costs The Company capitalizes certain legal, professional accounting and other third-party fees that are directly associated with in-process The Company did not record any deferred offering costs in the consolidated balance sheets as of December 31, 2019 and 2018. During the year ended December 31, 2019, the Company recorded $3,510 of equity issuance costs to the additional paid-in Underwritten Public Offering ” paid-in
Warrant Liability	Warrant Liability In connection with the issuance of the 2016 Loans, the Company issued to the loan holders warrants to purchase shares of Class A common stock. The Company classifie d balance sheet because each warrant provided for down-round protection which would cause the exercise price of the warrants to be adjusted if future equity issuances were below the current exercise price of the warrants. The price of the warrant was also subject to adjustment any time the price of another equity-linked instrument changed. The warrant liability was initially recorded at fair value upon issuance and was subsequently remeasured to fair value at each reporting date until the warrants were net exercised in December 2018 in connection with the Avista Merger. Changes in the fair value of the warrant liability were recognized as a component of other income (expense), net in the consolidated statements of operations. The Company had no warrant liability as of December 31, 2019 and 2018.
Revenue Recognition	Revenue Recognition Adoption of ASC Topic 606, Revenue from Contracts with Customers (“ASC 606”) The Company adopted ASC 606 on January 1, 2019, using the modified retrospective method for all contracts not completed as of the date of adoption. The reported results for the year ended December 31, 2019 reflect the application of ASC 606 guidance while the reported results for the years ended December 31, 2018 and 2017 were prepared under the guidance of ASC Topic 605, Revenue Recognition Historically, for certain customers, products were shipped in advance of the receipt of a purchase order and the Company recognized revenue on these products only upon receipt of the purchase order which is when the transaction price was deemed fixed and determinable. As control of these products has transferred upon use of the product in a procedure, the recognition of revenue is accelerated to the procedure date under ASC 606. The adoption of ASC 606 did not have a material impact on the Company’s consolidated financial position, results of operations, equity or cash flows as of the adoption date or for the year ended December 31, 2019. Product Revenue The Company generates revenue through the sale of Advanced Wound Care and Surgical & Sports Medicine products. There is a single performance obligation in all of the Company’s contracts, which is the Company’s promise to transfer the Company’s product to customers based on specific payment and shipping terms in the arrangement. The entire transaction price is allocated to this single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s product which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract. Reserves for Variable Consideratio n Revenues from product sales are recorded net of reserves for variable consideration which includes but is not limited to product return, discounts, rebates and group purchasing organization (“GPO”) fees that are offered within contracts between the Company and its customers relating to the Company’s sales of its products. These reserves are based on the amounts earned or to be claimed by its customers on the related sales and are recorded as a reduction of accounts receivable or an establishment of a liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract and is included in the net sales price to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately paid may differ from the Company’s estimates. If actual results vary from the Company’s estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Product Returns Consistent with industry practice, the Company generally offers customers a limited right of return for product purchased. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return reserves using its historical return rates as well as factors that it becomes aware of that it believes could significantly impact its expected returns, including product recalls, pricing changes, or change in reimbursement rates. The Company does not record an asset for the returned product as the product is discarded upon receipt. Rebates and Allowances The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts, resulting in a reduction of revenue and the establishment of a liability that is included in accrued expenses in the accompanying consolidated balance sheets in the period the related product revenue is recognized. GPO Fees The Company pays fees to GPOs for administrative services that the GPOs perform in connection with the purchases of the product by the GPO members. These fees are based on a contractually-determined percentage of the Company’s applicable sales. The Company classifies these GPO fees as a reduction of revenue based on the substance of the relationship of all parties involved in the transaction. For the years ended December 31, 2019, 2018 and 2017, the Company recorded GPO fees of $3,096, $1,923 Other Revenue Policies Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue. Applying the practical expedient in paragraph ASC 606-10-32-18, Applying the practical expedient in ASC 340-40-25-4, Applying the practical expedient in ASC 606-10-25-18B, Disaggregation of Revenue The following table sets forth revenue by product category: Year Ended December 31, 2019 2018 2017 Advanced Wound Care revenue $ 220,744 $ 164,332 $ 178,896 Surgical and Sports Medicine revenue 40,237 29,117 19,612 Total revenue $ 260,981 $ 193,449 $ 198,508 For the years ended December 31, 2019, 2018 and 2017, net PuraPly revenue totaled $126,812 , $69,773 and $109,085, respectively. For all periods presented, net revenue generated outside the US represented less than 1% of total net revenue.
Stock-Based Compensation	Stock-Based Compensation The Company measures stock-based awards granted based on the fair value of the awards on the date of grant and recognizes compensation expense for those awards over the requisite service period, which is generally the vesting period of the respective award. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Generally, the Company issues stock-based awards with only service-based vesting conditions and records the expense for these awards using the straight-line method. The Company has not issued any stock-based awards with performance-based vesting conditions. The Company recognizes stock-based compensation expense within the consolidated financial statements for all share-based payments based upon the estimated grant-date fair value for the awards expected to ultimately vest. The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company has been a public company for a short period of time, has limited public float and lacks company-specific historical and implied volatility information for its stock. Therefore, it estimates its expected stock price volatility based on the historical volatility of publicly traded peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The expected term of the Company’s stock options has been determined utilizing the “simplified” method for awards that qualify as “plain-vanilla” options. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is based on the fact that the Company has never paid cash dividends on its Class A common stock and does not expect to pay any cash dividends in the foreseeable future.
Advertising	Advertising Advertising costs are expensed as incurred and are included in selling, general and administrative expense in the consolidated statements of operations. Advertising costs were approximately $ 1,059, $773, and $947 f
Research and Development Costs	Research and Development Costs Research and development expenses include personnel costs for the Company’s research and development personnel, investments in improvements to manufacturing processes, enhancements to the Company’s currently available products, and additional investments in the product and platform development pipeline. Research and development expenses also include expenses for clinical trials. The Company expenses research and development costs as incurred.
Foreign Currency	Foreign Currency The Company’s functional currency, including the Company’s Swiss subsidiary, Organogenesis GmbH, is the U.S. dollar. Foreign currency gains and losses resulting from re-measurement of as non-operating income
Income Taxes	Income Taxes The Company accounts for income taxes using the asset and liability method which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the consolidated financial statements or in the Company’s tax returns. Deferred tax assets and liabilities are determined on the basis of the differences between the consolidated financial statement and the tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company annually assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. Potential for recovery of deferred tax assets is evaluated by estimating the future taxable profits expected and considering prudent and feasible tax planning strategies. The Company accounts for uncertain income tax positions recognized in the consolidated financial statements by applying a two-step more-likely-than-not
Fair Value of Financial Instruments	Fair Value of Financial Instruments Certain assets and liabilities of the Company are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable: • Level 1—Quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data. • Level 3—Unobservable inputs that are supported by little or no market activity that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques. The carrying values of accounts receivable, inventory, prepaid expenses and other current assets, accounts payable and accrued expenses approximate their fair values due to the short-term nature of these assets and liabilities. The fair value of the redeemable common stock liability was carried at fair value, determined according to Level 3 inputs in the fair value hierarchy described above (see Note “3. Fair Value Measurement of Financial Instruments”). The carrying values of outstanding borrowings under the Company’s debt arrangements (see Notes “10. Long-Term Debt—Affiliates” and “11. Line of Credit and Notes Payable”) approximate their fair values as determined based on a discounted cash flow model, which represents a Level 3 measurement.
Net Loss per Share	Net Loss per Share The Company follows the two-class two-class two-class Basic net income (loss) per share attributable to common stockholders is computed by dividing the net income (loss) attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net income (loss) attributable to common stockholders is computed by adjusting net income (loss) attributable to common stockholders to reallocate undistributed earnings based on the potential impact of dilutive securities. Diluted net income (loss) per share attributable to common stockholders is computed by dividing the diluted net income (loss) attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period, including potential dilutive common shares. For purpose of this calculation, outstanding stock options, warrants to purchase shares of common stock and unvested restricted stock are considered potential dilutive common shares.
Emerging Growth Company	Emerging Growth Company Section 102 (b) (1) of the JOBS Act exempts emerging growth companies from being required to comply with new or revised financial accounting standards until private companies (that is, those that have not had a Securities Act registration statement declared effective or do not have a class of securities registered under the Securities Exchange Act of 1934 , as amended (the ”Exchange Act”) are required to comply with the new or revised financial accounting standards. The JOBS Act provides that a company can elect to opt out of the extended transition period and comply with the requirements that apply to non-emerging growth companies but any such election to opt out is irrevocable. The Company has elected not to opt out of such extended transition period which means that when a standard is issued or revised and it has different application dates for public or private companies, the Company, as an emerging growth company, can adopt the new or revised standard at the time private companies adopt the new or revised standard. For example, the Company will adopt ASU 2016-02 , Leases (Topic 842) on January 1 , 2021 and ASU 2016-13 , Financial Instruments—Credit Losses (Topic 326) on January 1 , 2023 . As a result, the Company’s financial statements may not be comparable to other public companies. The Company may take advantage of these exemptions up until the last day of the fiscal year following October 14 , 2021 , the fifth anniversary of its IPO, or such earlier time that it is no longer an emerging growth company. It would cease to be an emerging growth company if the Company has more than $ billion in annual revenue, the Company has more than $ .0 million in market value of its stock held by non-affiliates or the Company issues more than $ billion of non-convertible debt securities over a three-year period.
Reclassification of Prior Period Balances	Reclassification of Prior Period Balances Reclassifications have been made to prior period amounts to conform to the current-year presentation of the reporting of deferred interest and principal on outstanding capital lease obligations and unpaid operating and common area maintenance costs as long-term liabilities on the consolidated balance sheets. The deferred interest and unpaid operating and common area maintenance costs were previously reported as accrued expenses on the consolidated balance sheets and the deferred principal on the capital lease obligations were recorded as part of the current portion of capital lease obligations on the consolidated balance sheet. These reclassifications have no effect on the reported net loss or equity for the years ended December 31, 2018 and 2017. Reclassification has been made to prior period amounts reported in the cash flows from operating activities section of the consolidated cash flow statements to conform to the current year presentation. The provision recorded for inventory reserve has been reduced by amounts not related to excess and obsolete inventory and change in inventory has been increased by a corresponding amount. The reclassification has no effect on the reported balance sheet as of December 31, 2018 or net loss or equity or total operating, investing or financing cash flows for the years ended December 31, 2018 and 2017.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers (Topic 606) 2014-09”). 2018-07, Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting Topic 718, Compensation—Stock Compensation
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) 2016-02”), 2018-10, 2016-02, 2018-11, 2016-02, 2019-01, 2016-02 right-of-use In June 2016, the FASB issued ASU 2016-13 , Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments 2016-13”). 2016-13, 2018-19, Codification Improvements to Topic 326, Financial Instruments- Credit Losses 2019-04, Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments 2019-05, Financial Instruments—Credit Losses (Topic 326)—Targeted Transition Relief 2019-11, Codification Improvements to Topic 326, Financial Instruments—Credit Losses 2016-13 2016-13 2016-13

