Organogenesis (ORGO) 10-Q 9 Nov 21 2021 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2021	Nov. 01, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Document Quarterly Report	true
Document Transition Report	false
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 Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Trading Symbol	ORGO
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Address, State or Province	MA
Title of 12(b) Security	Class A Common Stock, $0.0001 par value
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		128,641,628
Entity File Number	001-37906
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	85 Dan Road
Entity Address, City or Town	Canton
Entity Address, Postal Zip Code	02021
Entity Tax Identification Number	98-1329150
City Area Code	781
Local Phone Number	575-0775

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash	$ 102,237	$ 84,394
Restricted cash	487	412
Accounts receivable, net	74,583	56,804
Inventory	29,495	27,799
Prepaid expenses and other current assets	5,033	4,935
Total current assets	211,835	174,344
Property and equipment, net	74,774	55,792
Intangible assets, net	26,896	30,622
Goodwill	28,772	28,772
Operating lease right-of-use assets, net	26,522
Deferred tax asset, net	18	18
Other assets	1,606	670
Total assets	370,423	290,218
Current liabilities:
Deferred acquisition consideration		483
Current portion of term loan	2,186	16,666
Current portion of finance lease obligations	8,531	3,619
Current portion of operating lease obligations	4,667
Current portion of deferred rent and lease incentive obligation		95
Accounts payable	28,488	23,381
Accrued expenses and other current liabilities	37,128	23,973
Total current liabilities	81,000	68,217
Line of credit	0	10,000
Term loan, net of current portion	71,667	43,044
Deferred acquisition consideration, net of current portion	1,436	1,436
Earnout liability	0	3,985
Deferred rent and lease incentive obligation, net of current portion		2,315
Finance lease obligations, net of current portion	831	11,442
Operating lease obligations, net of current portion	24,204
Other liabilities	2,111	7,971
Total liabilities	181,249	148,410
Commitments and contingencies (Note 18)
Stockholders' equity:
Preferred stock, $0.0001 par value; 1,000,000 shares authorized; none issued
Common stock, $0.0001 par value; 400,000,000 shares authorized; 129,365,209 and 128,460,381 shares issued; 128,636,661 and 127,731,833 shares outstanding at September 30, 2021 and December 31, 2020, respectively.	13	13
Additional paid-in capital	300,989	296,830
Accumulated deficit	(111,828)	(155,035)
Total stockholders' equity	189,174	141,808
Total liabilities and stockholders' equity	$ 370,423	$ 290,218

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	400,000,000	400,000,000
Common stock, shares issued	129,365,209	128,460,381
Common stock, shares outstanding	128,636,661	127,731,833

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Net revenue	$ 113,753	$ 100,799	$ 339,501	$ 231,491
Cost of goods sold	26,167	22,964	81,602	61,799
Gross profit	87,586	77,835	257,899	169,692
Operating expenses:
Selling, general and administrative	62,369	51,325	182,950	150,797
Research and development	8,953	3,709	22,482	13,787
Total operating expenses	71,322	55,034	205,432	164,584
Income from operations	16,264	22,801	52,467	5,108
Other expense, net:
Interest expense, net	(1,482)	(2,969)	(6,383)	(8,391)
Loss on extinguishment of debt	(1,883)		(1,883)
Gain on settlement of deferred acquisition consideration		951		2,246
Other income, net	(19)	44	(4)	90
Total other expense, net	(3,384)	(1,974)	(8,270)	(6,055)
Net income (loss) before income taxes	12,880	20,827	44,197	(947)
Income tax expense	(303)	(72)	(990)	(134)
Net income (loss)	$ 12,577	$ 20,755	$ 43,207	$ (1,081)
Net income (loss), per share:
Basic	$ 0.10	$ 0.20	$ 0.34	$ (0.01)
Diluted	$ 0.09	$ 0.19	$ 0.32	$ (0.01)
Weighted-average common shares outstanding
Basic	128,546,301	105,040,035	128,219,674	104,748,297
Diluted	133,850,216	108,489,768	133,766,004	104,748,297

CONSOLIDATED STATEMENTS STOCKHO

CONSOLIDATED STATEMENTS STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Previously Reported [Member]	Revision of Prior Period, Reclassification, Adjustment [Member]	Common Stock	Common StockPreviously Reported [Member]	Additional Paid-in Capital	Additional Paid-in CapitalPreviously Reported [Member]	Additional Paid-in CapitalRevision of Prior Period, Reclassification, Adjustment [Member]	Accumulated Deficit	Accumulated DeficitPreviously Reported [Member]	Accumulated DeficitRevision of Prior Period, Reclassification, Adjustment [Member]
Balance at Dec. 31, 2019	$ 52,022	$ 55,583		$ 10	$ 10	$ 224,281	$ 226,580		$ (172,269)	$ (171,007)
Balance (in shares) at Dec. 31, 2019				104,870,886	104,870,886
Adjustment due to Private Warrant reclassification								$ (2,299)			$ 2,299
Adjustment due to right of use asset amortization			$ (3,561)								(3,561)
Exercise of stock options	1,286			$ 1		1,285
Exercise of stock options (in shares)				638,315
Issuance of common stock associated with business acquisition	7,986					7,986
Issuance of common stock associated with business acquisition (in shares)				1,947,953
Stock-based compensation expense	1,164					1,164
Net income (loss)	(1,081)	(545)							(1,081)
Balance at Sep. 30, 2020	61,377			$ 11		234,716			(173,350)
Balance (in shares) at Sep. 30, 2020				107,457,154
Balance at Jun. 30, 2020	31,832	35,750		$ 11	$ 11	225,926	228,225		(194,105)	(192,486)
Balance (in shares) at Jun. 30, 2020				105,417,168	105,417,168
Adjustment due to Private Warrant reclassification								(2,299)			2,299
Adjustment due to right of use asset amortization			(3,918)								(3,918)
Exercise of stock options	318					318
Exercise of stock options (in shares)				92,033
Issuance of common stock associated with business acquisition	7,986					7,986
Issuance of common stock associated with business acquisition (in shares)				1,947,953
Stock-based compensation expense	486					486
Net income (loss)	20,755								20,755
Balance at Sep. 30, 2020	61,377			$ 11		234,716			(173,350)
Balance (in shares) at Sep. 30, 2020				107,457,154
Balance at Dec. 31, 2020	$ 141,808	146,084		$ 13	$ 13	296,830	299,129		(155,035)	(153,058)
Balance (in shares) at Dec. 31, 2020	127,731,833			127,731,833	127,731,833
Adjustment due to Private Warrant reclassification								$ (2,299)			2,299
Adjustment due to right of use asset amortization			(4,276)								(4,276)
Exercise of stock options	$ 2,115					2,115
Exercise of stock options (in shares)				716,927
Vesting of RSUs, net of shares surrendered to pay taxes	(737)					(737)
Vesting of RSUs, net of shares surrendered to pay taxes (in shares)				187,901
Stock-based compensation expense	2,781					2,781
Net income (loss)	43,207								43,207
Balance at Sep. 30, 2021	$ 189,174			$ 13		300,989			(111,828)
Balance (in shares) at Sep. 30, 2021	128,636,661			128,636,661
Balance at Jun. 30, 2021	$ 174,646	$ 178,922		$ 13	$ 13	299,038	$ 299,038		(124,405)	$ (120,129)
Balance (in shares) at Jun. 30, 2021				128,283,241	128,283,241
Adjustment due to right of use asset amortization			$ (4,276)								$ (4,276)
Exercise of stock options	910					910
Exercise of stock options (in shares)				353,420
Stock-based compensation expense	1,041					1,041
Net income (loss)	12,577								12,577
Balance at Sep. 30, 2021	$ 189,174			$ 13		$ 300,989			$ (111,828)
Balance (in shares) at Sep. 30, 2021	128,636,661			128,636,661

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income (loss)	$ 43,207	$ (1,081)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation	4,010	3,285
Amortization of intangible assets	3,726	2,518
Amortization of operating lease right-of-use assets	4,117
Non-cash interest expense	236	160
Deferred interest expense	1,331	1,577
Deferred rent expense		33
Gain on settlement of deferred acquisition consideration		(2,246)
Provision recorded for sales returns and doubtful accounts	2,862	2,559
Loss on disposal of property and equipment	1,397	201
Adjustment for excess and obsolete inventories	8,045	2,024
Stock-based compensation	2,781	1,164
Change in fair value of Earnout liability	(3,985)
Loss on extinguishment of debt	1,883
Changes in operating assets and liabilities:
Accounts receivable	(20,642)	(19,160)
Inventory	(9,741)	(7,757)
Prepaid expenses and other current assets	(98)	(1,647)
Operating leases	(4,179)
Accounts payable	5,237	(3,778)
Accrued expenses and other current liabilities	6,765	3,521
Other liabilities	(2,922)	878
Net cash provided by (used in) operating activities	44,030	(17,749)
Cash flows from investing activities:
Purchases of property and equipment	(25,993)	(12,260)
Cash paid for business acquisition		(5,820)
Net cash used in investing activities	(25,993)	(18,080)
Cash flows from financing activities:
Line of credit borrowings (repayments) under the 2019 Credit Agreement	(10,000)	5,869
Term loan borrowings (repayments) under the 2019 Credit Agreement	(60,000)	10,000
Proceeds from term loan under the 2021 Credit Agreement, net of debt discount and issuance cost	73,174
Term loan repayments under the 2021 Credit Agreement	(469)
Payments of withholding taxes in connection with RSUs vesting	(737)
Proceeds from the exercise of stock options	2,115	1,286
Principal repayments of finance lease obligations	(2,099)	(1,776)
Payment to extinguish debt	(1,620)
Payment of deferred acquisition consideration	(483)	(3,034)
Net cash (used in) provided by financing activities	(119)	12,345
Change in cash and restricted cash	17,918	(23,484)
Cash and restricted cash, beginning of period	84,806	60,370
Cash and restricted cash, end of period	102,724	36,886
Supplemental disclosure of cash flow information:
Cash paid for interest	5,830	7,130
Cash paid for income taxes	582
Supplemental disclosure of non-cash investing and financing activities:
Fair value of shares issued for business acquisition		7,986
Deferred acquisition consideration and earnout liability recorded for business acquisition		5,218
Purchases of property and equipment included in accounts payable and accrued expenses	1,523	$ 2,628
Right-of-use assets obtained through operating lease obligations	$ 30,639

Nature of the Business and Basi

Nature of the Business and Basis of Presentation	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of the Business and Basis of Presentation	1. Nature of the 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 serv i COVID-19 The emergence of the coronavirus (COVID-19) e COVID-19 COVID-19 The Company is closely monitoring the evolving impact of the pandemic on all aspects of its business. The Company has implemented a number of measures designed to protect the health and safety of its employees, support its customers and promote business continuity. Merger with Avista Healthcare Public Acquisition Corp On December 10, 2018, Avista Healthcare Public Acquisition Corp., our predecessor company (“AHPAC”), consummated a business combination (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 direct wholly-owned subsidiary of AHPAC (“Avista Merger Sub”) and 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. AHPAC changed its name to Organogenesis Holdings Inc. (ORGO).

