0000856982-24-000078 | 10-Q | XBRL Viewer | Merit Medical Systems INC

Basis of Presentation and Other Items	6 Months Ended
Jun. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Other Items	1. Basis of Presentation and Other Items. The interim consolidated financial statements of Merit Medical Systems, Inc. ("Merit," "we" or "us") for the three and six-month periods ended June 30, 2024 and 2023 are not audited. Our consolidated financial statements are prepared in accordance with the requirements for unaudited interim periods and, consequently, do not include all disclosures required to be made in conformity with accounting principles generally accepted in the United States of America. In the opinion of our management, the accompanying consolidated financial statements contain all adjustments, consisting of normal recurring accruals, necessary for a fair presentation of our financial position as of June 30, 2024 and December 31, 2023, and our results of operations and cash flows for the three and six-month periods ended June 30, 2024 and 2023. The results of operations for the three and six-month periods ended June 30, 2024 and 2023 are not necessarily indicative of the results for a full-year period. Amounts presented in this report are rounded, while percentages and earnings per share amounts presented are calculated from the underlying amounts. These interim consolidated financial statements should be read in conjunction with the financial statements and risk factors included in our Annual Report on Form 10-K for the year ended December 31, 2023 (the “2023 Annual Report on Form 10-K”).

Basis of Presentation and Other Items

6 Months Ended

Jun. 30, 2024

Organization, Consolidation and Presentation of Financial Statements [Abstract]

1. Basis of Presentation and Other Items. The interim consolidated financial statements of Merit Medical Systems, Inc. ("Merit," "we" or "us") for the three and six-month periods ended June 30, 2024 and 2023 are not audited. Our consolidated financial statements are prepared in accordance with the requirements for unaudited interim periods and, consequently, do not include all disclosures required to be made in conformity with accounting principles generally accepted in the United States of America. In the opinion of our management, the accompanying consolidated financial statements contain all adjustments, consisting of normal recurring accruals, necessary for a fair presentation of our financial position as of June 30, 2024 and December 31, 2023, and our results of operations and cash flows for the three and six-month periods ended June 30, 2024 and 2023. The results of operations for the three and six-month periods ended June 30, 2024 and 2023 are not necessarily indicative of the results for a full-year period. Amounts presented in this report are rounded, while percentages and earnings per share amounts presented are calculated from the underlying amounts. These interim consolidated financial statements should be read in conjunction with the financial statements and risk factors included in our Annual Report on Form 10-K for the year ended December 31, 2023 (the “2023 Annual Report on Form 10-K”).

Commitments and Contingencies	6 Months Ended
Jun. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	10. Commitments and Contingencies. Litigation. In the ordinary course of business, we are involved in various claims and litigation matters. These proceedings, actions and claims may involve product liability, intellectual property, contract disputes, employment, governmental inquiries or other matters, including the matter described below. These matters generally involve inherent uncertainties and often require prolonged periods of time to resolve. In certain proceedings, the claimants may seek damages, as well as other compensatory and equitable relief that could result in the payment of significant claims and settlements and/or the imposition of injunctions or other equitable relief. For legal matters for which our management had sufficient information to reasonably estimate our future obligations, a liability representing management’s best estimate of the probable loss, or the minimum of the range of probable losses when a best estimate within the range is not known, is recorded. The estimates are based on consultation with legal counsel, previous settlement experience and settlement strategies. If actual outcomes are less favorable than those estimated by management, additional expense may be incurred, which could unfavorably affect our financial position, results of operations and cash flows. The ultimate cost to us with respect to actions and claims could be materially different than the amount of the current estimates and accruals and could have a material adverse effect on our financial position, results of operations and cash flows. Unless included in our legal accrual, we are unable to estimate a reasonably possible loss or range of loss associated with any individual material legal proceeding. Legal costs for these matters, such as outside counsel fees and expenses, are charged to expense in the period incurred. SEC Inquiry We have received requests from the Division of Enforcement of the U.S. Securities and Exchange Commission (“SEC”) seeking the voluntary production of information relating to the business activities of Merit’s subsidiary in China, including interactions with hospitals and health care officials in China (the “SEC Inquiry”). We are cooperating with the requests and investigating the matter. Currently, we are unable to predict the scope, timing, significance or outcome of the SEC Inquiry or estimate a reasonably possible loss or range of loss associated with the matter. It is possible that the ultimate resolution of the SEC Inquiry, if resolved in a manner unfavorable to us, may be materially adverse to our business, financial position, results of operations or liquidity. In management's opinion, based on its examination of these matters, its experience to date and discussions with counsel, other than the SEC Inquiry, we are not currently involved in any legal proceedings which, individually or in the aggregate, could have a material adverse effect on our financial position, results of operations or cash flows. Our management regularly assesses the risks of legal proceedings in which we are involved, and management’s view of these matters may change in the future.