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Schedule of Revenue by Product Category	The following table sets forth revenue by product category: Year Ended December 31, 2019 2018 2017 Advanced Wound Care revenue $ 220,744 $ 164,332 $ 178,896 Surgical and Sports Medicine revenue 40,237 29,117 19,612 Total revenue $ 260,981 $ 193,449 $ 198,508
Summary of Estimated Useful Lives of Property Plant and Equipment	Property and equipment estimated useful lives are as follows: Leasehold improvements Lesser of the life of the lease or the Furniture and computers 3 - Equipment 5 -
Schedule of Finite-Lived Intangible Assets	Amortization of intangible assets subject to amortization is calculated on the straight-line or accelerated method based on the following estimated useful lives: Trade names and trademarks 10 - 12 years Developed technology 10 - 12 years Independent sales agency network 3 years Non-compete 5 years

Fair Value Measurement of Fin_2

Fair Value Measurement of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value, by Balance Sheet Grouping	The following table presents information about the Company’s financial assets and liabilities measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values as of December 31, 2018. The redeemable common stock liability was settled in March 2019 as described below. Fair Value Measurements as of December 31, 2018 Using: Level 1 Level 2 Level 3 Total Liabilities: Redeemable common stock liability $ — $ — $ 6,762 $ 6,762 $ — $ — $ 6,762 $ 6,762

Accounts receivable, net (Table

Accounts receivable, net (Tables)	12 Months Ended
	Dec. 31, 2019
Receivables [Abstract]
Schedule of accounts receivable	Accounts receivable consisted of the following: December 31, 2019 2018 Accounts receivable $ 42,408 $ 37,497 Less—allowance for sales returns and doubtful accounts (3,049 ) (3,420 ) $ 39,359 $ 34,077
Schedule of allowance for sales returns and doubtful accounts	The Company’s allowance for sales returns and doubtful accounts was comprised of the following: Balance as of December 31, 2017 $ 3,225 Additions 1,157 Write-offs (962 ) Balance as of December 31, 2018 $ 3,420 Additions 239 Write-offs (610 ) Balance as of December 31, 2019 $ 3,049

Inventories (Tables)

Inventories (Tables)	12 Months Ended
	Dec. 31, 2019
Inventory Disclosure [Abstract]
Schedule of Inventory, Current	Inventories, net of related reserves, consisted of the following: December 31, 201 9 2018 Raw materials $ 9,178 $ 4,711 Work in process 781 1,759 Finished goods 12,959 6,851 $ 22,918 $ 13,321

Prepaid Expenses and Other Cu_2

Prepaid Expenses and Other Current Assets (Tables)	12 Months Ended
	Dec. 31, 2019
Payables and Accruals [Abstract]
Schedule of prepaid expenses and other current assets	Prepaid expenses and other current assets consisted of the following: December 31, 2019 2018 Prepaid subscriptions $ 1,041 $ 594 Prepaid inventory testing 291 116 Prepaid conferences and marketing expenses 925 392 Prepaid insurance 472 223 Prepaid deposits 87 764 Other 137 239 $ 2,953 $ 2,328

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	12 Months Ended
	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and equipment consisted of the following: December 31, 2019 2018 Leasehold improvements $ 36,344 $ 34,345 Furniture, computers and equipment 46,430 44,752 82,774 79,097 Accumulated depreciation and amortization (65,812 ) (62,435 ) Construction in progress 30,222 22,961 $ 47,184 $ 39,623

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Finite-Lived Intangible Assets	Identifiable intangible assets consisted of the following as of December 31, 2019: Original Accumulated Net Book Developed technology $ 30,570 $ (11,266 ) $ 19,304 Trade names and trademarks 2,000 (650 ) 1,350 Independent sales agency network 4,500 (4,500 ) — Non-compete 260 (117 ) 143 Total $ 37,330 $ (16,533 ) $ 20,797 Identifiable intangible assets consisted of the following as of December 31, 2018: Original Accumulated Net Book Developed technology $ 29,820 $ (8,454 ) $ 21,366 Trade names and trademarks 2,000 (413 ) 1,587 Independent sales agency network 4,500 (1,569 ) 2,931 Non-compete 260 (53 ) 207 Total $ 36,580 $ (10,489 ) $ 26,091
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	Amortization of intangible assets, calculated on a straight-line basis or using an s 6,043 20 20 $ 3,267 202 1 3,332 202 2 3,322 202 3 3,358 202 4 1,842 Thereafter 5,676 Total $ 20,797