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Unaudited Interim Financial Information The accompanying unaudited consolidated financial statements have been prepared by management in accordance with GAAP and the rules and regulations of the Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete financial statements. While we believe that the disclosures presented are adequate in order to make the information not misleading, these unaudited quarterly financial statements should be read in conjunction with the financial statements and notes thereto included in the Company’s Annual Report on Form 10-K The unaudited consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc. and its wholly-owned subsidiaries of Organogenesis Inc., including Organogenesis GmbH (a Switzerland corporation) and Prime Merger Sub, LLC. All intercompany balances and transactions have been eliminated in consolidation. The Company considers events or transactions that occur after the balance sheet date but before the financial statements are issued to provide additional evidence relative to certain estimates or to identify matters that require additional disclosure. In the opinion of management, the unaudited consolidated financial statements reflect all adjustments of a normal recurring nature necessary for a fair presentation of the Company’s financial position, results of operations and cash flows at the dates and for the periods indicated. The results for the nine months ended September 30, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021, any other interim periods, or any future years or periods. 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 the related disclosure as of the date of the consolidated financial statements and the reported results of operations during the reporting periods. Actual results could differ from those estimates. Summary of Significant Accounting Policies The Company’s significant accounting policies are described in Note “2. Significant Accounting Policies” to the Consolidated Financial Statements included in the Annual Report. There have been no material changes to the significant accounting policies previously disclosed in the Annual Report, other than as it related to the recently adopted accounting pronouncement disclosed below. Revision to Previously Issued Financial Statements Private Warrant Reclassification On April 12, 2021, the Staff of the SEC issued a statement regarding the accounting and reporting considerations for warrants issued by special purpose acquisition companies entitled “Staff Statement on Accounting and Reporting Considerations for Warrants Issued by Special Purpose Acquisition Companies (“SPACs”)” (the “SEC Statement”). In the SEC Statement, the SEC Staff expressed its view that certain terms and conditions common to SPAC warrants may require the warrants to be classified as liabilities on the SPAC’s financial statements as opposed to equity. As of December 31, 2018, the Company had 4.1 million private warrants outstanding, which were issued to Avista Capital Partners IV, L.P. and Avista Capital Partners IV (Offshore), L.P. in connection with the Avista Merger on December 10, 2018 (the “Private Warrants”), and 31.0 million public warrants outstanding that were issued in connection with the initial public offering of Avista Healthcare Public Acquisition Corp. on October 10, 2016 (the “Public Warrants”, together with the Private Warrants, the “Warrants”). The Company originally classified the Warrants as equity on its financial statements. In 2019, the outstanding Warrants were exchanged for 3.3 million shares of the Company’s Class A common stock. There were no Warrants outstanding as of December 31, 2019. As a result of the SEC Statement, the Company reevaluated the historical accounting treatment of its Public Warrants and Private Warrants and determined that the Private Warrants should have been recorded at fair value as a liability in the Company’s consolidated balance sheet with changes to the fair value recorded to the consolidated statements of operations. The Company assessed the materiality of this error on prior period financial statements in accordance with the SEC Staff Accounting Bulletin Number 99, Materiality, and ASC 250-10, $ from additional paid-in capital to accumulated deficit on the co n Right of Use Asset Amortization In August 2021, the Company identified an error in its accounting treatment for two ass e As of December 31, 2020 CONSOLIDATED BALANCE SHEETS As Previously Adjustments As Revised Property and equipment, net $ 60,068 $ (4,276 ) $ 55,792 Total assets $ 294,494 $ (4,276 ) $ 290,218 Accumulated deficit $ (150,759 ) $ (4,276 ) $ (155,035 ) Total stockholders’ equity $ 146,084 $ (4,276 ) $ 141,808 Total liabilities and stockholders’ equity $ 294,494 $ (4,276 ) $ 290,218 For For September CONSOLIDATED STATEMENTS OF OPERATIONS As Adjustments As As Adjustments As Selling, general and administrative $ 51,146 $ 179 $ 51,325 $ 150,261 $ 536 $ 150,797 Total operating expenses $ 54,855 $ 179 $ 55,034 $ 164,048 $ 536 $ 164,584 Income from operations $ 22,980 $ (179 ) $ 22,801 $ 5,644 $ (536 ) $ 5,108 Net income (loss) before income taxes $ 21,006 $ (179 ) $ 20,827 $ (411 ) $ (536 ) $ (947 ) Net income (loss) $ 20,934 $ (179 ) $ 20,755 $ (545 ) $ (536 ) $ (1,081 ) Nine Months Ended September 30, 2020 CONSOLIDATED STATEMENTS OF CASH FLOWS As Previously Adjustments As Net loss $ (545 ) $ (536 ) $ (1,081 ) Depreciation $ 2,749 $ 536 $ 3,285 Recently Adopted Accounting Pronouncements In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2016-02 2016-02”), Leases right-of-use o months or less. The Company also elected to account for lease components and the associated non-lease components in the contracts as a single lease component for most of the leased assets. Upon the adoption of this standard on January 1, 2021, the Company recognized an operating lease liability of $ , representing the present value of the minimum lease payments remaining as of the adoption date, and a right-of-use asset in the amount of $ . The right-of-use asset reflects adjustments for de-recognition of deferred lease liabilities and lease incentives. The Company’s accounting for finance leases (previously classified as capital leases under ASC 840) remained substantially unchanged. See Note “17. Leases” for further disclosures. Recently Issued Accounting Pronouncements Not Yet Adopted In June 2016, the FASB issued ASU 2016-13 , Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). Subsequent ASU 2016-13, the ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments- Credit Losses ASU 2019-04, Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments ASU 2019-05, Financial Instruments—Credit Losses (Topic 326)—Targeted Transition Relief ASU 2019-11, Codification Improvements to Topic 326, Financial Instruments—Credit Losses ASU 2016-13 and ASU 2016-13 and ASU 2016-13

Acquisition

Acquisition	9 Months Ended
	Sep. 30, 2021
Business Combinations [Abstract]
Acquisition	3. Acquisition On September 17, 2020 (the “Acquisition Date”), the Company acquired certain assets and assumed certain liabilities of CPN Biosciences, LLC (“CPN”) pursuant to an asset purchase agreement dated July 24, 2020. CPN offered a physician office management solution and advanced wound care products. The Company is obligated to pay a contingent consideration (the “Earnout”) to CPN’s former shareholders if CPN’s legacy product revenue in the Earnout Period (defined as a twelve-month period, starting on the first day of the next calendar quarter immediately following the post-closing sales meeting), exceeds CPN’s 2019 revenue. The amount of the Earnout, if any, will be equal to 70% of the excess and will be payable 60 days after the expiration of the Earnout Period. The post-closing sales meeting took place in April 2021 and the Earnout Period is July 1, 2021 to June 30, 2022. The Company recorded a non-current

Product and Geographic Sales

Product and Geographic Sales	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Product and Geographic Sales	4. Product and Geographic Sales 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 products to customers based on specific payment and shipping terms in the arrangement. The entire transaction price reflects a single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s products which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract. Revenue is recorded net of a reserve for returns, discounts and Group Purchasing Organization (“GPO”) rebates, which represent a direct reduction to the revenue recognized. These reductions are accrued at the time revenue is recognized, based upon historical experience and specific circumstances. For the three months ended September 30, 2021 and 2020, the Company recorded GPO fees of $794 and $1,013, respectively, as a direct reduction of revenue. For the nine months ended September 30, 2021 and 2020, the Company recorded GPO fees of $2,323 and $2,810, respectively, as a direct reduction of revenue. The following tables set forth revenue by product category: Three Months Ended September 30, 2021 2020 Advanced Wound Care $ 107,341 $ 89,990 Surgical & Sports Medicine 6,412 10,809 Total net revenue $ 113,753 $ 100,799 Nine Months Ended September 30, 2021 2020 Advanced Wound Care $ 309,485 $ 201,009 Surgical & Sports Medicine 30,016 30,482 Total net revenue $ 339,501 $ 231,491 For all periods presented, net revenue generated outside the United States represented less than 1% of total net revenue.

Fair Value of Financial Assets

Fair Value of Financial Assets and Liabilities	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Fair Value of Financial Assets and Liabilities	5. Fair Value of Financial Assets and Liabilities The following tables present information about the Company’s financial assets and liabilities measured at fair value on a recurring basis and indicate the level of the fair value hierarchy utilized to determine such fair values as of S e Fair Value Measurements as of September 30, 2021 Using: Level 1 Level 2 Level 3 Total Liabilities: Earnout liability $ — $ — $ — $ — $ — $ — $ — $ — Fair Value Measurements as of December 31, 2020 Using: Level 1 Level 2 Level 3 Total Liabilities: Earnout liability $ — $ — $ 3,985 $ 3,985 $ — $ — $ 3,985 $ 3,985 Earnout Liability In connection with accounting for the CPN acquisition on September 17, 2020, the Company recorded an Earnout liability of $3,782 on the Acquisition Date, representing the fair value of contingent consideration payable upon the ach i Earnout liability Balance as of December 31, 2020 $ 3,985 Change in fair value (3,985 ) Balance as of September 30, 2021 $ — The Company did not have any financial assets and liabilities measured at fair value on a non-recurring

Accounts Receivable, Net

Accounts Receivable, Net	9 Months Ended
	Sep. 30, 2021
Receivables [Abstract]
Accounts Receivable, Net	6. Accounts Receivable, Net Accounts receivable consisted of the following: September 30, December 31, 2021 2020 Accounts receivable $ 81,925 $ 61,792 Less — allowance for sales returns and doubtful accounts (7,342 ) (4,988 ) $ 74,583 $ 56,804 The Company’s allowance for sales returns and doubtful accounts was comprised of the following: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Balance at beginning of period $ 7,113 $ 3,928 $ 4,988 $ 3,049 Additions 704 1,589 2,862 2,559 Write-offs (475 ) (392 ) (508 ) (483 ) Balance at end of period $ 7,342 $ 5,125 $ 7,342 $ 5,125

Inventories

Inventories	9 Months Ended
	Sep. 30, 2021
Inventory Disclosure [Abstract]
Inventories	7. Inventories Inventories, net of related reserves for excess and obsolescence, consisted of the following: September 30, December 31, 2021 2020 Raw materials $ 8,761 $ 10,075 Work in process 2,144 1,305 Finished goods 18,590 16,419 $ 29,495 $ 27,799 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 level, and working with operations to maximize recovery of excess inventory. During the three months ended September 30, 2021 and 2020, the Company charged $3,367 and $315, respectively, for inventory excess and obsolescence to cost of goods sold within the consolidated statements of operations. During the nine months ended September 30, 2021 and 2020, the Company charged $8,045 and $2,024, respectively, for inventory excess and obsolescence to cost of goods sold within the consolidated statements of operations.

Prepaid Expenses and Other Curr

Prepaid Expenses and Other Current Assets	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Prepaid Expenses and Other Current Assets	8. Prepaid Expenses and Other Current Assets Prepaid expenses and other current assets consisted of the following: September 30, December 31, 2021 2020 Subscriptions $ 2,091 $ 2,013 Conferences and marketing expenses 623 63 Deposits 1,185 1,438 Reimbursement of offering expenses — 1,009 Insurance 997 240 Other 137 172 $ 5,033 $ 4,935 Deposits are funds held by vendors which are expected to be released within twelve months and therefore they are recorded as current assets.

Property and Equipment, Net

Property and Equipment, Net	9 Months Ended
	Sep. 30, 2021
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	9. Property and Equipment, Net Property and equipment consisted of the following: September 30, December 31, 2021 2020 Leasehold improvements $ 45,050 $ 39,574 Building 4,943 $ — Furniture, computers and equipment 52,696 48,236 102,689 87,810 Accumulated depreciation and amortization (73,894 ) (73,797 ) Construction in progress 45,979 41,779 $ 74,774 $ 55,792 Depreciation expense was $1,937 and $1,135 for the three months ended September 30, 2021 and 2020. Depreciation expense was $4,010 and $3,285 for the nine months ended September 30, 2021 and 2020. As of December 31, 2020, the Company had $21,689 of buildings under finance leases recorded within leasehold improvements and had $18,716 recorded within accumulated depreciation related to these buildings. In August 2021, the Company purchased one building previously under a finance lease (see Note “17. Leases”) from a related party and removed the lease from leasehold improvements and recorded the asset to buildings. As of September 30, 2021, the Company had i

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	10. Goodwill and Intangible Assets Goodwill was $28,772 as of September 30, 2021 and December 31, 2020. Identifiable intangible assets consisted of the following as of September 30, 2021: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ (16,864 ) $ 15,756 Trade names and trademarks 2,080 (1,128 ) 952 Customer relationships 10,690 (1,114 ) 9,576 Non-compete 1,010 (398 ) 612 Total $ 46,400 $ (19,504 ) $ 26,896 Identifiable intangible assets consisted of the following as of December 31, 2020: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ (14,330 ) $ 18,290 Trade names and trademarks 2,080 (906 ) 1,174 Customer relationship 10,690 (312 ) 10,378 Non-compete 1,010 (230 ) 780 Total $ 46,400 $ (15,778 ) $ 30,622 Amortization of intangible assets, calculated on a straight-line basis or using an accelerated method, was $1,240 and $885 for the three months ended September 30, 2021 and 2020, respectively, and $3,726 and $2,518 for the nine months ended September 30, 2021 and 2020, respectively.