Commitments and Contingencies

6 Months Ended

Jun. 30, 2024

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

10. Commitments and Contingencies.

Litigation. In the ordinary course of business, we are involved in various claims and litigation matters. These proceedings, actions and claims may involve product liability, intellectual property, contract disputes, employment, governmental inquiries or other matters, including the matter described below. These matters generally involve inherent uncertainties and often require prolonged periods of time to resolve. In certain proceedings, the claimants may seek damages, as well as other compensatory and equitable relief that could result in the payment of significant claims and settlements and/or the imposition of injunctions or other equitable relief. For legal matters for which our management had sufficient information to reasonably estimate our future obligations, a liability representing management’s best estimate of the probable loss, or the minimum of the range of probable losses when a best estimate within the range is not known, is recorded. The estimates are based on consultation with legal counsel, previous settlement experience and settlement strategies. If actual outcomes are less favorable than those estimated by management, additional expense may be incurred, which could unfavorably affect our financial position, results of operations and cash flows. The ultimate cost to us with respect to actions and claims could be materially different than the amount of the current estimates and accruals and could have a material adverse effect on our financial position, results of operations and cash flows. Unless included in our legal accrual, we are unable to estimate a reasonably possible loss or range of loss associated with any individual material legal proceeding. Legal costs for these matters, such as outside counsel fees and expenses, are charged to expense in the period incurred.

SEC Inquiry

We have received requests from the Division of Enforcement of the U.S. Securities and Exchange Commission (“SEC”) seeking the voluntary production of information relating to the business activities of Merit’s subsidiary in China, including interactions with hospitals and health care officials in China (the “SEC Inquiry”). We are cooperating with the requests and investigating the matter. Currently, we are unable to predict the scope, timing, significance or outcome of the SEC Inquiry or estimate a reasonably possible loss or range of loss associated with the matter. It is possible that the ultimate resolution of the SEC Inquiry, if resolved in a manner unfavorable to us, may be materially adverse to our business, financial position, results of operations or liquidity.

In management's opinion, based on its examination of these matters, its experience to date and discussions with counsel, other than the SEC Inquiry, we are not currently involved in any legal proceedings which, individually or in the aggregate, could have a material adverse effect on our financial position, results of operations or cash flows. Our management regularly assesses the risks of legal proceedings in which we are involved, and management’s view of these matters may change in the future.

Derivatives - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	$ (1,711)	$ 3,422	$ 1,261	$ 1,731
Interest expense	(7,679)	(3,682)	(15,725)	(5,693)
Net sales	338,003	320,056	661,511	617,621
Cost of sales	(176,903)	(167,274)	(348,696)	(326,477)
Derivatives designated as cash flow hedges \| Interest rate swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	(197)	719	151	600
Derivatives designated as cash flow hedges \| Interest rate swap \| Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	699	631	1,401	1,165
Derivatives designated as cash flow hedges \| Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	(31)	4,325	4,135	4,564
Derivatives designated as cash flow hedges \| Foreign currency forward contracts \| Revenue
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	427	658	840	1,985
Derivatives designated as cash flow hedges \| Foreign currency forward contracts \| Cost of sales
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	$ 357	$ 333	$ 784	$ 283