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	12 Months Ended
	Dec. 31, 2019
Payables and Accruals [Abstract]
Schedule of Accounts Payable and Accrued Liabilities	Accrued expenses and other current liabilities consisted of the foll o December 31, 2019 2018 Accrued personnel costs $ 17,640 $ 15,218 Other 5,810 5,170 $ 23,450 $ 20,388

Line of Credit and Notes Paya_2

Line of Credit and Notes Payable (Tables)	12 Months Ended
	Dec. 31, 2019
Line of Credit Facility [Abstract]
Schedule of line of credit facilities	December 31, 2019 2018 Line of credit $ 33,484 $ 26,484 Term loan 50,000 — Less debt discount and debt issuance cost (366 ) — L — — Term loan, net of debt discount and debt issuance cost $ 49,634 $ — Notes payable — 15,885 Less debt discount and debt issuance cost — (762 ) L — (2,545 ) Notes payable, net of debt discount and debt issuance cost $ — $ 12,578
Schudle of future payments of term loan facility	Future payments of Term Loan Facility, as of December 31, 2019, are as follows for the calendar years ended December 31: 2020 $ — 202 1 13,889 202 2 16,666 202 3 16,667 2024 2,778 Total $ 50,000

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2019
Equity [Abstract]
Schedule Of Common Stock Shares Reserved For Future Issuance	At December 31, 2019 and December 31, 2018, the Company has reserved the following shares of Class A common stock for future issuance: December 31, December 31, Shares reserved for issuance for outstanding options 6,503,646 6,590,195 Shares reserved for issuance for future option grant 9,008,996 9,108,996 Shares reserved for issuance under the warrants — 17,732,700 Total shares of authorized common stock reserved for future issuance 15,512,642 33,431,891
Schedule of Outstanding Warrants	As of December 31, 2018, the outstanding warrants to purchase shares of Class A common stock consisted of the following: December 31, 2018 Date Exercisable Number of Number of Exercise Exercisable for Classification Expiration November 3, 2010 109,620 109,620 $ 3.95 Common Stock Equity Later of 8/31/2019 or upon repayment of the notes payable August 31, 2013 36,540 36,540 $ 3.95 Common Stock Equity Later of 8/31/2019 or upon repayment of the notes payable August 31, 2015 36,540 36,540 $ 3.95 Common Stock Equity Later of 8/31/2019 or upon repayment of the notes payable December 10, 2018 4,100,000 2,050,000 $ 11.50 Common Stock Equity December 10, 2023 December 10, 2018 31,000,000 15,500,000 $ 11.50 Common Stock Equity December 10, 2023 35,282,700 17,732,700

Equity Incentive Plan Share-B_2

Equity Incentive Plan Share-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2019
Share-based Payment Arrangement [Abstract]
Schedule of Fair Value of Stock Options Granted to Employees and Directors	The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods were as follows, presented on a weighted-average basis: Year Ended 2019 2018 Risk-free interest rate 2.24 % 2.73 % Expected term (in years) 6.50 5.89 Expected volatility 42.7 % 42.0 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 7.08 $ 5.99 Underlying stock price $ 7.08 $ 5.82
Summary of Stock Option Activity	The following table summarizes the Company’s stock option activity since December 31, 2018: Number of Weighted Weighted Aggregate (in years) Outstanding as of December 31, 2018 7,266,185 $ 1.92 5.89 $ 33,909 Granted 100,000 7.08 Cancelled / forfeited (34,416 ) 4.10 Exercised (152,133 ) 1.76 715 Outstanding as of December 31, 2019 7,179,636 1.98 5.06 20,799 Options exercisable as of December 31, 2019 6,195,889 1.64 4.60 19,767 Options vested or expected to vest as of December 31, 2019 6,984,130 $ 1.92 4.98 $ 20,603

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Schedule of Components of Income Tax Expense (Benefit)	The components of the income tax provision (benefit) consisted of the following for the years ended December 31, 2019, 2018 and 2017: Year Ended 201 9 201 8 201 7 (Benefit from) provision for income taxes: Current tax expense ( benefit Federal $ (105 ) $ (212 ) $ — State 116 101 214 Foreign 28 9 62 Total current tax expense (benefit) 39 (102 ) 276 Deferred tax expense (benefit) Federal 105 212 (6,401 ) State — — (900 ) Foreign 6 (26 ) — Total deferred tax expense (benefit) 111 186 (7,301 ) Total income tax expense (benefit) $ 150 $ 84 $ (7,025 )
Component of Company's Deferred Tax Assets and Liabilities	Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2019 and 2018 are as follows: December 31, 201 9 201 8 Net operating loss carryforwards Federal $ 36,511 $ 34,707 State 4,075 3,208 Foreign 21 26 Other 11,858 12,219 Stock-based compensation 633 29 Fresh start and intangible assets acquired 1,280 (2,765 ) Net deferred tax assets before valuation allowance 54,378 47,424 Valuation allowance (54,251 ) (47,186 ) Net deferred tax assets $ 127 $ 238
Schedule of Effective Income Tax Rate Reconciliation	The differences between income taxes expected at the U.S. federal statutory income tax rate of 21 % December 31, 201 9 201 8 201 7 U.S. federal statutory income tax rate 21.0 % 21.0 % 35.0 % Tax reform act — % — % (134.4 ) % Federal valuation allowance (17.6 )% (18.4 )% 147.5 % State valuation allowance (3.9 )% (3.9 )% 3.0 % State and local 3.5 % 3.5 % 2.3 % Nondeductible expenses (1.4 )% (2.3 )% (6.8 )% Noncontrolling interest — % — % 2.2 % Uncertain tax position reserves (0.1 ) % (0.1 ) % (0.5 ) % Research and development credits (1.9 )% — % — % Effective income tax rate (0.4 )% (0.2 )% 48.3 %
Schedule of Unrecognized Tax Benefits Roll Forward	A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below: Year Ended 201 9 201 8 201 7 Gross balance at beginning of year $ 3,286 $ 3,486 $ 3,663 Additions based on tax positions related to the current period 133 157 231 Reductions for tax positions of prior years (801 ) (357 ) (408 ) Gross balance at end of year $ 2,618 $ 3,286 $ 3,486

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	Basic and diluted net loss per share attributable to Organogenesis Holdings Inc. common shareholders was calculated as follows: Year Ended December 31, 2019 2018 2017 Numerator: Net loss $ (40,454 ) $ (64,831 ) $ (7,525 ) Less: Net income attributable to non-controlling — — 863 Less: Accretion of redeemable common shares — — 423 Less: Non-cash dividend to warrant holders 645 — — Net loss attributable to Organogenesis Holdings Inc. common shareholders $ (41,099 ) $ (64,831 ) $ (8,811 ) Denominator: Weighted average common shares outstanding 92,840,401 69,318,456 63,876,767 Net loss per share $ (0.44 ) $ (0.94 ) $ (0.14 )
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block]	Year Ended December 31, 2019 2018 2017 Options to purchase common stock 7,179,636 7,266,715 7,150,214 Redeemable common stock — 728,548 728,548 Warrants to purchase common stock — 17,732,700 1,561,485 7,179,636 25,727,963 9,440,247