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Accrued Expenses and Other Current Liabilities	11. Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of the following: September 30, December 31, 2021 2020 Personnel costs $ 25,482 $ 18,943 Royalties 3,338 2,971 Accrued but unpaid lease obligations and interest 6,390 — Other 1,918 2,059 $ 37,128 $ 23,973 The accrued but unpaid lease obligations and the interest accrual on these obligations were previously included in the long-term portion of the finance lease obligations, and other liabilities as of December 31, 2020. The reclassification was due to the purchase of a building previously recorded as a finance lease from a related party (see Note “17. Leases”) and the termination of the 2019 Credit Agreement (see Note “13. Long-Term Debt Obligations”).

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2021
Restructuring and Related Activities [Abstract]
Restructuring	12. Restructuring On October 21, 2020, the Company committed to a plan to restructure the workforce and consolidate its La Jolla facilities as part of the Company’s long-term plan to consolidate manufacturing operations in Massachusetts to reduce the Company’s cost structure. The majority of the restructuring costs are expected to be incurred by the end of 2021, with certain facility and storage costs continuing through the middle of 2024. The restructuring will result in a charge of approximately $6.5 million, of which approximately $4.0 million is attributable to the retention benefits associated with approximately 65 employees and the remaining $2.5 million is related to the facility closures. As employees are required to provide future services, employee retention and other benefit-related costs related to the Company’s restructuring are expensed over the service period. As a result of this restructuring activity, the Company incurred a pr e e Employee Facility Liability balance as of June 30, 2021 $ 2,381 $ 29 Expenses 854 156 Payments (26 ) (160 ) Liability balance as of September 30, 2021 $ 3,209 $ 25 Employee Facility Liability balance as of December 31, 2020 $ 618 $ — Expenses 2,617 259 Payments (26 ) (234 ) Liability balance as of September 30, 2021 $ 3,209 $ 25

Long-Term Debt Obligations

Long-Term Debt Obligations	9 Months Ended
	Sep. 30, 2021
Long-term Debt, Unclassified [Abstract]
Long-Term Debt Obligations	13. Long-Term Debt Obligations Long-term debt obligations consisted of the following: September 30, December 31, 2021 2020 Line of credit $ — $ 10,000 Term loan 74,531 60,000 Less debt discount and debt issuance cost (678 ) (290 ) Term loan, net of debt discount and debt issuance cost $ 73,853 $ 59,710 2021 Credit Agreement In August 2021, the Company, as borrower, its subsidiaries, as guarantors, and Silicon Valley Bank (“SVB”), and the several other lenders thereto (collectively, the “Lenders”) entered into a credit agreement (the “2021 Credit Agreement”), providing for a term loan facility not to exceed $75,000 (the “Term Loan Facility”) and a revolving credit facility not to exceed $125,000 (the “Revolving Facility”). The Company’s obligations to the Lenders are secured by substantially all of Company’s assets, including intellectual property. Capitalized terms used h e Advances made under the 2021 Credit Agreement may be either Eurodollar Lo a plus The 2021 Credit Agreement requires the Company to make consecutive quarterly installment payments equal to the following percentages of the original principal amount of the Term Loans: (a) from September 30, 2021 through and including June 30, 2022, (or $469) ; (b) from (or $938); (c) from September 30, 2023 through and including June 30, 2025, (or (or of the aggregate amount of Term Loans prepaid. Once repaid, amounts borrowed under the Term Loan Facility The Company must pay in arrears, on the first day of each quarter prior to August 6, 2026 (the “Revolving Termination Date”) and on the Revolving Termination Date, a fee for the Company’s non-use of (B) the aggregate undrawn amount of all Letters of Credit outstanding at such time and (c) the aggregate amount of all L/C Disbursements that have not yet been reimbursed or converted into Revolving Loans or Swingline Loans. The Commitment Fee Rate is equal to (i) if the Total Net Leverage Ratio is greater than or equal to 3.25x, ; (ii) if the Total Net Leverage Ratio is greater than or equal to 2.50x but less than 3.25x, ; (iii) if the Total Net Leverage Ratio is greater than or equal to 2.00x but less than 2.50x, ; (iv) if the Total Net Leverage Ratio is greater than or equal to 1.50x but less than 2.00x, ; and (v) if the Total Net Leverage Ratio is less . The maturity date for advances made under the Revolving Facility is the Revolving Termination Date. The Company may elect to reduce or terminate the Revolving Facility in its entirety at any time by repaying all outstanding principal, unpaid accrued interest and, with respect to any such reduction or termination of the Revolving Commitments made prior to August 6, 2022, of the aggregate amount of the Revolving Commitments so reduced or terminated. Under the 2021 Credit Agreement, the Company is required to comply with certain financial covenants. The Company may not permit the Consolidated Fixed Charge Coverage Ratio at the last day of any period of four consecutive fiscal quarters, commencing with the fiscal quarter ending September 30, 2021, to be less than 1.25:1.00. Additionally, the Company may not permit the Consolidated Total Net Leverage Ratio at the last day of any period of four consecutive fiscal quarters, commencing with the fiscal quarter ending September 30, 2021, to exceed the following ratios: (i) for the trailing four fiscal quarters ending September 30, 2021, December 31, 2021, March 31, 2022, June 30, 2022 and September 30, 2022, a ratio of 3.50:1.00; (ii) for the trailing four fiscal quarters ending December 31, 2022, March 31, 2023, June 30, 2023 and September 30, 2023, a ratio of 3.25:1.00; and (iii) for the trailing four fiscal quarters ending December 31, 2023 and each fiscal quarter thereafter, a ratio of 3.00:1.00. As of September 30, 2021, the Company had outstanding borrowings of $74,531 under the Term Loan Facility and $0 under the Revolving Facility with $125,000 available for future revolving borrowings. The Company recorded additional debt issuance costs and related fees of Future payments of the 2021 Credit Agreement, as of September 30, 2021, are as follows for the calendar years ending December 31: 2021 469 2022 2,812 2023 4,687 2024 5,625 2025 and beyond 60,938 Total $ 74,531 2019 Credit Agreement In March 2019 , the Company, its subsidiaries and SVB, and the several other lenders thereto entered into a credit agreement, as amended (the “2019 Credit Agreement”), providing for a term loan facility of $ and a revolving credit facility of up to $ . Both facilities w ere mature in . The interest rate for the term loan facility was a floating per . If the Company elected to prepay the loan or terminate the facilities, the Company was required to pay a certain percentage of the outstanding principal as a prepayment fee. A final payment fee (the “Final Payment”) of % multiplied by the original aggregate principal amount of term loan facility was due upon the earlier to occur of the maturity date of the term loan or prepayment of all outstanding principal. In August 2021, upon entering into the 2021 Credit Agreement, the Company paid an aggregate amount of $70,559 due under the 2019 Credit Agreement, including unpaid principal, accrued interest, the Final Payment and a prepayment fee, with proceeds from the 2021 Credit Agreement, and the 2019 Credit Agreement was terminated. Upon termination of the 2019 Credit Agreement, the Company recognized as loss on the extinguishment of the loan for the three and nine months ended September 30, 2021.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Stockholders' Equity	14. Stockholders’ Equity Common Stock As of September 30, 2021, the Company was authorized to issue 400,000,000 shares of $0.0001 par value Class A common stock and 1,000,000 shares of $0.0001 par value preferred stock. 129,365,209 shares of Class A common stock were issued and 128,636,661 shares were outstanding as of September 30, 2021. No shares of preferred stock were outstanding as of September 30, 2021. The issued shares of Class A common stock include 728,548 treasury shares that were reacquired in connection with the redemption of redeemable shares in March 2019. As of September 30, 2021 and December 31, 2020, the Company reserved the following shares of Class A common stock for future issuance: September 30, December 31, 2021 2020 Shares reserved for issuance for outstanding options 6,724,574 6,425,040 Shares reserved for issuance for outstanding restricted stock units 768,203 806,048 Shares reserved for issuance for future grants 5,635,822 6,832,649 Total shares of authorized common stock reserved for future issuance 13,128,599 14,063,737

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	15. Stock-Based Compensation Stock Incentive Plans-the 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 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 stock options; incentive stock options; restricted stock awards; restricted stock units; stock appreciation rights; unrestricted stock awards; performance share awards; and dividend equivalent rights. The Plan is administered by the Company’s Board of Directors. As of September 30, 2021, 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). Stock Incentive Plans-the 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 o 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. Stock-Based Compensation Expense Stock options awarded under the stock incentive plans expire 10 years after the grant date and typically vest over four or five years. Restricted stock units awarded typically vest over four years. Stock-based compensation expense was $1,041 and $486 for the three months ended September 30, 2021 and 2020, respectively, and was $2,781 and $1,164 for the nine months ended September 30, 2021 and 2020, respectively. The total amount of stock-based compensation expense was included within selling, general and administrative expenses on the consolidated statements of operations. Restricted Stock Units (RSUs) In the nine months ended September 30, 2021, the Company granted 299,352 time-based restricted stock units to its employees, executives and the Board of Directors. Each restricted stock unit represents the contingent right to receive one share of the Company’s common stock. A majority of the restricted stock units will vest in four equal annual installments. The fair value of the restricted stock units was based on the fair market value of the Company’s stock on the date of grant. The activity of restricted stock units is set forth below: Weighted Number Grant Date of Shares Fair Value Unvested at December 31, 2020 787,923 $ 3.81 Granted 299,352 14.46 Vested (248,305 ) 4.20 Canceled/Forfeited (70,767 ) 8.01 Unvested at September 30, 2021 768,203 $ 7.45 As of September 30, 2021, the total unrecognized compensation cost related to unvested restricted stock units expected to vest was $3,559 and the weighted average remaining recognition period for unvested awards was 2.92 years. Stock Option Valuation The stock options granted during the nine months ended September 30, 2021 and 2020 were 1,069,658 and 1,553,723 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: September 30, September 30, 2021 2020 Risk-free interest rate 0.83 % 0.46 % Expected term (in years) 6.22 6.22 Expected volatility 39.31 % 37.42 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 13.57 $ 4.04 Underlying stock price $ 13.57 $ 3.37 These assumptions resulted in an estimated weighted-average grant-date fair value per share of stock options granted during the nine months ended September 30, 2021 and 2020 of $5.32 and $1.05, respectively. Stock Option Activity The following table summarizes the Company’s stock option activity since December 31, 2020: Weighted Average Weighted Remaining Average Contractual Aggregate Number of Exercise Term Intrinsic Shares Price (in years) Value Outstanding as of December 31, 2020 6,617,403 $ 2.32 5.22 $ 34,447 Granted 1,069,658 13.57 Exercised (912,205 ) 2.31 9,720 Canceled / forfeited (50,282 ) 8.30 Outstanding as of September 30, 2021 6,724,574 4.07 5.36 68,605 Options exercisable as of September 30, 2021 4,335,117 1.74 3.57 54,186 Options vested or expected to vest as of September 30, 2021 6,271,605 $ 3.71 5.11 $ 66,231 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 nine months ended September 30, 2021 and 2020 was $592 and $387, respectively. As of September 30, 2021, the total unrecognized stock compensation expense related to unvested stock options expected to vest was $4,431 and was expected to be recognized over a weighted-average period of 3.10 years. Between 2010 and 2013, a former executive took several partial recourse notes totaling $635 to exercise his 675,990 shares of stock options. The notes were secured with these shares held by the former executive. When the loans were outstanding, the options were not considered exercised and were included within the options outstanding for accounting purposes. As of December 31, 2020, $334 of the principal balance of the partial recourse notes was outstanding and 195,278 shares were not considered outstanding for accounting purposes. In the three months ended March 31, 2021, the former executive repaid the remaining principal balance of the notes (see Note “19. Related Parties Transactions”). The repayments were treated as the exercise price for the 195,278 shares of the options and were included in the consolidated statement of stockholders’ equity. As of September 30, 2021, none of the partial recourse notes was outstanding and all of the 675,990 shares used to secure the notes were considered outstanding for accounting purposes.