Acquisitions - Fluidx Medical Technology, Inc (Details) - Fluidx - USD ($) $ in Millions	1 Months Ended	36 Months Ended
	Mar. 31, 2024	Dec. 31, 2021
Business Acquisition [Line Items]
Payments to acquire shares	$ 0.3	$ 4.7
Ownership percentage	19.90%

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 636,658	$ 587,036
Trade receivables - net of allowance for credit losses - 2024 - $9,276 and 2023 - $9,023	182,415	177,885
Other receivables	10,612	10,517
Inventories	298,224	303,871
Prepaid expenses and other current assets	26,179	24,286
Prepaid income taxes	4,123	4,016
Income tax refund receivables	4,335	859
Total current assets	1,162,546	1,108,470
Property and equipment:
Land and land improvements	25,952	26,017
Buildings	191,030	191,491
Manufacturing equipment	330,290	316,930
Furniture and fixtures	64,755	63,044
Leasehold improvements	58,595	53,638
Construction-in-progress	61,060	61,439
Total property and equipment	731,682	712,559
Less accumulated depreciation	(345,743)	(329,036)
Property and equipment - net	385,939	383,523
Other assets:
Goodwill	381,433	382,240
Deferred income tax assets	7,013	7,288
Right-of-use operating lease assets	69,903	63,047
Other assets	61,583	54,793
Total other assets	823,354	833,251
Total assets	2,371,839	2,325,244
Current liabilities:
Trade payables	55,573	65,944
Accrued expenses	117,574	120,447
Short-term operating lease liabilities	11,743	12,087
Income taxes payable	1,325	5,086
Total current liabilities	186,215	203,564
Long-term debt	801,321	823,013
Deferred income tax liabilities	5,510	5,547
Long-term income taxes payable	347	347
Liabilities related to unrecognized tax benefits	1,912	1,912
Deferred compensation payable	18,588	17,167
Deferred credits	1,553	1,605
Long-term operating lease liabilities	58,036	56,259
Other long-term obligations	15,912	13,830
Total liabilities	1,089,394	1,123,244
Commitments and contingencies
Stockholders' equity:
Preferred stock - 5,000 shares authorized; no shares issued as of June 30, 2024 and December 31, 2023
Common stock, no par value - 100,000 shares authorized; issued and outstanding as of June 30, 2024 - 58,192 and December 31, 2023 - 57,858	658,724	638,150
Retained earnings	639,150	575,184
Accumulated other comprehensive loss	(15,429)	(11,334)
Total stockholders' equity	1,282,445	1,202,000
Total liabilities and stockholders' equity	2,371,839	2,325,244
Developed technology
Other assets:
Intangible assets:	264,195	283,999
Other
Other assets:
Intangible assets:	$ 39,227	$ 41,884

Fair Value Measurements - Allowance for Credit Losses (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Financing Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 1,388	$ 290	$ 568	$ 281
Provision for credit loss expense	18	6	838	15
Ending balance	$ 1,406	$ 296	$ 1,406	$ 296

- Definition

Amount of allowance for credit loss on financing receivable. Excludes allowance for financing receivable covered under loss sharing agreement.

+ References + Details

Earnings Per Common Share (EPS) - Diluted EPS (Details) - $ / shares shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Earnings Per Share [Abstract]
Average common shares outstanding (in shares)	58,139	57,537	58,049	57,445
Effect of dilutive stock awards (in shares)	601	936	604	884
Total potential shares outstanding (in shares)	58,740	58,473	58,653	58,329
Diluted EPS (in dollars per share)	$ 0.61	$ 0.35	$ 1.09	$ 0.70
Equity awards excluded as the impact was anti-dilutive (in shares)	802	1,114	1,009	1,014

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References

+ Details

Stock-Based Compensation Expense

6 Months Ended

Jun. 30, 2024

Share-based Payment Arrangement [Abstract]

Stock-Based Compensation Expense

12. Stock-Based Compensation Expense. Stock-based compensation expense before income tax expense for the three and six-month periods ended June 30, 2024 and 2023 consisted of the following (in thousands):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Cost of sales
Nonqualified stock options	$	363	$	432	$	725	$	873
Research and development
Nonqualified stock options		345		413		781		841
Selling, general and administrative
Nonqualified stock options		1,565		1,851		3,247		3,221
Performance-based restricted stock units		2,897		1,817		4,764		2,632
Restricted stock units		1,131		467		1,718		911
Cash-settled performance-based awards		710		600		1,010		1,071
Total selling, general and administrative		6,303		4,735		10,739		7,835