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Future Lease Payments	2020 $ 4,791 2021 4,780 2022 4,945 2023 — 20 2 9,834 24,350 Less amount representing interest (6,862 ) Present value of minimum lease payments 17,488 Less current maturities (3,057 ) Long-term portion $ 14,431
Schedule Of Operating Leased Assets	20 20 $ 5,661 202 1 5,077 202 2 2,677 202 3 1,874 202 4 1,224 Thereafter 6,898 $ 23,411

Nature of the Business and Basi

Nature of the Business and Basis of Presentation - Additional Information (Detail) $ / shares in Units, $ in Thousands	Dec. 06, 2019USD ($)	Dec. 10, 2018USD ($)shares	Mar. 24, 2017USD ($)shares	Aug. 17, 2018USD ($)shares	Mar. 31, 2017	Dec. 31, 2019USD ($)Segments$ / shares	Dec. 31, 2018USD ($)$ / sharesshares	Dec. 31, 2017USD ($)	Nov. 30, 2019$ / shares
Business Acquisition [Line Items]
Working capital						$ 65,706
Cash						60,174	$ 21,291
Accumulated deficit						(171,007)	(130,240)
Net loss						(40,454)	(64,831)	$ (8,388)
Cash used in operation						$ (33,528)	$ (60,635)	(3,493)
Commoon stock par value | $ / shares						$ 0.0001	$ 0.0001
Business acquisition consideration deferred						$ 5,000	$ 5,000
Number of Operating Segments | Segments						1
Number of Reportable Segments | Segments						1
Proceeds from issuance of stock	$ 50,340					$ 50,340	$ 92,000
Initial Shareholders And Other Holders [Member]
Business Acquisition [Line Items]
Common Stock, Shares Agreed to Surrender in Which Shares were Canceled with Merger Agreement Execution | shares				1,390,993
Founder Shares Transactions [Member] | Sponsor And Other Holders [Member]
Business Acquisition [Line Items]
Common Stock, Shares Agreed to Surrender in Which Shares were Canceled with Merger Agreement Execution | shares				6,359,007
Accounting Standards Update 2013-07 [Member]
Business Acquisition [Line Items]
Net loss						40,454
Cash used in operation						$ 33,528
Warrant [Member] | Founder Shares Transactions [Member] | Initial Shareholders And Other Holders [Member]
Business Acquisition [Line Items]
Common Stock, Shares Agreed to Surrender in Which Shares were Canceled with Merger Agreement Execution | shares				16,400,000
Warrant [Member] | Pipe Investor [Member]
Business Acquisition [Line Items]
Shares granted for business consideration | shares							4,100,000
Avista Merger Sub [Member]
Business Acquisition [Line Items]
Description of shares issuable						right to receive 2.03 shares of ORGO Class A common stock
NuTech Medical [Member]
Business Acquisition [Line Items]
Shares granted for business consideration | shares			3,642,746
Date of business acquisition					Mar. 18, 2017
Busniess acquisition consideration paid in cash			$ 12,000
Business acquisition consideration deferred			7,500
NuTech Medical [Member] | Restricted Stock Units (RSUs) [Member]
Business Acquisition [Line Items]
Restricted shares, forfeiture right asset			$ 377
NuTech Medical [Member] | Forfeiture Rights [Member]
Business Acquisition [Line Items]
Restricted shares, forfeiture right asset							$ 0	$ 589
NuTech Medical [Member] | Stock Option [Member]
Business Acquisition [Line Items]
Shares granted for business consideration | shares			137,543
Avista Merger [Member]
Business Acquisition [Line Items]
professional fees							11,206
Avista Merger [Member] | Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
professional fees							$ 3,072
Common Class A [Member]
Business Acquisition [Line Items]
Commoon stock par value | $ / shares						$ 0.0001			$ 0.0001
Shares granted for business consideration | shares			728,548
Common Class A [Member] | Pipe Investor [Member]
Business Acquisition [Line Items]
Shares granted for business consideration | shares		9,022,741		6,538,732
Business acquistion consideration purchase price of stock		$ 46,000		$ 46,000
Common Class A [Member] | Avista Merger Sub [Member]
Business Acquisition [Line Items]
Shares granted for business consideration | shares		75,073,548
Common Class A [Member] | NuTech Medical [Member]
Business Acquisition [Line Items]
Shares granted for business consideration | shares			2,185,647
Redeemable Common Stock | NuTech Medical [Member]
Business Acquisition [Line Items]
Shares granted for business consideration | shares			728,548

Significant Accounting Polici_4

Significant Accounting Policies - Property, Plant and Equipment (Detail)	12 Months Ended
	Dec. 31, 2019
Leasehold improvements
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	Lesser of the life of the lease or the economic life of the asset
Furniture and computers | Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	3 years
Furniture and computers | Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment | Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment | Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	10 years

Significant Accounting Polici_5

Significant Accounting Policies -Schedule of Finite-Lived Intangible Assets (Detail)	12 Months Ended
	Dec. 31, 2019
Trade names and trademarks | Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	10 years
Trade names and trademarks | Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Developed technology | Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	10 years
Developed technology | Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Independent sales agency network
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	3 years
Non-compete agreements
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	5 years

Significant Accounting Polici_6

Significant Accounting Policies - Schedule of Revenue by Product Category (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Total net revenue	$ 260,981	$ 193,449	$ 198,508
Advanced Wound Care
Total net revenue	220,744	164,332	178,896
Surgical & Sports Medicine
Total net revenue	$ 40,237	$ 29,117	$ 19,612

Significant Accounting Polici_7

Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Significant Accounting Policies [Line Items]
Revenue	$ 260,981	$ 193,449	$ 198,508
GPO Fees	3,096	1,923	1,159
Restricted Cash, Current	196	114
Deferred offering cost written off		3,494
Equity issuance costs recorded to additional paid-in capital	3,510	270
Selling, General and Administrative Expenses
Significant Accounting Policies [Line Items]
Advertising Expense	1,059	$ 773	$ 947
Emerging Growth Company | Maximum
Significant Accounting Policies [Line Items]
Annual Revenue	1,070,000
Market value of stocks held by non-affiliates	700,000
Issue of non convertible debt securiities	$ 1,000,000
Sales Revenue | International sales
Significant Accounting Policies [Line Items]
Concentration Risk, Percentage	1.00%	1.00%	1.00%
PuraPly
Significant Accounting Policies [Line Items]
Revenue	$ 126,812	$ 69,773	$ 109,085

Fair Value Measurement of Fin_3

Fair Value Measurement of Financial Instruments - Financial Assets And Liabilities Measured At Fair Value (Detail) - Fair Value, Measurements, Recurring $ in Thousands	Dec. 31, 2018USD ($)
Liabilities:
Redeemable common stock liability	$ 6,762
Redeemable common stock liability
Liabilities:
Redeemable common stock liability	6,762
Fair Value, Inputs, Level 3
Liabilities:
Redeemable common stock liability	6,762
Fair Value, Inputs, Level 3 | Redeemable common stock liability
Liabilities:
Redeemable common stock liability	$ 6,762

Fair Value Measurement of Fin_4

Fair Value Measurement of Financial Instruments - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Mar. 24, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2019	Mar. 24, 2019
Treasury stock				728,548
Accretion Expense		$ 0	$ 423
NuTech Medical
Temporary Equity, Redemption Price Per Share					$ 9.28
Common Class A
Company issued acquisition of shares	728,548
Redeemable common stock, Carrying amount		$ 6,762
Common Class A | NuTech Medical
Business Acquisition, Share Price	$ 8.70