Net Income (Loss) Per Share (EP

Net Income (Loss) Per Share (EPS)	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Net Income (Loss) per Share (EPS)	16. Net Income (Loss) per Share (EPS) Basic EPS is calculated by dividing net income (loss) by the weighted-average number of shares outstanding during the period. Diluted EPS is calculated by dividing net income (loss) by the weighted-average number of shares outst a A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income (loss) attributable to the common stockholders of Organogenesis Holdings Inc. is as follows. Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Numerator: Net Income (loss) $ 12,577 $ 20,755 $ 43,207 $ (1,081 ) Denominator: Weighted average common shares outstanding 128,546,301 105,040,035 128,219,674 104,748,297 Dilutive effect of restricted stock units 458,642 134,759 498,105 — Dilutive effect of options 4,845,273 3,314,974 5,048,225 — Weighted-average common shares outstanding—diluted 133,850,216 108,489,768 133,766,004 104,748,297 Earnings (loss) per share—basic $ 0.10 $ 0.20 $ 0.34 $ (0.01 ) Earnings (loss) per share—diluted $ 0.09 $ 0.19 $ 0.32 $ (0.01 ) For the three and nine months ended September 30, 2021, outstanding stock-based awards of were excluded from the diluted EPS calculation. For the three months ended September 30, 2020, outstanding stock-based awards of were excluded from the diluted EPS calculation. For the nine months ended September 30, 2020, the Company had a net loss. As such, shares of potentially dilutive securities were excluded from the computation of diluted net loss per share as these securities had anti-dilutive effects and including them would 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 was the same for this period.

Leases

Leases	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Leases	17. Leases As of December 31, 2020 and September 30, 2021, the Company’s contracts that contained a lease consisted primarily of real estate, equipment and vehicle leases. The Company leases real estate for office, lab and production space under noncancelable operating and finance leases that expire at various dates through 2031, subject to the Company’s options to terminate or renew certain leases for an additional five The Company leases vehicles under operating leases for certain employees and has fleet services agreements for service on these vehicles. The minimum lease term for each newly leased vehicle is 367 days with renewal options. The Company may terminate the vehicle lease after the minimum lease term upon thirty days’ prior notice. The Company also leases other equipment under noncancelable operating and finance leases that expire at various dates through 2025. The Company determines if an arrangement is a lease at lease inception. The options to extend or terminate a lease are included in the lease terms when it is reasonably certain that the Company will exercise the options. Operating leases are included in operating lease right-of-use assets lease right-of-use assets Right-of-use assets leases. Right-of-use assets a The right-of-use assets made at or before the commencement date and are reduced by lease incentives. The Company uses its incremental borrowing rate as the discount rate to determine the present value of the lease payments for leases that do not have a readily determinable implicit discount rate. The Company’s incremental borrowing rate is the rate of interest that it would have to borrow on a collateralized basis over a similar term and amount in a similar economic environment. The Company determines the incremental borrowing rates for its leases by adjusting the risk-free interest rate with a credit risk premium corresponding to the Company’s credit rating. The Company records rent expense for its operating leases on a straight-line basis from the lease commencement date until the end of the lease term. The Company records finance lease cost as a combination of the depreciation expense for the right-of-use assets initial right-of-use assets In August 2020, the Company entered into a lease for approximately 23,000 square feet in San Diego, California for office and laboratory use. The lease commenced on April 1, 2021. The initial lease term is ten years from the lease commencement date, with an option to extend the term for a period of five years. Annual lease payments during the first year are $1,562 with a 3% increase each year during the lease term. A security deposit of $237 is required throughout the term of the lease. On January 1, 2013, the Company entered into finance 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 As of September 30, 2021 and December 31, 2020, the Company owed an aggregate of $10,336 of accrued but unpaid lease obligations that include rent in arrears and unpaid operating and common area maintenance costs under the aforementioned leases. 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 Credit Agreement. These accrued but unpaid lease obligations as well as the accrued interest on these obligations were subordinated to the 2019 Credit Agreement. With the termination of the 2019 Credit Agreement and the execution of the 2021 Credit Agreement (see Note “13. Long-Term Debt Obligations”) in August 2021, these obligations are no longer subordinated to the Company’s existing loans. In August 2021, the Company purchased the building (the “275 Dan Road Building”) under the lease with 275 Dan Road SPE, LLC for $6,013 and the lease was terminated. The Company recorded an asset of $4,943 to buildings within fixed asset, net in accordance with ASC 842-20-40-2 Purchase of the Underlying Asset for the purchase of the leased asset The principal portion of rent in arrears totaled $7,393 and $6,946 as of September 30, 2021 and December 31, 2020, respectively. This liability was included in the short-term portion of finance lease obligations other than the balance related to the 275 Dan Road Building that was primarily included in accrued expenses and other current liabilities on the consolidated balance sheet. The interest portion of rent in arrears totaled The components of lease cost were as follows: Classification Three Months September 30, Nine Months September 30, Finance lease Amortization of right-of-use COGS and SG&A $ 793 $ 1,396 Interest on lease liabilities Interest Expense 218 879 Total Finance lease cost 1,011 2,275 Operating lease cost COGS, R&D, SG&A 1,857 4,872 Short-term lease cost COGS, R&D, SG&A 758 2,172 Variable lease cost COGS, R&D, SG&A 1,304 3,753 Total lease cost $ 4,930 $ 13,072 Supplemental balance sheet information related to finance le a September 30, January 1 Property and equipment, gross $ 18,670 $ 22,989 Accumulated depreciation (16,736 ) (19,250 ) Property and equipment, net $ 1,934 $ 3,739 Current portion of finance lease obligations $ 8,531 $ 3,619 Finance lease long-term obligations 831 11,442 Total finance lease liabilities $ 9,362 $ 15,061 Supplemental cash flow information related to leases was as follows: Nine Months September 30, 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases 4,933 Operating cash flows for finance leases 1,327 Financing cash flows for finance leases 2,099 Right-of-use Operating leases 13,525 Finance leases — Right-of-use Operating leases 17,114 Finance leases — September 30, Weighted-average remaining lease term Finance leases 1.23 Operating leases 8.06 September 30, 2021 Weighted-average discount rate Finance leases 15.04 % Operating leases 4.18 % As of September 30, 2021, the maturities of lease liabilities were as follows: Operating leases Finance leases 2021 (remaining 3 months) $ 1,975 $ 889 2022 4,980 8,887 2023 4,137 — 2024 3,345 — 2025 3,249 — Thereafter 16,644 — Total lease payments 34,330 9,776 Less: interest (5,459 ) (414 ) Total lease liabilities $ 28,871 $ 9,362 Under ASC 840, for the three and nine months ended September 30, 2020, the Company recorded lease expenses of

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies Disclosure	18. Commitments and Contingencies Royalty Commitments 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 September 30, 2021 and December 31, 2020, respectively, and were classified as part of accrued expenses on the Company’s consolidated balance sheets. There was no royalty expense incurred during the three and nine months end e 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 of the underlying patent in October 2026, subject to minimum royalty payment provisions. The Company recorded royalty expense of $1,707 and $1,201 during the three months ended September 30, 2021 and 2020, respectively, and $4,062 and $3,020 As part of the NuTech Medical acquisition, 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 canceled in January 2020 for total consideration of $1,950 that was paid on February 14, 2020. The $1,950 cancellation fee was recorded within selling, general and administrative expenses on the consolidated statement of operations for the nine months ended September 30, 2020. Legal Proceedings 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 am o The Company accrued $150 as of September 30, 2021 and December 31, 2020 for certain pending lawsuits. The purchase price for NuTech Medical acquired in 2017 included $7,500 deferred acquisition consideration of which the Company paid $2,500 in 2017. The remaining $5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical was previously in dispute. 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 and the remaining $2,000 was paid in four quarterly installments of $500 each. As of March 31, 2021, the entire settlement was paid off. In addition, the Company assumed from the sellers of NuTech Medical the payment responsibilities related to a legacy lawsuit existing at the acquisition date of NuTech Medical. The assumed legacy lawsuit was settled in October 2020. In connection with the settlement of the deferred acquisition consideration dispute and the legacy lawsuit, the Company recorded a gain of $1,295 and $951 for the three months ended March 31, 2020 and September 30, 2020, respectively. The gain was included as a component of other expense, net, on the consolidated statement of operations.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2021
Related Party Transactions [Abstract]
Related Party Transactions	19. Related Party Transactions Finance lease obligations to affiliates, including accrued but unpaid lease obligations, and purchase of an asset under a finance lease with an affiliate are further described in Note “17. Leases”. 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 ex e

Taxes

Taxes	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Taxes	20. Taxes The Company is principally subject to taxation in the United States. The Company has a history of net operating losses both federally and in various states and began utilizing those losses to offset current taxable income in 2020. The Company’s wholly-owned Swiss subsidiary, Organogenesis GmbH, is subject to taxation in Switzerland and generally has profits as a result of a transfer pricing arrangement in place with Organogenesis Inc., its U.S. parent and a wholly-owned subsidiary of the Company. The income tax rate for the nine months ended September 30, 2021 varied from the U.S. statutory rate of 21% primarily due to the utilization of net operating losses federally and in many states as well as the cash taxes in Switzerland. The Company maintains a full valuation allowance against its U.S. deferred tax assets and as such, the Company’s provision for income taxes primarily relates to cash taxes to be paid in certain states where the net operating losses are expected to be fully utilized or limited based on state statute. Income tax expense for the nine months ended September 30, 2021 was $990, which included a discrete tax expense of $31 related to the interest on certain uncertain tax positions. Income tax expense for the nine months ended September 30, 2020 was $134 and related primarily to state and foreign taxes. The Company examines all positive and negative evidence to estimate whether sufficient future taxable income in the U.S. will be generated to permit the use of existing deferred tax assets. The Company has significant negative evidence in the form of cumulative losses and believes that it is more likely than not that these United States deferred tax assets will not be util i would be realized in the future and the Company would therefore release all or a portion of the valuation allowance related to the net operating loss carryforwards and other deferred tax assets. The Company will perform a study to determine if ownership changes, as defined by the Internal Revenue Code, have occurred that have limited the amount of net operating losses and research and development tax credit carryforwards that can be utilized annually to offset future taxable income.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	21. Subsequent Events The Company has evaluated subsequent events through November 9, 2021, the date on which these consolidated financial statements were issued has determined that there were no such events to report.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Unaudited Interim Financial Information	Unaudited Interim Financial Information The accompanying unaudited consolidated financial statements have been prepared by management in accordance with GAAP and the rules and regulations of the Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete financial statements. While we believe that the disclosures presented are adequate in order to make the information not misleading, these unaudited quarterly financial statements should be read in conjunction with the financial statements and notes thereto included in the Company’s Annual Report on Form 10-K The unaudited consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc. and its wholly-owned subsidiaries of Organogenesis Inc., including Organogenesis GmbH (a Switzerland corporation) and Prime Merger Sub, LLC. All intercompany balances and transactions have been eliminated in consolidation. The Company considers events or transactions that occur after the balance sheet date but before the financial statements are issued to provide additional evidence relative to certain estimates or to identify matters that require additional disclosure. In the opinion of management, the unaudited consolidated financial statements reflect all adjustments of a normal recurring nature necessary for a fair presentation of the Company’s financial position, results of operations and cash flows at the dates and for the periods indicated. The results for the nine months ended September 30, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021, any other interim periods, or any future years or periods.
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 the related disclosure as of the date of the consolidated financial statements and the reported results of operations during the reporting periods. Actual results could differ from those estimates.
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies The Company’s significant accounting policies are described in Note “2. Significant Accounting Policies” to the Consolidated Financial Statements included in the Annual Report. There have been no material changes to the significant accounting policies previously disclosed in the Annual Report, other than as it related to the recently adopted accounting pronouncement disclosed below.
Revision to Previously Issued Financial Statements	Revision to Previously Issued Financial Statements Private Warrant Reclassification On April 12, 2021, the Staff of the SEC issued a statement regarding the accounting and reporting considerations for warrants issued by special purpose acquisition companies entitled “Staff Statement on Accounting and Reporting Considerations for Warrants Issued by Special Purpose Acquisition Companies (“SPACs”)” (the “SEC Statement”). In the SEC Statement, the SEC Staff expressed its view that certain terms and conditions common to SPAC warrants may require the warrants to be classified as liabilities on the SPAC’s financial statements as opposed to equity. As of December 31, 2018, the Company had 4.1 million private warrants outstanding, which were issued to Avista Capital Partners IV, L.P. and Avista Capital Partners IV (Offshore), L.P. in connection with the Avista Merger on December 10, 2018 (the “Private Warrants”), and 31.0 million public warrants outstanding that were issued in connection with the initial public offering of Avista Healthcare Public Acquisition Corp. on October 10, 2016 (the “Public Warrants”, together with the Private Warrants, the “Warrants”). The Company originally classified the Warrants as equity on its financial statements. In 2019, the outstanding Warrants were exchanged for 3.3 million shares of the Company’s Class A common stock. There were no Warrants outstanding as of December 31, 2019. As a result of the SEC Statement, the Company reevaluated the historical accounting treatment of its Public Warrants and Private Warrants and determined that the Private Warrants should have been recorded at fair value as a liability in the Company’s consolidated balance sheet with changes to the fair value recorded to the consolidated statements of operations. The Company assessed the materiality of this error on prior period financial statements in accordance with the SEC Staff Accounting Bulletin Number 99, Materiality, and ASC 250-10, $ from additional paid-in capital to accumulated deficit on the co n Right of Use Asset Amortization In August 2021, the Company identified an error in its accounting treatment for two ass e As of December 31, 2020 CONSOLIDATED BALANCE SHEETS As Previously Adjustments As Revised Property and equipment, net $ 60,068 $ (4,276 ) $ 55,792 Total assets $ 294,494 $ (4,276 ) $ 290,218 Accumulated deficit $ (150,759 ) $ (4,276 ) $ (155,035 ) Total stockholders’ equity $ 146,084 $ (4,276 ) $ 141,808 Total liabilities and stockholders’ equity $ 294,494 $ (4,276 ) $ 290,218 For For September CONSOLIDATED STATEMENTS OF OPERATIONS As Adjustments As As Adjustments As Selling, general and administrative $ 51,146 $ 179 $ 51,325 $ 150,261 $ 536 $ 150,797 Total operating expenses $ 54,855 $ 179 $ 55,034 $ 164,048 $ 536 $ 164,584 Income from operations $ 22,980 $ (179 ) $ 22,801 $ 5,644 $ (536 ) $ 5,108 Net income (loss) before income taxes $ 21,006 $ (179 ) $ 20,827 $ (411 ) $ (536 ) $ (947 ) Net income (loss) $ 20,934 $ (179 ) $ 20,755 $ (545 ) $ (536 ) $ (1,081 ) Nine Months Ended September 30, 2020 CONSOLIDATED STATEMENTS OF CASH FLOWS As Previously Adjustments As Net loss $ (545 ) $ (536 ) $ (1,081 ) Depreciation $ 2,749 $ 536 $ 3,285
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2016-02 2016-02”), Leases right-of-use o months or less. The Company also elected to account for lease components and the associated non-lease components in the contracts as a single lease component for most of the leased assets. Upon the adoption of this standard on January 1, 2021, the Company recognized an operating lease liability of $ , representing the present value of the minimum lease payments remaining as of the adoption date, and a right-of-use asset in the amount of $ . The right-of-use asset reflects adjustments for de-recognition of deferred lease liabilities and lease incentives. The Company’s accounting for finance leases (previously classified as capital leases under ASC 840) remained substantially unchanged. See Note “17. Leases” for further disclosures.
Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Issued Accounting Pronouncements Not Yet Adopted In June 2016, the FASB issued ASU 2016-13 , Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). Subsequent ASU 2016-13, the ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments- Credit Losses ASU 2019-04, Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments ASU 2019-05, Financial Instruments—Credit Losses (Topic 326)—Targeted Transition Relief ASU 2019-11, Codification Improvements to Topic 326, Financial Instruments—Credit Losses ASU 2016-13 and ASU 2016-13 and ASU 2016-13