Stock-based compensation expense before taxes	$	7,011	$	5,580	$	12,245	$	9,549

We recognize stock-based compensation expense (net of a forfeiture rate), for those awards which are expected to vest, on a straight-line basis over the requisite service period. We estimate the forfeiture rate based on our historical experience and expectations about future forfeitures.

Nonqualified Stock Options

During the six-month period ended June 30, 2023, we granted stock options representing 327,294 shares of our Common Stock. We did not grant any stock options during the six-month period ended June 30, 2024. We use the Black-Scholes methodology to value the stock-based compensation expense for options. In applying the Black-Scholes methodology to the option grants, the fair value of our stock-based awards granted was estimated using the following assumptions for the periods indicated below:


	Six Months Ended
	June 30,
	2023
Risk-free interest rate	3.6% - 4.5%
Expected option term	4.0 years
Expected dividend yield	—
Expected price volatility	46.7% - 47.1%

The average risk-free interest rate is determined using the U.S. Treasury rate in effect as of the date of grant, based on the expected term of the stock award. We determine the expected term of stock options using the historical exercise behavior of employees. The expected price volatility was determined using a weighted average of daily historical volatility of our stock price over the corresponding expected option term and implied volatility based on recent trends of the daily historical volatility. For awards with a vesting period, compensation expense is recognized on a straight-line basis over the service period, which corresponds to the vesting period.

As of June 30, 2024, the total remaining unrecognized compensation cost related to non-vested stock options was $15.4 million, which was expected to be recognized over a weighted average period of 2.0 years.

Stock-Settled Performance-Based Restricted Stock Units (“Performance Stock Units”)

During the six-month periods ended June 30, 2024 and 2023, we granted performance stock units which represented up to 364,810 and 286,863 shares of Common Stock, respectively. Conversion of the performance stock units occurs at the end of the relevant performance periods, or one year after the agreement date, whichever is later. The number of shares delivered upon vesting at the end of the performance periods are based upon performance against specified financial performance metrics and relative total shareholder return as compared to the Russell 2000 Index (“rTSR”), as defined in the award agreements.

We use Monte-Carlo simulations to estimate the grant-date fair value of the performance stock units linked to total shareholder return. The fair value of each performance stock unit was estimated as of the grant date using the following assumptions for awards granted in the periods indicated below:


	Six Months Ended
	June 30,
	2024	2023
Risk-free interest rate	4.4%	3.9% - 4.6%
Performance period	2.8 years	2.8 years
Expected dividend yield	—	—
Expected price volatility	31.1%	31.4% - 32.6%

The risk-free interest rate of return was determined using the U.S. Treasury rate at the time of grant with a term equal to the expected term of the award. The expected volatility was based on the weighted average volatility of our stock price and the average volatility of our compensation peer group's stock price. The expected dividend yield was assumed to be zero because, at the time of the grant, we had no plans to declare a dividend.

Compensation expense is recognized using the grant-date fair value for the number of shares that are likely to be awarded based on the performance metrics. Each reporting period, this probability assessment is updated, and cumulative adjustments are recorded based on the financial performance metrics expected to be achieved. At the end of the performance period, cumulative expense is calculated based on the actual performance metrics achieved. As of June 30, 2024, the total remaining unrecognized compensation cost related to stock-settled performance stock units was $20.3 million, which is expected to be recognized over a weighted average period of 2.1 years.

Cash-Settled Performance-Based Awards

During the six-month periods ended June 30, 2024 and 2023, we granted performance stock units to our Chief Executive Officer that provide for settlement in cash upon achievement of specific metrics (“Liability Awards”), with total target cash incentives in the amount of $1.6 million and $1.3 million, respectively. The Liability Awards entitle him to a target cash payment based upon our level of rTSR performance and achievement of other performance metrics, as defined in the award agreements.