Accounts receivable, net (Detai

Accounts receivable, net (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Receivables [Abstract]
Accounts receivable	$ 42,408	$ 37,497
Less—allowance for sales returns and doubtful accounts	(3,049)	(3,420)
Accounts receivable	$ 39,359	$ 34,077

Accounts receivable, net - Sale

Accounts receivable, net - Sales Returns and Doubtful Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Balance	$ 3,420	$ 3,225
Additions	239	1,157	$ 1,166
Write-offs	(610)	(962)
Balance	$ 3,049	$ 3,420	$ 3,225

Inventories (Detail)

Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Raw materials	$ 9,178	$ 4,711
Work in process	781	1,759
Finished goods	12,959	6,851
Inventory	$ 22,918	$ 13,321

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Inventory reserve and obsolescence charged to cost of goods	$ 1,297	$ 2,473	$ 3,170
Reserve for excess and obsolete inventory	$ 1,417	$ 1,206

Prepaid Expenses and Other Cu_3

Prepaid Expenses and Other Current Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Prepaid subscriptions	$ 1,041	$ 594
Prepaid inventory testing	291	116
Prepaid conferences and marketing expenses	925	392
Prepaid insurance	472	223
Prepaid deposits	87	764
Other	137	239
Prepaid Expense	$ 2,953	$ 2,328

Property and Equipment, Net (De

Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment, Gross	$ 82,774	$ 79,097
Accumulated depreciation and amortization	(65,812)	(62,435)
Property, Plant and Equipment, Net	47,184	39,623
Leasehold improvements
Property, Plant and Equipment, Gross	36,344	34,345
Furniture, computers and equipment
Property, Plant and Equipment, Gross	46,430	44,752
Construction in progress
Property, Plant and Equipment, Net	$ 30,222	$ 22,961

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Depreciation expense	$ 3,388	$ 3,309	$ 3,591
Leasehold improvements
Capital leases recorded within leasehold improvements	21,689	21,689
Accumulated depreciation to capital lease asset recorded within leasehold improvement	$ 13,777	$ 12,579

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Identifiable intangible assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Original Cost	$ 37,330	$ 36,580
Accumulated Amortization	(16,533)	(10,489)
Net Book Value	20,797	26,091
Developed technology
Original Cost	30,570	29,820
Accumulated Amortization	(11,266)	(8,454)
Net Book Value	19,304	21,366
Trade names and trademarks
Original Cost	2,000	2,000
Accumulated Amortization	(650)	(413)
Net Book Value	1,350	1,587
Independent sales agency network
Original Cost	4,500	4,500
Accumulated Amortization	(4,500)	(1,569)
Net Book Value	0	2,931
Non-compete agreements
Original Cost	260	260
Accumulated Amortization	(117)	(53)
Net Book Value	$ 143	$ 207

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Estimated future annual amortization expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
2020	$ 3,267
2021	3,332
2022	3,322
2023	3,358
2024	1,842
Thereafter	5,676
Total	$ 20,797	$ 26,091

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Apr. 30, 2019	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Mar. 24, 2017
Goodwill		$ 25,539	$ 25,539
Amortization of Intangible Assets		6,043	$ 3,669	$ 2,037
Intangible asset purchase, cash paid		250
Intangible asset purchase, remaining payables		500
Developed Technology Rights [Member]
Intangible asset purchase, value	$ 750
Intangible asset purchase, cash paid	$ 250
Intangible asset purchase, remaining payables		$ 500
NuTech Medical [Member]
Goodwill					$ 19,446

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Payables and Accruals [Abstract]
Accrued personnel costs	$ 17,640	$ 15,218
Other	5,810	5,170
Total Accrued Expenses and Other Current Liabilities	$ 23,450	$ 20,388

Long-Term Debt-Affiliates - Add

Long-Term Debt-Affiliates - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Gain (loss) on extinguishment of debt	$ (1,862)	$ (2,095)
Affiliated Entity [Member]
Long-term Debt			$ 56,642
Interest expense on the affiliate debt		3,892	3,189
Avista Merger Agreement [Member]
Outstanding principal amount		$ 45,746
Debt conversion, converted shares		6,502,679
Cash payment to creditors		$ 35,641
Gain (loss) on extinguishment of debt		(2,095)
Write off of unamortized debt discount		5,078
Difference between the FV of CS and the debt principal		$ 2,983
Maximum
Interest rate		15.00%
Minimum
Interest rate		1.60%
2018 Loans [Member]
Long-term Debt, Gross		$ 15,000
Affiliate Debt Principal [Member] | Avista Health care Public Acquisition Corp [Member]
Cash payment to creditors		22,000
Affiliate Debt Interest [Member] | Avista Health care Public Acquisition Corp [Member]
Cash payment to creditors		13,641
2016 Loans [Member]
Long-term Debt, Gross		$ 17,000
Extinguishment of debt unamorized discount amortized to interest expense			$ 4,577
Common Class A [Member] | Avista Merger Agreement [Member]
Common stock per share		$ 6.58

Line of Credit and Notes Paya_3

Line of Credit and Notes Payable (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Term loan, net of debt discount and debt issuance cost	$ 49,634
Notes payable		$ 15,885
Less debt discount and debt issuance cost	(366)	(762)
Less current maturities	0	(2,545)
Notes payable, net of debt discount and debt issuance cost	0	12,578
2017 Credit Agreement
Line of credit		$ 26,484
2019 Credit Agreement
Line of credit	33,484
Term loan	$ 50,000

Line of Credit and Notes Paya_4

Line of Credit and Notes Payable - Future payments of term loan (Detail) - 2019 Credit Agreement $ in Thousands	Dec. 31, 2019USD ($)
2021	$ 13,889
2022	16,666
2023	16,667
2024	2,778
Total	$ 50,000

Line of Credit and Notes Paya_5

Line of Credit and Notes Payable - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands

Mar. 14, 2019

Apr. 30, 2018

Apr. 27, 2017

Sep. 30, 2019

Mar. 31, 2019

Apr. 30, 2018

Dec. 31, 2019

Sep. 30, 2019

Jun. 30, 2019

Mar. 31, 2019

Dec. 31, 2018

Dec. 31, 2017

Mar. 31, 2020

Apr. 28, 2017

Mar. 31, 2017

Revenues

$ 260,981

$ 193,449

$ 198,508

Gain (loss) on extinguishment of debt

$ (1,862)

$ (2,095)

Warrants outstanding

35,282,700

Shares of common stock issuable under warrant

17,732,700

Warrants five [Member]

Warrants, Date exercisable

Dec. 10, 2018

Warrants outstanding

31,000,000

Warrants, Exercise price

$ 11.50

Shares of common stock issuable under warrant

15,500,000

ML Agreement

Letter of credit sub facility

$ 16,000

Aggregate amounts of loan

$ 20,000

Percentage of final payment fee

6.50%

Gain (loss) on extinguishment of debt

$ (1,862)

Warrants, Date exercisable

Apr. 27, 2017

Warrants outstanding

473,011

Repayment under Master Lease Agreement

$ 17,649

Warrants, Exercise price

$ 2.53

Equity securities

$ 959

ML Agreement | Common Class A

Shares of common stock issuable under warrant

302,434

2017 Credit Agreement

Letter of credit sub facility

$ 26,541

Future revolving borrowings

$ 3,516

Aggregate amounts of loan

$ 35,000

$ 35,000

2019 Credit Agreement

Term Loan Facility, financial covenants

maintain Minimum Liquidity (as defined in the 2019 Credit Agreement) equal to the greater of (i) 6 months Monthly Burn (as defined in the 2019 Credit Agreement) and (ii) $10,000.