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Schedule Of Revision Of Previously Issued Financial Statements To Correct The Immaterial Misstatement	To correct the immaterial misstatement, the Company revised its previously issued financial statements as follows: As of December 31, 2020 CONSOLIDATED BALANCE SHEETS As Previously Adjustments As Revised Property and equipment, net $ 60,068 $ (4,276 ) $ 55,792 Total assets $ 294,494 $ (4,276 ) $ 290,218 Accumulated deficit $ (150,759 ) $ (4,276 ) $ (155,035 ) Total stockholders’ equity $ 146,084 $ (4,276 ) $ 141,808 Total liabilities and stockholders’ equity $ 294,494 $ (4,276 ) $ 290,218 For For September CONSOLIDATED STATEMENTS OF OPERATIONS As Adjustments As As Adjustments As Selling, general and administrative $ 51,146 $ 179 $ 51,325 $ 150,261 $ 536 $ 150,797 Total operating expenses $ 54,855 $ 179 $ 55,034 $ 164,048 $ 536 $ 164,584 Income from operations $ 22,980 $ (179 ) $ 22,801 $ 5,644 $ (536 ) $ 5,108 Net income (loss) before income taxes $ 21,006 $ (179 ) $ 20,827 $ (411 ) $ (536 ) $ (947 ) Net income (loss) $ 20,934 $ (179 ) $ 20,755 $ (545 ) $ (536 ) $ (1,081 ) Nine Months Ended September 30, 2020 CONSOLIDATED STATEMENTS OF CASH FLOWS As Previously Adjustments As Net loss $ (545 ) $ (536 ) $ (1,081 ) Depreciation $ 2,749 $ 536 $ 3,285

Product and Geographic Sales (T

Product and Geographic Sales (Tables)	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Schedule of Revenue by Product Category	The following tables set forth revenue by product category: Three Months Ended September 30, 2021 2020 Advanced Wound Care $ 107,341 $ 89,990 Surgical & Sports Medicine 6,412 10,809 Total net revenue $ 113,753 $ 100,799 Nine Months Ended September 30, 2021 2020 Advanced Wound Care $ 309,485 $ 201,009 Surgical & Sports Medicine 30,016 30,482 Total net revenue $ 339,501 $ 231,491

Fair Value of Financial Asset_2

Fair Value of Financial Assets and Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Fair Value, by Balance Sheet Grouping	The following tables present information about the Company’s financial assets and liabilities measured at fair value on a recurring basis and indicate the level of the fair value hierarchy utilized to determine such fair values as of S e Fair Value Measurements as of September 30, 2021 Using: Level 1 Level 2 Level 3 Total Liabilities: Earnout liability $ — $ — $ — $ — $ — $ — $ — $ — Fair Value Measurements as of December 31, 2020 Using: Level 1 Level 2 Level 3 Total Liabilities: Earnout liability $ — $ — $ 3,985 $ 3,985 $ — $ — $ 3,985 $ 3,985
Summary of Fair Value of Earnout liability	The following table provides a roll-forward of the fair value of the Company’s Earnout liability, for which fair value is determined using Level 3 inputs: Earnout liability Balance as of December 31, 2020 $ 3,985 Change in fair value (3,985 ) Balance as of September 30, 2021 $ —

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	9 Months Ended
	Sep. 30, 2021
Receivables [Abstract]
Schedule of accounts receivable	Accounts receivable consisted of the following: September 30, December 31, 2021 2020 Accounts receivable $ 81,925 $ 61,792 Less — allowance for sales returns and doubtful accounts (7,342 ) (4,988 ) $ 74,583 $ 56,804
Schedule of allowance for sales returns and doubtful accounts	The Company’s allowance for sales returns and doubtful accounts was comprised of the following: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Balance at beginning of period $ 7,113 $ 3,928 $ 4,988 $ 3,049 Additions 704 1,589 2,862 2,559 Write-offs (475 ) (392 ) (508 ) (483 ) Balance at end of period $ 7,342 $ 5,125 $ 7,342 $ 5,125

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2021
Inventory Disclosure [Abstract]
Schedule of Inventory, Current	Inventories, net of related reserves for excess and obsolescence, consisted of the following: September 30, December 31, 2021 2020 Raw materials $ 8,761 $ 10,075 Work in process 2,144 1,305 Finished goods 18,590 16,419 $ 29,495 $ 27,799

Prepaid Expenses and Other Cu_2

Prepaid Expenses and Other Current Assets (Tables)	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Schedule of prepaid expenses and other current assets	Prepaid expenses and other current assets consisted of the following: September 30, December 31, 2021 2020 Subscriptions $ 2,091 $ 2,013 Conferences and marketing expenses 623 63 Deposits 1,185 1,438 Reimbursement of offering expenses — 1,009 Insurance 997 240 Other 137 172 $ 5,033 $ 4,935

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	9 Months Ended
	Sep. 30, 2021
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and equipment consisted of the following: September 30, December 31, 2021 2020 Leasehold improvements $ 45,050 $ 39,574 Building 4,943 $ — Furniture, computers and equipment 52,696 48,236 102,689 87,810 Accumulated depreciation and amortization (73,894 ) (73,797 ) Construction in progress 45,979 41,779 $ 74,774 $ 55,792 Depreciation expense was $1,937 and $1,135 for the three months ended September 30, 2021 and 2020. Depreciation expense was $4,010 and $3,285 for the nine months ended September 30, 2021 and 2020. As of December 31, 2020, the Company had $21,689 of buildings under finance leases recorded within leasehold improvements and had $18,716 recorded within accumulated depreciation related to these buildings. In August 2021, the Company purchased one building previously under a finance lease (see Note “17. Leases”) from a related party and removed the lease from leasehold improvements and recorded the asset to buildings. As of September 30, 2021, the Company had i

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Finite-Lived Intangible Assets	Identifiable intangible assets consisted of the following as of September 30, 2021: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ (16,864 ) $ 15,756 Trade names and trademarks 2,080 (1,128 ) 952 Customer relationships 10,690 (1,114 ) 9,576 Non-compete 1,010 (398 ) 612 Total $ 46,400 $ (19,504 ) $ 26,896 Identifiable intangible assets consisted of the following as of December 31, 2020: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ (14,330 ) $ 18,290 Trade names and trademarks 2,080 (906 ) 1,174 Customer relationship 10,690 (312 ) 10,378 Non-compete 1,010 (230 ) 780 Total $ 46,400 $ (15,778 ) $ 30,622

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Schedule of Accounts Payable and Accrued Liabilities	Accrued expenses and other current liabilities consisted of the following: September 30, December 31, 2021 2020 Personnel costs $ 25,482 $ 18,943 Royalties 3,338 2,971 Accrued but unpaid lease obligations and interest 6,390 — Other 1,918 2,059 $ 37,128 $ 23,973

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2021
Restructuring and Related Activities [Abstract]
Summary of Restructuring Liability	The following table provides a roll-forward of the restructuring liability. Employee Facility Liability balance as of June 30, 2021 $ 2,381 $ 29 Expenses 854 156 Payments (26 ) (160 ) Liability balance as of September 30, 2021 $ 3,209 $ 25 Employee Facility Liability balance as of December 31, 2020 $ 618 $ — Expenses 2,617 259 Payments (26 ) (234 ) Liability balance as of September 30, 2021 $ 3,209 $ 25

Long-Term Debt Obligations (Tab

Long-Term Debt Obligations (Tables)	9 Months Ended
	Sep. 30, 2021
Long-term Debt, Unclassified [Abstract]
Schedule of long-term debt obligations	Long-term debt obligations consisted of the following: September 30, December 31, 2021 2020 Line of credit $ — $ 10,000 Term loan 74,531 60,000 Less debt discount and debt issuance cost (678 ) (290 ) Term loan, net of debt discount and debt issuance cost $ 73,853 $ 59,710
Schudle of future payments of term loan facility	Future payments of the 2021 Credit Agreement, as of September 30, 2021, are as follows for the calendar years ending December 31: 2021 469 2022 2,812 2023 4,687 2024 5,625 2025 and beyond 60,938 Total $ 74,531 2019 Credit Agreement In March 2019 , the Company, its subsidiaries and SVB, and the several other lenders thereto entered into a credit agreement, as amended (the “2019 Credit Agreement”), providing for a term loan facility of $ and a revolving credit facility of up to $ . Both facilities w ere mature in . The interest rate for the term loan facility was a floating per . If the Company elected to prepay the loan or terminate the facilities, the Company was required to pay a certain percentage of the outstanding principal as a prepayment fee. A final payment fee (the “Final Payment”) of % multiplied by the original aggregate principal amount of term loan facility was due upon the earlier to occur of the maturity date of the term loan or prepayment of all outstanding principal.