During the six-month periods ended June 30, 2024 and 2023, we granted additional performance stock units to certain employees that provide for settlement in cash upon our achievement of specified financial metrics. The cash payable upon vesting at the end of the service period is based upon performance against specified financial performance metrics and relative total shareholder return as compared to the rTSR, as defined in the award agreements. Compensation expense is recognized for the cash payment likely to be awarded based on the performance metrics.

The potential maximum payout of these Liability Awards is 250% of the target cash incentive, resulting in a total potential maximum payout of $4.4 million and $4.4 million for Liability Awards granted during the six-month periods ended June 30, 2024 and 2023, respectively. The settlement generally occurs at the end of three-year performance periods based upon the same performance metrics and vesting period as our performance stock units.

The fair value of these Liability Awards is measured at each reporting period until the awards are settled. As of June 30, 2024 and December 31, 2023, the recorded balance associated with these Liability Awards is $3.4 million and $3.4 million, respectively, which are classified as liabilities and reported in accrued expenses and other long-term obligations within our consolidated balance sheets. As of June 30, 2024, the total remaining unrecognized compensation cost related to Liability Awards was $4.4 million, which is expected to be recognized over a weighted average period of 2.0 years.

Restricted Stock Units

During the six-month periods ended June 30, 2024 and 2023, we granted restricted stock units to certain employees and and non-employee directors representing 158,719 and 20,358 shares of Common Stock, respectively. The expense recognized for restricted stock units is equal to the closing stock price on the date of grant, which is recognized over the vesting period. Restricted stock units granted to each employee are subject to such employee’s continued employment through the vesting date, which is four years from the date of grant. Restricted stock units granted to each non-employee director are subject to such director’s continued service through the vesting date, which is one year from the grant date. As of June 30, 2024, the total remaining unrecognized compensation cost related to restricted stock units was $10.2 million, which will be recognized over a weighted average period of 3.3 years.

Segment Reporting - Narrative (Details)	6 Months Ended
Segment Reporting - Narrative (Details)	Jun. 30, 2024 item segment
Segment Reporting Information [Line Items]
Number of operating segments \| segment	2
Cardiovascular
Segment Reporting Information [Line Items]
Number of Product Categories \| item	4

Recently Issued Accounting Standards

6 Months Ended

Jun. 30, 2024

Accounting Policies [Abstract]

Recently Issued Accounting Standards

2. Recently Issued Accounting Standards. In November 2023, the Financial Accounting Standards Board (“FASB’) issued Accounting Standard Update (“ASU”) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, which requires a public entity to disclose significant segment expenses and other segment items on an annual and interim basis and to provide in interim periods all disclosures about reportable segment’s profit or loss and assets that are currently required annually. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The provisions of this update must be applied retrospectively to all periods presented in the financial statements. We are currently assessing the anticipated impact of this standard on our consolidated financial statements.

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, to improve annual basis income tax disclosures related to (1) rate reconciliation, (2) income taxes paid, and (3) other disclosures related to pretax income (or loss) and income tax expense (or benefit) from continuing operations. ASU 2023-09 is effective for fiscal years beginning after December 15, 2025, with early adoption permitted. These amendments are to be applied on a prospective basis. Retrospective application is permitted. We are currently evaluating the impact this standard will have on our consolidated financial statement disclosures.

We currently believe there are no other issued and not yet effective accounting standards that are materially relevant to our financial statements.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Fair Value Measurements

6 Months Ended

Jun. 30, 2024

Fair Value Disclosures [Abstract]

Fair Value Measurements

14. Fair Value Measurements.

Assets (Liabilities) Measured at Fair Value on a Recurring Basis

Our financial assets and (liabilities) carried at fair value and measured on a recurring basis as of June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