Aggregate amounts of loan

$ 100,000

EBITDA income (loss)

$ 5,000

2019 Credit Agreement | Tranche One [Member]

Aggregate principal amount

$ 40,000

2019 Credit Agreement | Tranche Two [Member]

Aggregate principal amount

10,000

$ 10,000

Term Loan Facility, financial covenants

Borrower's achievement of trailing twelve month Consolidated Revenue of not less than $221,250 and a trailing three month Adjusted EBITDA (as defined in the 2019 Credit Agreement) loss not in excess of $5,000;

2019 Credit Agreement | Tranche Three [Member]

Expiration Date

Mar. 31, 2020

2019 Credit Agreement | Tranche Three [Member] | Scenario, Forecast [Member]

Aggregate principal amount

$ 10,000

2019 Credit Agreement | Minimum Trailing Twelve Month Achievement [Member]

Revenues

$ 221,250

231,500

$ 221,250

$ 213,500

$ 200,000

Repaid Before Two Years | ML Agreement

Prepayment fees

3.00%

Repaid After Two Years | ML Agreement

Prepayment fees

2.00%

Term Loan | 2017 Credit Agreement

Additional fund

$ 5,000

$ 5,000

Term Loan | 2019 Credit Agreement

Outstanding borrowings

50,000

Debt Issuance Costs, Net

$ 554

Debt Instrument, Basis Spread on Variable Rate

3.75%

Debt Instrument, Description of Variable Rate Basis

interest rate equal to 3.75% above the Wall Street Journal Prime Rate

Additional payment in aggregate of the principal amount percentage

6.25%

Expected Availability Of Credit Facility

$ 10,000

Interest payable non current

681

Term Loan | 2019 Credit Agreement | Repaid Before One year

Prepayment premium percentage

3.00%

Term Loan | 2019 Credit Agreement | Repaid After One year Before Two Years

Prepayment premium percentage

2.00%

Term Loan | 2019 Credit Agreement | Repaid After Two year Before Three Years [Member]

Prepayment premium percentage

1.00%

Term Loan | 2019 Credit Agreement | Repaid After Three Years [Member]

Prepayment premium percentage

0.00%

Term Loan | 2019 Credit Agreement | Tranche Three [Member]

Debt Issuance Costs, Net

92

Term Loan | 2019 Credit Agreement | Tranche One and Tranche Two

Debt Issuance Costs, Net

462

Revolving Credit Facility | 2017 Credit Agreement

Aggregate under revolving credit facility

$ 26,484

Aggregate amounts of loan

$ 30,000

Revolving Credit Facility | 2019 Credit Agreement

Letter of credit sub facility

$ 40,000

33,484

Future revolving borrowings

6,516

Debt Issuance Costs, Net

$ 370

Advance outstanding amount revolving facility

25.00%

Unused Line Fee

0.25%

Revolving Credit Facility | 2019 Credit Agreement | Repaid Before One year

Termination fee percentage

4.00%

Revolving Credit Facility | 2019 Credit Agreement | Repaid After One year Before Two Years

Termination fee percentage

3.00%

Revolving Credit Facility | 2019 Credit Agreement | Repaid After Two year Before Three Years [Member]

Termination fee percentage

2.00%

Revolving Credit Facility | 2019 Credit Agreement | Repaid After Three Years [Member]

Termination fee amount

$ 0

Stockholders' Equity (Detail)

Stockholders' Equity (Detail) - shares	Dec. 31, 2019	Dec. 31, 2018
Equity [Abstract]
Shares reserved for issuance for outstanding options	6,503,646	6,590,195
Shares reserved for issuance for future option grant	9,008,996	9,108,996
Shares reserved for issuance under the warrants		17,732,700
Common Stock, Capital Shares Reserved for Future Issuance	15,512,642	33,431,891

Stockholders Equity - Schedule

Stockholders Equity - Schedule of Outstanding Warrants to Purchase Common Stock (Detail)	12 Months Ended
	Dec. 31, 2018$ / sharesshares
Class of Warrant or Right [Line Items]
Number of Warrants	35,282,700
Number of common stock issuable	17,732,700
Warrant Exercisable at November 3, 2010
Class of Warrant or Right [Line Items]
Warrants, Date exercisable	Nov. 3, 2010
Number of Warrants	109,620
Number of common stock issuable	109,620
Warrants, Exercise price | $ / shares	$ 3.95
Warrants, Exercisable for	Common Stock
Warrants, Classification	Equity
Warrants, Expiration	Later of 8/31/2019 or upon repayment of the notes payable
Warrant Exercisable at August 31, 2013
Class of Warrant or Right [Line Items]
Warrants, Date exercisable	Aug. 31, 2013
Number of Warrants	36,540
Number of common stock issuable	36,540
Warrants, Exercise price | $ / shares	$ 3.95
Warrants, Exercisable for	Common Stock
Warrants, Classification	Equity
Warrants, Expiration	Later of 8/31/2019 or upon repayment of the notes payable
Warrant Exercisable at August 31, 2015
Class of Warrant or Right [Line Items]
Warrants, Date exercisable	Aug. 31, 2015
Number of Warrants	36,540
Number of common stock issuable	36,540
Warrants, Exercise price | $ / shares	$ 3.95
Warrants, Exercisable for	Common Stock
Warrants, Classification	Equity
Warrants, Expiration	Later of 8/31/2019 or upon repayment of the notes payable
Avista Investment Warrant
Class of Warrant or Right [Line Items]
Warrants, Date exercisable	Dec. 10, 2018
Number of Warrants	4,100,000
Number of common stock issuable	2,050,000
Warrants, Exercise price | $ / shares	$ 11.50
Warrants, Exercisable for	Common Stock
Warrants, Classification	Equity
Warrants, Expiration	December 10, 2023
Avista Merger Warrant
Class of Warrant or Right [Line Items]
Warrants, Date exercisable	Dec. 10, 2018
Number of Warrants	31,000,000
Number of common stock issuable	15,500,000
Warrants, Exercise price | $ / shares	$ 11.50
Warrants, Exercisable for	Common Stock
Warrants, Classification	Equity
Warrants, Expiration	December 10, 2023