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Schedule Of Common Stock Shares Reserved For Future Issuance	As of September 30, 2021 and December 31, 2020, the Company reserved the following shares of Class A common stock for future issuance: September 30, December 31, 2021 2020 Shares reserved for issuance for outstanding options 6,724,574 6,425,040 Shares reserved for issuance for outstanding restricted stock units 768,203 806,048 Shares reserved for issuance for future grants 5,635,822 6,832,649 Total shares of authorized common stock reserved for future issuance 13,128,599 14,063,737

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement [Abstract]
Summary of Unvested Restricted Stock Units	The activity of restricted stock units is set forth below: Weighted Number Grant Date of Shares Fair Value Unvested at December 31, 2020 787,923 $ 3.81 Granted 299,352 14.46 Vested (248,305 ) 4.20 Canceled/Forfeited (70,767 ) 8.01 Unvested at September 30, 2021 768,203 $ 7.45
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: September 30, September 30, 2021 2020 Risk-free interest rate 0.83 % 0.46 % Expected term (in years) 6.22 6.22 Expected volatility 39.31 % 37.42 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 13.57 $ 4.04 Underlying stock price $ 13.57 $ 3.37
Summary of Stock Option Activity	The following table summarizes the Company’s stock option activity since December 31, 2020: Weighted Average Weighted Remaining Average Contractual Aggregate Number of Exercise Term Intrinsic Shares Price (in years) Value Outstanding as of December 31, 2020 6,617,403 $ 2.32 5.22 $ 34,447 Granted 1,069,658 13.57 Exercised (912,205 ) 2.31 9,720 Canceled / forfeited (50,282 ) 8.30 Outstanding as of September 30, 2021 6,724,574 4.07 5.36 68,605 Options exercisable as of September 30, 2021 4,335,117 1.74 3.57 54,186 Options vested or expected to vest as of September 30, 2021 6,271,605 $ 3.71 5.11 $ 66,231

Net Income (Loss) Per Share (_2

Net Income (Loss) Per Share (EPS) (Tables)	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income (loss) attributable to the common stockholders of Organogenesis Holdings Inc. is as follows. Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Numerator: Net Income (loss) $ 12,577 $ 20,755 $ 43,207 $ (1,081 ) Denominator: Weighted average common shares outstanding 128,546,301 105,040,035 128,219,674 104,748,297 Dilutive effect of restricted stock units 458,642 134,759 498,105 — Dilutive effect of options 4,845,273 3,314,974 5,048,225 — Weighted-average common shares outstanding—diluted 133,850,216 108,489,768 133,766,004 104,748,297 Earnings (loss) per share—basic $ 0.10 $ 0.20 $ 0.34 $ (0.01 ) Earnings (loss) per share—diluted $ 0.09 $ 0.19 $ 0.32 $ (0.01 )

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Schedule of Lease Cost	The components of lease cost were as follows: Classification Three Months September 30, Nine Months September 30, Finance lease Amortization of right-of-use COGS and SG&A $ 793 $ 1,396 Interest on lease liabilities Interest Expense 218 879 Total Finance lease cost 1,011 2,275 Operating lease cost COGS, R&D, SG&A 1,857 4,872 Short-term lease cost COGS, R&D, SG&A 758 2,172 Variable lease cost COGS, R&D, SG&A 1,304 3,753 Total lease cost $ 4,930 $ 13,072
Summary of Balance Sheet Information Related To Finance Leases	Supplemental balance sheet information related to finance le a September 30, January 1 Property and equipment, gross $ 18,670 $ 22,989 Accumulated depreciation (16,736 ) (19,250 ) Property and equipment, net $ 1,934 $ 3,739 Current portion of finance lease obligations $ 8,531 $ 3,619 Finance lease long-term obligations 831 11,442 Total finance lease liabilities $ 9,362 $ 15,061
Summary of Cash Flow Information Related To Leases	Supplemental cash flow information related to leases was as follows: Nine Months September 30, 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases 4,933 Operating cash flows for finance leases 1,327 Financing cash flows for finance leases 2,099 Right-of-use Operating leases 13,525 Finance leases — Right-of-use Operating leases 17,114 Finance leases — September 30, Weighted-average remaining lease term Finance leases 1.23 Operating leases 8.06 September 30, 2021 Weighted-average discount rate Finance leases 15.04 % Operating leases 4.18 %
Summary of Maturities of Lease Liabilities	As of September 30, 2021, the maturities of lease liabilities were as follows: Operating leases Finance leases 2021 (remaining 3 months) $ 1,975 $ 889 2022 4,980 8,887 2023 4,137 — 2024 3,345 — 2025 3,249 — Thereafter 16,644 — Total lease payments 34,330 9,776 Less: interest (5,459 ) (414 ) Total lease liabilities $ 28,871 $ 9,362

Nature of the Business and Ba_2

Nature of the Business and Basis of Presentation - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2021Segments
Liquidity and Financial Conditions [Line Items]
Number of Operating Segments	1
Number of Reportable Segments	1

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Schedule Of Revision Of Previously Issued Financial Statements To Correct The Immaterial Misstatement (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Jun. 30, 2021	Dec. 31, 2020	Jun. 30, 2020	Dec. 31, 2019
CONSOLIDATED BALANCE SHEETS
Property and equipment, net	$ 74,774		$ 74,774			$ 55,792
Total assets	370,423		370,423			290,218
Accumulated deficit	(111,828)		(111,828)			(155,035)
Total stockholders' equity	189,174	$ 61,377	189,174	$ 61,377	$ 174,646	141,808	$ 31,832	$ 52,022
Total liabilities and stockholders' equity	370,423		370,423			290,218
CONSOLIDATED STATEMENTS OF OPERATIONS
Selling, general and administrative	62,369	51,325	182,950	150,797
Total operating expenses	71,322	55,034	205,432	164,584
Income from operations	16,264	22,801	52,467	5,108
Net income (loss) before income taxes	12,880	20,827	44,197	(947)
Net income (loss)	12,577	20,755	43,207	(1,081)
CONSOLIDATED STATEMENTS OF CASH FLOWS
Net loss	12,577	20,755	43,207	(1,081)
Depreciation expense	$ 1,937	1,135	$ 4,010	3,285
Previously Reported [Member]
CONSOLIDATED BALANCE SHEETS
Property and equipment, net						60,068
Total assets						294,494
Accumulated deficit						(150,759)
Total stockholders' equity					$ 178,922	146,084	$ 35,750	$ 55,583
Total liabilities and stockholders' equity						294,494
CONSOLIDATED STATEMENTS OF OPERATIONS
Selling, general and administrative		51,146		150,261
Total operating expenses		54,855		164,048
Income from operations		22,980		5,644
Net income (loss) before income taxes		21,006		(411)
Net income (loss)		20,934		(545)
CONSOLIDATED STATEMENTS OF CASH FLOWS
Net loss				(545)
Depreciation expense				2,749
Revision of Prior Period, Adjustment [Member]
CONSOLIDATED BALANCE SHEETS
Property and equipment, net						(4,276)
Total assets						(4,276)
Accumulated deficit						(4,276)
Total stockholders' equity						(4,276)
Total liabilities and stockholders' equity						(4,276)
CONSOLIDATED STATEMENTS OF OPERATIONS
Selling, general and administrative		179		536
Total operating expenses		179		536
Income from operations		(179)		(536)
Net income (loss) before income taxes		(179)		(536)
Net income (loss)		(179)		(536)
CONSOLIDATED STATEMENTS OF CASH FLOWS
Net loss				(536)
Depreciation expense				536
As Revised [Member]
CONSOLIDATED BALANCE SHEETS
Property and equipment, net						55,792
Total assets						290,218
Accumulated deficit						(155,035)
Total stockholders' equity						141,808
Total liabilities and stockholders' equity						$ 290,218
CONSOLIDATED STATEMENTS OF OPERATIONS
Selling, general and administrative		51,325		150,797
Total operating expenses		55,034		164,584
Income from operations		22,801		5,108
Net income (loss) before income taxes		20,827		(947)
Net income (loss)		$ 20,755		(1,081)
CONSOLIDATED STATEMENTS OF CASH FLOWS
Net loss				(1,081)
Depreciation expense				$ 3,285

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Jan. 01, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Significant Accounting Policies [Line Items]
Lease liabilities, Term	12 months
Operating lease liability	$ 28,871	$ 15,935
Right-of-use asset	26,522	$ 13,525
Number of Warrants				0
Retained ​Earnings​ Accumulated​ Deficit	$ (111,828)		$ (155,035)
Error Correction, Warrant
Significant Accounting Policies [Line Items]
Retained ​Earnings​ Accumulated​ Deficit			$ 2,299
Common Class A
Significant Accounting Policies [Line Items]
Number of common stock issuable				3,300,000
Private Warrants
Significant Accounting Policies [Line Items]
Number of Warrants					4,100,000
Public Warrant
Significant Accounting Policies [Line Items]
Number of Warrants					31,000,000

Acquisition - Additional Inform

Acquisition - Additional Information (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 17, 2020
Business Acquisitions, Contingent Consideration Liability Noncurrent	$ 0	$ 3,985	$ 3,782
CPN Biosciences, LLC
Earnout Calculation			70.00%

Product and Geographic Sales -

Product and Geographic Sales - Schedule of Revenue by Product Category (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Total revenue	$ 113,753	$ 100,799	$ 339,501	$ 231,491
Advanced Wound Care
Total revenue	107,341	89,990	309,485	201,009
Surgical & Sports Medicine
Total revenue	$ 6,412	$ 10,809	$ 30,016	$ 30,482

Product and Geographic Sales _2

Product and Geographic Sales - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Significant Accounting Policies [Line Items]
GPO Fees	$ 794	$ 1,013	$ 2,323	$ 2,810
Sales Revenue | Geographic Concentration Risk | International
Significant Accounting Policies [Line Items]
Concentration Risk, Percentage			1.00%

Fair Value of Financial Asset_3

Fair Value of Financial Assets and Liabilities - Financial Assets And Liabilities Measured At Fair Value (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 17, 2020
Liabilities:
Liabilities	$ 0	$ 3,985	$ 3,782
Fair Value, Measurements, Recurring
Liabilities:
Liabilities	0	3,985
Fair Value, Measurements, Recurring | Earnout Liability [Member]
Liabilities:
Liabilities	0	3,985
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 3
Liabilities:
Liabilities	0	3,985
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 3 | Earnout Liability [Member]
Liabilities:
Liabilities	$ 0	$ 3,985

Fair Value of Financial Asset_4

Fair Value of Financial Assets and Liabilities - Fair value of the Company's Earnout liability (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value	$ (3,985)
Fair Value, Inputs, Level 3 | Earnout Liability [Member]
Business Acquisition, Contingent Consideration [Line Items]
Beginning balance	3,985
Change in fair value	(3,985)
Ending balance	$ 0

Fair Value of Financial Asset_5

Fair Value of Financial Assets and Liabilities - Additional Information (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 17, 2020
Earnout liability	$ 0	$ 3,985	$ 3,782

Accounts Receivable, Net (Detai

Accounts Receivable, Net (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Receivables [Abstract]
Accounts receivable	$ 81,925	$ 61,792
Less — allowance for sales returns and doubtful accounts	(7,342)	(4,988)
Accounts receivable	$ 74,583	$ 56,804

Accounts Receivable, Net - Sale

Accounts Receivable, Net - Sales Returns and Doubtful Accounts (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Balance at beginning of period	$ 7,113	$ 3,928	$ 4,988	$ 3,049
Additions	704	1,589	2,862	2,559
Write-offs	(475)	(392)	(508)	(483)
Balance at end of period	$ 7,342	$ 5,125	$ 7,342	$ 5,125

Inventories (Detail)

Inventories (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Raw materials	$ 8,761	$ 10,075
Work in process	2,144	1,305
Finished goods	18,590	16,419
Inventory	$ 29,495	$ 27,799

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Inventory reserve and obsolescence charged to cost of goods	$ 3,367	$ 315	$ 8,045	$ 2,024