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Dec. 06, 2019	Nov. 21, 2019	Jul. 22, 2019	Dec. 10, 2018	Mar. 24, 2017	Mar. 24, 2019	Mar. 31, 2019	Dec. 31, 2019	Dec. 31, 2018	Nov. 30, 2019	Aug. 19, 2019	Aug. 16, 2019	Aug. 13, 2019	Jul. 12, 2019
Common stock, shares authorized								400,000,000	400,000,000
Common stock, par value								$ 0.0001	$ 0.0001
Common Stock, Shares, Issued								105,599,434	91,261,413
Class of Warrant or Right, Outstanding									35,282,700
Common stock issuable upon warrant exercise									17,732,700
Non-cash deemed dividend to warrant holders								$ 645
Aggregate Purchase Price of Class A common stock	$ 50,340							$ 50,340	$ 92,000
Shares outstanding								104,870,886	91,261,413
Proceeds from Stock issued in the underwritten public offering								$ 46,831
Proceeds from warrant excercises								$ 628
PIPE Investor [Member]
Class of Warrant or Right, Outstanding														4,100,000
Public Warrants [Member]
Class of Warrant or Right, Outstanding				31,000,000				0
Common stock shares issued warrants excercised							54,626
Proceeds from warrant excercises							$ 628
Avista Merger [Member]
Common Stock, Shares, Issued									15,561,473
Class of Warrant or Right, Outstanding									4,100,000
Excecise price of warrants per unit				$ 11.50
Conversion of debts into Shares				6,502,679
Warrants, Date exercisable				Dec. 10, 2018
Underwritten Public Offer [Member]
Common stock price per share		$ 5
Shares issued in the underwritten public offering	1,068,056
Proceeds from Stock issued in the underwritten public offering	$ 46,830
Other offering expense	$ 3,510
Underwritten Public Offer [Member] | Maximum
Shares issued in the underwritten public offering	1,350,000	1,350,000
Initial Shareholders And Other Holders | Founder Shares Transactions
Common Stock, Shares Agreed to Surrender Subjected to Satisfaction or Waiver of Certain Closing Conditions									6,359,007
Initial Shareholders And Other Holders | Private Placement Warrants
Common Stock, Shares Agreed to Surrender Subjected to Satisfaction or Waiver of Certain Closing Conditions									16,400,000
Joshua Tamaroff [Member]
Professional Fees								$ 1,725
Exchange offer | Public Warrants [Member]
Class of Warrant or Right, Outstanding			30,890,748
Number of warrants exchanged for share issue			29,950,150
Common Class A
Common stock, par value								$ 0.0001		$ 0.0001
Company issued acquisition of shares					728,548
Common Stock, Shares, Issued								105,599,434
Percentage of common stock outstanding as a result of warrant conversion								3.00%
Common Class A | Avista Merger [Member] | Debt [Member]
Aggregate Purchase Price of common stock									$ 92,000
Common Class A | Underwritten Public Offer [Member]
Shares issued in the underwritten public offering		9,000,000
Common Class A | Underwritten Public Offer [Member] | Avista capital Partners IV LP [Member]
Shares issued in the underwritten public offering								6,000,000
Common Class A | Initial Shareholders And Other Holders | Avista Merger [Member]
Common Stock, Shares, Issued									1,390,993
Common Class A | Exchange offer
Common stock issuable upon warrant exercise								3,334,658
Common Class A | Exchange offer | PIPE Investor [Member]
Common stock issuable upon warrant exercise														389,501
Common Class A | Exchange offer | Public Warrants [Member]
Number Of Securities Called By Each Warrant			0.095								0.0855
Common stock issuable upon warrant exercise											80,451	2,845,280
Common Class A | Massachusetts Capital Resource Company Life Insurance Community Investment Initiative LLC [Member]
Excecise price of warrants per unit													$ 3.95
Common stock issuable upon warrant exercise													19,426
Maximum Shares Issuable Upon Warrant Exercise													182,700
Common Class B
Common stock, shares authorized								20,000,000
Common stock, par value								$ 0.0001
Preferred Stock
Common stock, shares authorized								1,000,000
Common stock, par value								$ 0.0001
Redeemable Common Stock | Nutech Acquisition [Member]
Company issued acquisition of shares						728,548

Equity Incentive Plan Share-B_3

Equity Incentive Plan Share-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 10, 2018
Common stock options outstanding	7,179,636	7,266,185
Weighted average grant-date fair value	$ 3.24	$ 2.39
Fair value of option vested	$ 1,079	$ 963
Unrecognized stock compensation expense	$ 1,252
Share-based compensation expected to be recognized over a weighted-average period	2 years 4 months 2 days
Option Loans
Related Parties Notes Receivable	$ 635	635
Number of shares issued as collateral for the option loans	675,990
Selling, General and Administrative Expenses
Share-based compensation expense	$ 936	$ 1,075	$ 919
2003 and 2018 Stock Incentive Plan
Stock option expiration period	10 years
2003 and 2018 Stock Incentive Plan | Maximum
Stock option granted vesting period	5 years
2003 and 2018 Stock Incentive Plan | Minimum
Stock option granted vesting period	4 years
Common Class A | Avista Merger [Member]
Common stock options outstanding				7,176,715
Common Class A | 2018 Stock Incentive Plan
Common stock options authorized	9,198,996
Common stock options outstanding	190,000

Equity Incentive Plan Share-B_4

Equity Incentive Plan Share-Based Compensation - Schedule of Fair Value of Stock Options Granted to Employees and Directors (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Risk-free interest rate	2.24%	2.73%
Expected term (in years)	6 years 6 months	5 years 10 months 20 days
Expected volatility	42.70%	42.00%
Expected dividend yield	0.00%	0.00%
Exercise price	$ 7.08	$ 5.99
Underlying stock price	$ 7.08	$ 5.82

Equity Incentive Plan Share-B_5

Equity Incentive Plan Share-Based Compensation - Summary of Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Number of Shares Outstanding	7,266,185
Number of Shares Granted	100,000	248,567
Number of Shares Canceled / forfeited	(34,416)
Number of Shares Exercised	(152,133)
Number of Shares Outstanding	7,179,636	7,266,185
Number of Shares Options Exercisable	6,195,889
Number of Shares Options vested or expected to vest	6,984,130
Weighted Average Exercise Price Outstanding	$ 1.92
Weighted Average Exercise Price Granted	7.08
Weighted Average Exercise Price Cancelled / forfeited	4.10
Weighted Average Exercise Price Exercised	1.76
Weighted Average Exercise Price Outstanding	1.98	$ 1.92
Weighted Average Exercise Price Options Exercisable	1.64
Weighted Average Exercise Price Options Vested or Expected to Vest	$ 1.92
Weighted Average Remaining Contractual Term (in years) Outstanding	5 years 21 days	5 years 10 months 20 days
Weighted Average Remaining Contractual Term (in years) Options Exercisable	4 years 7 months 6 days
Weighted Average Remaining Contractual Term (in years) Options Vested or Expected to Vest	4 years 11 months 23 days
Aggregate Intrinsic Value Outstanding	$ 20,799	$ 33,909
Aggregate Intrinsic Value Options Exercised	715
Aggregate Intrinsic Value Options Exercisable	19,767
Aggregate Intrinsic Value Options Vested or Expected to Vest	$ 20,603

Equity Incentive Plan Share-B_6

Equity Incentive Plan Share-Based Compensation - Parenthetical (Detail) - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Payment Arrangement [Abstract]
Options granted	100,000	248,567

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Income Tax Expense (Benefit) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Current Income Tax Expense (Benefit), Continuing Operations [Abstract]
Federal	$ (105)	$ (212)
State	116	101	$ 214
Foreign	28	9	62
Total current tax expense (benefit)	39	(102)	276
Federal	105	212	(6,401)
State			(900)
Foreign	6	(26)
Total deferred tax expense (benefit)	111	186	(7,301)
Total income tax expense (benefit)	$ 150	$ 84	$ (7,025)

Income Taxes - Component of Com

Income Taxes - Component of Company's Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Deferred Tax Assets, Operating Loss Carryforwards, Components [Abstract]
Federal	$ 36,511	$ 34,707
State	4,075	3,208
Foreign	21	26
Other	11,858	12,219
Stock-based compensation	633	29
Fresh start and intangible assets acquired	1,280	(2,765)
Net deferred tax assets before valuation allowance	54,378	47,424
Deferred tax assets valuation allowance	(54,251)	(47,186)
Net deferred tax assets	$ 127	$ 238

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation (Detail)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
U.S. federal statutory income tax rate	21.00%	21.00%	35.00%
Tax reform act			(134.40%)
Federal valuation allowance	(17.60%)	(18.40%)	147.50%
State valuation allowance	(3.90%)	(3.90%)	3.00%
State and local income taxes	3.50%	3.50%	2.30%
Nondeductible expenses	(1.40%)	(2.30%)	(6.80%)
Noncontrolling interest			2.20%
Uncertain tax position reserves	(0.10%)	(0.10%)	(0.50%)
Research and development tax credits	(1.90%)
Effective income tax rate	(0.40%)	(0.20%)	48.30%