Prepaid Expenses and Other Cu_3

Prepaid Expenses and Other Current Assets (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Subscriptions	$ 2,091	$ 2,013
Conferences and marketing expenses	623	63
Deposits	1,185	1,438
Reimbursement of offering expenses	0	1,009
Insurance	997	240
Other	137	172
Prepaid Expense	$ 5,033	$ 4,935

Property and Equipment, Net (De

Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Property, Plant and Equipment, Gross	$ 102,689	$ 87,810
Accumulated depreciation and amortization	(73,894)	(73,797)
Property and equipment net	74,774	55,792
Leasehold improvements
Property, Plant and Equipment, Gross	45,050	39,574
Building
Property, Plant and Equipment, Gross	4,943
Furniture, computers and equipment
Property, Plant and Equipment, Gross	52,696	48,236
Construction in progress
Property and equipment net	$ 45,979	$ 41,779

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Depreciation expense	$ 1,937	$ 1,135	$ 4,010	$ 3,285
Leasehold improvements
Finance leases recorded within leasehold improvements	17,370		17,370		$ 21,689
Accumulated depreciation to finance lease asset recorded within leasehold improvement	$ 15,873		$ 15,873		$ 18,716

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Identifiable intangible assets (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Original Cost	$ 46,400	$ 46,400
Accumulated Amortization	(19,504)	(15,778)
Net Book Value	26,896	30,622
Developed technology
Original Cost	32,620	32,620
Accumulated Amortization	(16,864)	(14,330)
Net Book Value	15,756	18,290
Trade names and trademarks
Original Cost	2,080	2,080
Accumulated Amortization	(1,128)	(906)
Net Book Value	952	1,174
Customer relationships
Original Cost	10,690	10,690
Accumulated Amortization	(1,114)	(312)
Net Book Value	9,576	10,378
Non-compete agreements
Original Cost	1,010	1,010
Accumulated Amortization	(398)	(230)
Net Book Value	$ 612	$ 780

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Goodwill	$ 28,772		$ 28,772		$ 28,772
Amortization of Intangible Assets	$ 1,240	$ 885	$ 3,726	$ 2,518

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Payables and Accruals [Abstract]
Personnel costs	$ 25,482	$ 18,943
Royalties	3,338	2,971
Accrued but unpaid lease obligations and interest	6,390
Other	1,918	2,059
Total Accrued Expenses and Other Current Liabilities	$ 37,128	$ 23,973

Restructuring - Summary of Rest

Restructuring - Summary of Restructuring Liability (Detail) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021
Employee
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	$ 2,381	$ 618
Restructuring Charges	854	2,617
Payments	(26)	(26)
Liability balance as of ending	3,209	3,209
Facility
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	29	0
Restructuring Charges	156	259
Payments	(160)	(234)
Liability balance as of ending	$ 25	$ 25

Restructuring - Additional Info

Restructuring - Additional Information (Detail) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021USD ($)Employees	Sep. 30, 2021USD ($)Employees
Restructuring Cost and Reserve [Line Items]
Restructuring and Related Cost	$ 6,500	$ 6,500
Number of employees to retention Benefits | Employees	65	65
Restructuring Reserve Current	$ 3,234	$ 3,234
Selling, General and Administrative Expenses
Restructuring Cost and Reserve [Line Items]
Restructuring Charges	1,010	2,876
Employee Cost
Restructuring Cost and Reserve [Line Items]
Restructuring and Related Cost	4,000	4,000
Restructuring Charges	854	2,617
Facility and Other
Restructuring Cost and Reserve [Line Items]
Restructuring and Related Cost	2,500	2,500
Restructuring Charges	$ 156	$ 259

Long-Term Debt Obligations (Det

Long-Term Debt Obligations (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Line of credit	$ 0	$ 10,000
Term loan	74,531	60,000
Less debt discount and debt issuance cost	(678)	(290)
Term loan, net of debt discount and debt issuance cost	$ 73,853	$ 59,710

Long-Term Debt Obligations - Fu

Long-Term Debt Obligations - Future payments of term loan (Detail) $ in Thousands	Sep. 30, 2021USD ($)
2021	$ 469
2022	2,812
2023	4,687
2024	5,625
2025 and beyond	60,938
Total	$ 74,531

Long-Term Debt Obligations - Ad

Long-Term Debt Obligations - Additional Information (Detail) - USD ($) $ in Thousands	Aug. 09, 2021	May 14, 2019	Mar. 14, 2019	Sep. 30, 2021	Sep. 30, 2021	Dec. 31, 2020
Secured debt				$ 74,531	$ 74,531	$ 60,000
Total payment					469
Loss on the extinguishment of debt				$ (1,883)	(1,883)
ABR Loans [Member] | Total Net Leverage Ratio Greater Than Or Equal To 3.25x [Member]
Applicable margin rate	2.25%
ABR Loans [Member] | Total Net Leverage Ratio Is Greater Than Or Equal To 2.50x But Less Than 3.25x [Member]
Applicable margin rate	1.75%
ABR Loans [Member] | Total Net Leverage Ratio Is Greater Than Or Equal To 2.00x But Less 2.50x [Member]
Applicable margin rate	1.50%
ABR Loans [Member] | Total Net Leverage Ratio Is Greater Than Or Equal To 1.50x But Less Than 2.00x [Member]
Applicable margin rate	1.25%
ABR Loans [Member] | Total Net Leverage Ratio Is Less Than 1.50x [Member]
Applicable margin rate	1.00%
2019 Credit Agreement
Total payment	$ 70,559
Loss on the extinguishment of debt					$ (1,883)
2021 Credit Agreement
Debt Instrument Variable Interest Rate				2.08%	2.08%
Debt Instrument, Covenant Description	Under the 2021 Credit Agreement, the Company is required to comply with certain financial covenants. The Company may not permit the Consolidated Fixed Charge Coverage Ratio at the last day of any period of four consecutive fiscal quarters, commencing with the fiscal quarter ending September 30, 2021, to be less than 1.25:1.00. Additionally, the Company may not permit the Consolidated Total Net Leverage Ratio at the last day of any period of four consecutive fiscal quarters, commencing with the fiscal quarter ending September 30, 2021, to exceed the following ratios: (i) for the trailing four fiscal quarters ending September 30, 2021, December 31, 2021, March 31, 2022, June 30, 2022 and September 30, 2022, a ratio of 3.50:1.00; (ii) for the trailing four fiscal quarters ending December 31, 2022, March 31, 2023, June 30, 2023 and September 30, 2023, a ratio of 3.25:1.00; and (iii) for the trailing four fiscal quarters ending December 31, 2023 and each fiscal quarter thereafter, a ratio of 3.00:1.00.
2021 Credit Agreement | Euro Dollar Loans [Member]
Debt Instrument, Description of Variable Rate Basis	For Eurodollar Loans, the interest rate is a per annum interest rate equal to LIBOR plus an Applicable Margin as follows: (i) if the Total Net Leverage Ratio is greater than or equal to 3.25x, 3.25%; (ii) if the Total Net Leverage Ratio is greater than or equal to 2.50x but less than 3.25x, 2.75% ; (iii) if the Total Net Leverage Ratio is greater than or equal to 2.00x but less than 2.50x, 2.50%; (iv) if the Total Net Leverage Ratio is greater than or equal to 1.50x but less than 2.00x, 2.25% and (v) if the Total Net Leverage Ratio is less than 1.50x, 2.00%.
2021 Credit Agreement | Euro Dollar Loans [Member] | Total Net Leverage Ratio Greater Than Or Equal To 3.25x [Member]
Debt instrument Interest and applicable margin rate percentage	3.25%
2021 Credit Agreement | Euro Dollar Loans [Member] | Total Net Leverage Ratio Is Greater Than Or Equal To 2.50x But Less Than 3.25x [Member]
Debt instrument Interest and applicable margin rate percentage	2.75%
2021 Credit Agreement | Euro Dollar Loans [Member] | Total Net Leverage Ratio Is Greater Than Or Equal To 2.00x But Less 2.50x [Member]
Debt instrument Interest and applicable margin rate percentage	2.50%
2021 Credit Agreement | Euro Dollar Loans [Member] | Total Net Leverage Ratio Is Greater Than Or Equal To 1.50x But Less Than 2.00x [Member]
Debt instrument Interest and applicable margin rate percentage	2.25%
2021 Credit Agreement | Euro Dollar Loans [Member] | Total Net Leverage Ratio Is Less Than 1.50x [Member]
Debt instrument Interest and applicable margin rate percentage	2.00%
2021 Credit Agreement | ABR Loans [Member]
Debt Instrument, Description of Variable Rate Basis	For ABR Loans, the interest rate is equal to (1) the highest of (a) the Wall Street Journal Prime Rate, (b) the Federal Funds Rate plus 0.50% and (c) the LIBOR rate plus 1.0%, plus (2) an Applicable Margin as follows: (i) if the Total Net Leverage Ratio is greater than or equal to 3.25x, 2.25%; (ii) if the Total Net Leverage Ratio is greater than or equal to 2.50x but less than 3.25x, 1.75% ; (iii) if the Total Net Leverage Ratio is greater than or equal to 2.00x but less than 2.50x, 1.50%; (iv) if the Total Net Leverage Ratio is greater than or equal to 1.50x but less than 2.00x, 1.25%; and (v) if the Total Net Leverage Ratio is less than 1.50x, 1.00%.
2021 Credit Agreement | ABR Loans [Member] | Federal Funds Rate [Member]
Interest rate	0.50%
2021 Credit Agreement | ABR Loans [Member] | London Interbank Offered Rate (LIBOR) [Member]
Interest rate	1.00%
Term Loan [Member] | 2019 Credit Agreement
Debt Instrument, Basis Spread on Variable Rate			3.75%
Debt Instrument Variable Interest Rate				9.25%	9.25%
Additional Payment in Aggregate of the Principal Amount Percentage		6.50%
Debt instrument face amount			$ 40,000
Debt Instrument, Description of Variable Rate Basis			annum interest rate equal to the greater of 3.75% above the Wall Street Journal Prime Rate and 9.25%
Debt instrument maturity date			2024
Term Loan [Member] | 2021 Credit Agreement
Secured debt				$ 74,531	$ 74,531
Debt Issuance Costs, Net				604	604
Debt instrument face amount	$ 75,000
Prepayment premium percentage	1.00%
Term Loan [Member] | 2021 Credit Agreement | September 30, 2021 through and including June 30, 2022
Debt instrument consecutive quarterly installment payments equal to percentages of the original principal amount of the Term Loans	0.625%
Debt instrument quarterly installment payment to original principal amount	$ 469
Term Loan [Member] | 2021 Credit Agreement | September 30, 2022 through and including June 30, 2023
Debt instrument consecutive quarterly installment payments equal to percentages of the original principal amount of the Term Loans	1.25%
Debt instrument quarterly installment payment to original principal amount	$ 938
Term Loan [Member] | 2021 Credit Agreement | September 30, 2023 through and including June 30, 2025
Debt instrument consecutive quarterly installment payments equal to percentages of the original principal amount of the Term Loans	1.875%
Debt instrument quarterly installment payment to original principal amount	$ 1,406
Term Loan [Member] | 2021 Credit Agreement | September 30, 2025 and the last day of each quarter thereafter until August 6, 2026
Debt instrument consecutive quarterly installment payments equal to percentages of the original principal amount of the Term Loans	2.50%
Debt instrument quarterly installment payment to original principal amount	$ 1,875
Revolving Credit Facility [Member] | 2019 Credit Agreement
Maximum borrowing capacity			$ 60,000
Line of credit maturity date			2024
Line of credit description of variable rate basis for advances under revolving facility			The interest rate for advances under the revolving facility was a floating per annum interest rate equal to the greater of the Wall Street Journal Prime Rate and 5.50%.
Revolving Credit Facility [Member] | 2021 Credit Agreement
Maximum borrowing capacity	$ 125,000			125,000	125,000
Debt Issuance Costs, Net				$ 1,223	$ 1,223
Prepayment premium percentage	1.00%
Revolving Credit Facility [Member] | 2021 Credit Agreement | Total Net Leverage Ratio Greater Than Or Equal To 3.25x [Member]
Unused Line Fee	0.45%
Revolving Credit Facility [Member] | 2021 Credit Agreement | Total Net Leverage Ratio Is Greater Than Or Equal To 2.50x But Less Than 3.25x [Member]
Unused Line Fee	0.40%
Revolving Credit Facility [Member] | 2021 Credit Agreement | Total Net Leverage Ratio Is Greater Than Or Equal To 2.00x But Less 2.50x [Member]
Unused Line Fee	0.35%
Revolving Credit Facility [Member] | 2021 Credit Agreement | Total Net Leverage Ratio Is Greater Than Or Equal To 1.50x But Less Than 2.00x [Member]
Unused Line Fee	0.30%
Revolving Credit Facility [Member] | 2021 Credit Agreement | Total Net Leverage Ratio Is Less Than 1.50x [Member]
Unused Line Fee	0.25%

Stockholders' Equity (Detail)

Stockholders' Equity (Detail) - shares	Sep. 30, 2021	Dec. 31, 2020
Equity [Abstract]
Shares reserved for issuance for outstanding options	6,724,574	6,425,040
Shares reserved for issuance for outstanding restricted stock units	768,203	806,048
Shares reserved for issuance for future grants	5,635,822	6,832,649
Total shares of authorized common stock reserved for future issuance	13,128,599	14,063,737

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - $ / shares	1 Months Ended
	Mar. 24, 2019	Sep. 30, 2021	Dec. 31, 2020
Common stock, shares authorized		400,000,000	400,000,000
Common stock, par value		$ 0.0001	$ 0.0001
Common stock, shares issued		129,365,209	128,460,381
Shares outstanding		128,636,661	127,731,833
Common Class A
Common stock, shares authorized		400,000,000
Common stock, par value		$ 0.0001
Company issued acquisition of shares	728,548
Common stock, shares issued		129,365,209
Preferred Stock
Common stock, shares authorized		1,000,000
Common stock, par value		$ 0.0001
Shares outstanding		0
Redeemable Common Stock | Nutech Acquisition [Member]
Company issued acquisition of shares	728,548

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Stock option expiration period			10 years
Common stock options outstanding	6,724,574		6,724,574		6,617,403
Share-based compensation expense	$ 1,041	$ 486	$ 2,781	$ 1,164
Fair value of option vested			$ 592	$ 387
Weighted average grant-date fair value			$ 5.32	$ 1.05
Maximum
Stock option granted vesting period			5 years
Minimum
Stock option granted vesting period			4 years
Restricted Stock Units [Member]
Unrecognized stock compensation expense	3,559		$ 3,559
Share-based compensation expected to be recognized over a weighted-average period			2 years 11 months 1 day
Restricted stock units issued to employees			299,352
Option Loans
Common stock options outstanding					195,278	675,990
Related Parties Notes Receivable	0		$ 0		$ 334	$ 635
Number of shares issued as collateral for the option loans						675,990
Number of options exercised			195,278
Option
Unrecognized stock compensation expense	$ 4,431		$ 4,431
Share-based compensation expected to be recognized over a weighted-average period			3 years 1 month 6 days
Common Class A | 2018 Stock Incentive Plan
Common stock options authorized	9,198,996		9,198,996

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Fair Value of Stock Options Granted to Employees and Directors (Detail) - $ / shares	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Risk-free interest rate	0.83%	0.46%
Expected term (in years)	6 years 2 months 19 days	6 years 2 months 19 days
Expected volatility	39.31%	37.42%
Expected dividend yield	0.00%	0.00%
Exercise price	$ 13.57	$ 4.04
Underlying stock price	$ 13.57	$ 3.37

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Restricted Stock Units (Detail) - Restricted Stock Units (RSUs) [Member]	9 Months Ended
	Sep. 30, 2021$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested at December 31, 2020 | shares	787,923
Unvested Granted | shares	299,352
Unvested Vested | shares	(248,305)
Unvested Canceled/Forfeited | shares	(70,767)
Unvested at September 30,2021 | shares	768,203
Unvested at December 31, 2020 | $ / shares	$ 3.81
Unvested Granted | $ / shares	14.46
Unvested Vested | $ / shares	4.20
Unvested Canceled/Forfeited | $ / shares	8.01
Unvested at September 30,2021 | $ / shares	$ 7.45

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Number of Shares Outstanding	6,617,403
Number of Shares Granted	1,069,658	1,553,723
Number of Shares Exercised	(912,205)
Number of Shares Canceled / forfeited	(50,282)
Number of Shares Outstanding	6,724,574		6,617,403
Number of Shares Options Exercisable	4,335,117
Number of Shares Options vested or expected to vest	6,271,605
Weighted Average Exercise Price Outstanding	$ 2.32
Weighted Average Exercise Price Granted	13.57
Weighted Average Exercise Price Exercised	2.31
Weighted Average Exercise Price Cancelled / forfeited	8.30
Weighted Average Exercise Price Outstanding	4.07		$ 2.32
Weighted Average Exercise Price Options Exercisable	1.74
Weighted Average Exercise Price Options Vested or Expected to Vest	$ 3.71
Weighted Average Remaining Contractual Term (in years) Outstanding	5 years 4 months 9 days		5 years 2 months 19 days
Weighted Average Remaining Contractual Term (in years) Options Exercisable	3 years 6 months 25 days
Weighted Average Remaining Contractual Term (in years) Options Vested or Expected to Vest	5 years 1 month 9 days
Aggregate Intrinsic Value Outstanding	$ 34,447
Aggregate Intrinsic Value Options Exercised	9,720
Aggregate Intrinsic Value Options Exercisable	54,186
Aggregate Intrinsic Value Options Vested or Expected to Vest	66,231
Aggregate Intrinsic Value Outstanding	$ 68,605		$ 34,447

Stock-Based Compensation - Pare

Stock-Based Compensation - Parenthetical (Detail) - shares	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Options granted	1,069,658	1,553,723

Net Income (Loss) Per Share (_3

Net Income (Loss) Per Share (EPS) - Basic and diluted net loss per share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Net income (loss)	$ 12,577	$ 20,755	$ 43,207	$ (1,081)
Weighted-average common shares outstanding—basic	128,546,301	105,040,035	128,219,674	104,748,297
Weighted-average common shares outstanding—diluted	133,850,216	108,489,768	133,766,004	104,748,297
Earnings (loss) per share—basic	$ 0.10	$ 0.20	$ 0.34	$ (0.01)
Earnings (loss) per share—diluted	$ 0.09	$ 0.19	$ 0.32	$ (0.01)
Restricted Stock Units [Member]
Dilutive effect of awards	458,642	134,759	498,105
Employee Stock Option
Dilutive effect of awards	4,845,273	3,314,974	5,048,225

Net Income (Loss) per Share (_4

Net Income (Loss) per Share (EPS) - Additional Information (Detail) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Earnings Per Share [Abstract]
Anti-dilutive shares excluded from the diluted EPS	956,466	2,009,245	956,466	8,283,893

Leases - Additional Information

Leases - Additional Information (Detail) $ in Thousands	Aug. 11, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)ft²	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Operating lease, expense		$ 1,620		$ 4,971
Lessee, operating lease, term of contract			12 months
Property plant and equipment net			$ 74,774		$ 55,792
Accrued But Unpaid Capital Lease Obligation
Accrued interest on the accrued but unpaid lease obligations amount			2,357		1,673
Accrued But Unpaid Capital Lease Obligation | CAM Portion of Accrued Rent
Capital lease rental arrears			558		525
Accrued But Unpaid Capital Lease Obligation | Principal, Interest and CAM [Member]
Capital lease rental arrears			10,336		10,336
Accrued But Unpaid Capital Lease Obligation | Principal
Capital lease rental arrears			7,393		6,946
Accrued But Unpaid Capital Lease Obligation | Interest [Member]
Capital lease rental arrears			2,384		$ 2,865
Dan Road Associates
Capital Lease Obligations			$ 3,098
Capital Leases Aggregate Annual Lease Payments Rent Percentage			10.00%
275 Dan Road SPE LLC [Member]
Purchase of building under the lease amount	$ 6,013
Percentage of amount required to pay for the accrued but unpaid lease obligations associated with building	50.00%
Interest on the balance of the accrued but unpaid lease obligations associated with building was reduced to annula simplete rate,Percentage			4.50%
Property plant and equipment net	$ 4,943
Net book value of right of use asset removed from leasehold improvement	408
Difference between the cash paid and the lease liability extinguished	$ 4,535
California
Lessee, operating lease, term of contract			10 years
Lessee, Operating Lease, Option to Extend			five years
Annual lease payments during the first year			$ 1,562
Aggregate​ annual lease payments rent​ percentage increases			3.00%
Security Deposit			$ 237
Land Subject to Ground Leases | ft²			23,000
Fleet Lease
Lessee, operating lease, term of contract			367 days
Maximum
Lessee, operating lease, renewal term			10 years
Minimum
Lessee, operating lease, renewal term			5 years

Leases - Schedule of Lease Cost

Leases - Schedule of Lease Cost (Detail) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021
Leases [Abstract]
Finance lease Amortization of right-of-use assets	$ 793	$ 1,396
Finance lease Interest on lease liabilities	218	879
Total Finance lease cost	1,011	2,275
Operating lease cost	1,857	4,872
Short-term lease cost	758	2,172
Variable lease cost	1,304	3,753
Total lease cost	$ 4,930	$ 13,072

Leases - Summary of Balance She

Leases - Summary of Balance Sheet Information Related To Finance Leases (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Jan. 01, 2021
Lessee Disclosure [Abstract]
Property and equipment, gross	$ 18,670	$ 22,989
Accumulated depreciation	(16,736)	(19,250)
Property and equipment, net	1,934	3,739
Current portion of finance lease obligations	8,531	3,619
Finance lease long-term obligations	831	11,442
Total lease liabilities	$ 9,362	$ 15,061

Leases - Summary of Cash Flow I

Leases - Summary of Cash Flow Information Related To Leases (Detail) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$ 4,933
Operating cash flows for finance leases	1,327
Financing cash flows for finance leases	2,099	$ 1,776
Right-of-use assets obtained in exchange for lease obligations
Operating leases	$ 30,639
Weighted-average remaining lease term
Finance leases	1 year 2 months 23 days
Operating leases	8 years 21 days
Weighted-average discount rate
Finance leases	15.04%
Operating leases	4.18%
Post Adoption [Member]
Right-of-use assets obtained in exchange for lease obligations
Operating leases	$ 17,114
Upon Adoption [Member]
Right-of-use assets obtained in exchange for lease obligations
Operating leases	$ 13,525

Leases - Summary of Maturities

Leases - Summary of Maturities of Lease Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2021	Jan. 01, 2021
Lessee Disclosure [Abstract]
2021 (remaining 3 months)	$ 1,975
2022	4,980
2023	4,137
2024	3,345
2025	3,249
Thereafter	16,644
Total lease payments	34,330
Less: interest	(5,459)
Total lease liabilities	28,871	$ 15,935
2021 (remaining 3 months)	889
2022	8,887
2023	0
2024	0
2025	0
Thereafter	0
Total lease payments	9,776
Less: interest	(414)
Total lease liabilities	$ 9,362	$ 15,061

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Thousands	Feb. 24, 2020	Feb. 14, 2020	Sep. 30, 2021	Sep. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2017	Dec. 31, 2020
Accrued Legal Expenses			$ 150			$ 150			$ 150
Gain on litigation settlement				$ 951	$ 1,295
Selling, General and Administrative Expenses
Royalty Expense			1,707	1,201		4,062	$ 3,020
License Agreement with University
Accrued Royalties			1,187			1,187			$ 1,187
Royalty Expense			$ 0	$ 0		$ 0	0
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
Agreement cancellation charges paid		$ 1,950					$ 1,950
Consulting service and royalty payment term		15 years
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	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020	Dec. 31, 2019
Selling, General and Administrative Expenses
Related Party Transaction, Amounts of Transaction	$ 179
Option Loans
Related Parties Notes Receivable	0	$ 334	$ 635
Proceeds from Collection of Long-term Loans to Related Parties	$ 334
Liquidity Loan [Member]
Related Parties Notes Receivable		$ 100
Maximum [Member] | Liquidity Loan and Option Loans
Interest Rate	3.86%
Minimum [Member] | Liquidity Loan and Option Loans
Interest Rate	2.30%

Taxes - Additional Information

Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Federal corporate income tax rate			21.00%
Income tax expense	$ 303	$ 72	$ 990	$ 134
Income tax penalities and interest expense			$ 31