Income Taxes - Schedule of Unre

Income Taxes - Schedule of Unrecognized Tax Benefits Roll Forward (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Gross balance at beginning of year	$ 3,286	$ 3,486	$ 3,663
Additions based on tax positions related to the current period	133	157	231
Reductions for tax positions of prior years	(801)	(357)	(408)
Gross balance at end of year	$ 2,618	$ 3,286	$ 3,486

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Federal corporate income tax rate	21.00%	21.00%	35.00%
Operating loss carryforwards research and development credit	$ 919
Deferred tax assets valuation allowance	54,251	$ 47,186
Increase in valuation allowance	7,065
Net deferred tax asset, AMT credit	106
Unrecognized tax benefits	$ 3,192	3,722	$ 3,801
Description of tax benefits upon ultimate settlement	The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement.
Income tax penalities and interest expense	$ 269	$ 209
Percentage of alternative minimum tax deferred tax asset reclasified	50.00%
Operating loss carryforward indefinately	$ 59,376
Subsidiaries [Member]
Net operating loss cary forward	21
Domestic Tax Authority [Member]
Operating Loss Carryforwards	173,843
Domestic Tax Authority [Member] | Expiration December 31, 2020 through 2037
Operating Loss Carryforwards	$ 114,467
Domestic Tax Authority [Member] | Minimum
Operating loss carryforward expiration term	Dec. 31, 2020
Tax credit carryforward expiration term	Dec. 31, 2020
Domestic Tax Authority [Member] | Maximum
Operating loss carryforward expiration term	Dec. 31, 2037
Tax credit carryforward expiration term	Dec. 31, 2037
State and Local Jurisdiction [Member] | Expiration December 31, 2020 through 2039
Operating Loss Carryforwards	$ 73,278
State and Local Jurisdiction [Member] | Minimum
Operating loss carryforward expiration term	Dec. 31, 2020
State and Local Jurisdiction [Member] | Maximum
Operating loss carryforward expiration term	Dec. 31, 2039

Net Loss Per Share - Basic and

Net Loss Per Share - Basic and diluted net loss per share (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Earnings Per Share [Abstract]
Net loss	$ (40,454)	$ (64,831)	$ (7,525)
Less: Net income attributable to non-controlling interests			863
Less: Accretion of redeemable common shares			423
Less: Non-cash dividend to warrant holders	645
Net loss attributable to Organogenesis Holdings Inc. common shareholders	$ (41,099)	$ (64,831)	$ (8,811)
Weighted average common shares outstanding—basic and diluted	92,840,401	69,318,456	63,876,767
Net loss per share—basic and diluted	$ (0.44)	$ (0.94)	$ (0.14)

Net Loss Per Share - Schedule o

Net Loss Per Share - Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share (Detail) - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	7,179,636	25,727,963	9,440,247
Employee Stock Option
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	7,179,636	7,266,715	7,150,214
Redeemable Common Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount		728,548	728,548
Warrant [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount		17,732,700	1,561,485

Commitments and Contingencies_2

Commitments and Contingencies (Schedule of leases payments) (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
2020	$ 4,791
2021	4,780
2022	4,945
2023
2024	9,834
Total	24,350
Less amount representing interest	(6,862)
Present value of minimum lease payments	17,488
Less current maturities	(3,057)	$ (2,236)
Long-term portion	$ 14,431	$ 15,418

Commitments and Contingencies_3

Commitments and Contingencies (Schedule Of Operating Leased Assets) (Detail) $ in Thousands	Dec. 31, 2019USD ($)
2020	$ 5,661
2021	5,077
2022	2,677
2023	1,874
2024	1,224
Thereafter	6,898
Total	$ 23,411

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) ft² in Thousands, $ in Thousands	Feb. 24, 2020USD ($)	Feb. 14, 2020USD ($)	Dec. 31, 2019USD ($)ft²	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Accrued Legal Expenses			$ 542	$ 1,000
Operating Lease, Expense			6,231	4,628	$ 4,205
Business Combination Contingent Consideration Liability Accrued Interest			$ 918
Land Subject to Ground Leases | ft²			43,850
Annual lease payments			$ 1,052
Annual lease payments ten year lease term			44
Annual lease payments five year lease term			33
Security Deposit			526
Increase (Decrease) in Security Deposits			$ (263)
Capital lease month of expiry			2022-12
Selling, General and Administrative Expenses
Royalty Expense			$ 3,778	2,059	3,122
Accrued But Unpaid Capital Lease Obligation
Accrued Interest			717
Accrued But Unpaid Capital Lease Obligation | Principal and Interest
Capital lease rental arrears			10,336	10,293
Accrued But Unpaid Capital Lease Obligation | Interest
Capital lease rental arrears			3,512	4,174
Accrued But Unpaid Capital Lease Obligation | Principal
Capital lease rental arrears			6,321	5,265
Accrued But Unpaid Capital Lease Obligation | CAM Portion of Accrued Rent
Capital lease rental arrears			503	854
License Agreement with University
Accrued Royalties			1,187	1,187
Royalty Expense			0	$ 0	$ 0
Dan Road Associates
Capital Lease Obligations			$ 4,308
Capital Leases Aggregate Annual Lease Payments Rent Percentage			10.00%
NuTech Medical
Deferred Acquisition Cost Paid			$ 2,500
The amount, if any, of the remaining $5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical is currently in dispute.			5,000
Business Combination Deferred Consideration			7,500
Under the lease, the Company is required to make monthly rent payments of approximately			$ 21
Consulting service and royalty payment term			15 years
NuTech Medical | Subsequent Event
Agreement cancellation charges paid		$ 1,950
Damages awarded	$ 4,000
Loss contingency damages paid	2,000
Loss contingency value of each instalment to be paid	500
Loss contigency damages payable	$ 2,000

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Net principal and interest receivable	$ 556	$ 477
Interest Income	78	64	$ 111
Chief Executive Officer [Member] | Principal Forgiveness [Member]
Loans advanced written off		997
Chief Executive Officer [Member] | Interest Forgiveness [Member]
Loans advanced written off		133
Option Loans
Related Parties Notes Receivable	635	635
Liquidity Loan to Two Former Employee
Note Receivable	$ 2,350	$ 2,350
Class A | Employer Loan Former Executive One
Stock Held By Employee	1,857,450
Class A | Employer Loan Former Executive Two
Stock Held By Employee	675,990
Maximum | Liquidity Loan and Option Loans
Interest Rate	3.86%
Minimum | Liquidity Loan and Option Loans
Interest Rate	2.30%

Employee Benefit Plan - Additio

Employee Benefit Plan - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Retirement Benefits [Abstract]
Company made employer contributions	$ 2,290	$ 1,883	$ 1,006
Company is required to make matching contributions	3.00%

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) - Subsequent Event [Member] - USD ($) $ in Thousands	Mar. 02, 2020	Feb. 24, 2020	Feb. 14, 2020
Restricted Stock Units [Member]
Stock option granted during the period	596,000
Stock option granted vesting period	4 years
Aggregate fair value of stock option granted	$ 2,408
Restricted Stock Units [Member] | Tranche One [Member]
Vesting date	Jan. 15, 2021
NuTech Medical
Agreement cancellation charges paid			$ 1,950
Damages awarded		$ 4,000
Loss contingency damages paid		2,000
Loss contingency value of each instalment to be paid		$ 500
Description of the terms of the loss contingency payment		Four quarterly installments
Loss contigency damages payable		$ 2,000