			Fair Value Measurements Using
	Total Fair		Quoted prices in		Significant other		Significant
	Value at		active markets		observable inputs		unobservable inputs
	June 30, 2024		(Level 1)		(Level 2)		(Level 3)
Marketable securities ⁽¹⁾	$	61	$	61	$	—	$	—
Interest rate contract asset, current ⁽²⁾	$	254	$	—	$	254	$	—
Foreign currency contract assets, current and long-term ⁽³⁾	$	4,946	$	—	$	4,946	$	—
Foreign currency contract liabilities, current and long-term ⁽⁴⁾	$	(2,250)	$	—	$	(2,250)	$	—
Contingent consideration liabilities	$	(3,435)	$	—	$	—	$	(3,435)


			Fair Value Measurements Using
	Total Fair		Quoted prices in		Significant other		Significant
	Value at		active markets		observable inputs		unobservable inputs
	December 31, 2023		(Level 1)		(Level 2)		(Level 3)
Marketable securities ⁽¹⁾	$	78	$	78	$	—		—
Interest rate contract asset, current ⁽²⁾	$	1,503	$	—	$	1,503	$	—
Foreign currency contract assets, current and long-term ⁽³⁾	$	3,105	$	—	$	3,105	$	—
Foreign currency contract liabilities, current and long-term ⁽⁴⁾	$	(3,860)	$	—	$	(3,860)	$	—
Contingent consideration liabilities	$	(3,447)	$	—	$	—	$	(3,447)

(1)	Our marketable securities, which consist entirely of available-for-sale equity securities, are valued using market prices in active markets. Level 1 instrument valuations are obtained from real-time quotes for transactions in active exchange markets involving identical assets.

(2)	The fair value of the interest rate contract is determined using Level 2 fair value inputs and is recorded as prepaid and other current assets in the consolidated balance sheets.

(3)

The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as a prepaid expense and other current asset or other long-term asset in the consolidated balance sheets.

(4)

The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expense or other long-term obligation in the consolidated balance sheets.

Certain of our past business combinations involve the potential for the payment of future contingent consideration, generally based on a percentage of future product sales or upon attaining specified future revenue or other milestones. The contingent consideration liability is re-measured at the estimated fair value at the end of each reporting period with the change in fair value recognized within operating expenses in the accompanying consolidated statements of income for such period. We measure the initial liability and re-measure the liability on a recurring basis using Level 3 inputs as defined under authoritative guidance for fair value measurements. Changes in the fair value of our contingent consideration liabilities during the three and six-month periods ended June 30, 2024 and 2023 consisted of the following (in thousands):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Beginning balance	$	3,225	$	16,000	$	3,447	$	18,073
Contingent consideration expense		305		1,094		188		1,615
Contingent payments made		(95)		(13,513)		(200)		(16,107)
Ending balance	$	3,435	$	3,581	$	3,435	$	3,581

As of June 30, 2024, $3.0 million in contingent consideration liability was included in other long-term obligations and $0.4 million in contingent consideration liability was included in accrued expenses in our consolidated balance sheet. As of December 31, 2023, $3.0 million in contingent consideration liability was included in other long-term obligations and $0.4 million in contingent consideration liability was included in accrued expenses in our consolidated balance sheet.

Payments related to the settlement of the contingent consideration liability recognized at fair value as of the applicable acquisition date of $0.1 million and $3.4 million for the six-month periods ended June 30, 2024 and 2023, respectively, have been reflected as a cash outflow from financing activities in the accompanying consolidated statements of cash flows. Payments related to increases in the contingent consideration liability subsequent to the date of acquisition of $0.1 million and $12.7 million for the six-month periods ended June 30, 2024 and 2023, respectively, are reflected as operating cash flows.

The recurring Level 3 measurement of our contingent consideration liabilities included the following significant unobservable inputs at June 30, 2024 and December 31, 2023 (amounts in thousands):


	Fair value at
	June 30,		Valuation			Weighted
Contingent consideration liability	2024		technique	Unobservable inputs	Range	Average⁽¹⁾
Revenue-based royalty payments contingent liability	$	2,937	Discounted cash flow	Discount rate	12% - 16%	14.6%
				Projected year of payments	2024-2034	2028

Revenue milestones contingent liability	$	91	Monte Carlo simulation	Discount rate	13.0%
				Projected year of payments	2024-2040	2040

Regulatory approval contingent liability	$	407	Scenario-based method	Discount rate	6.1%
				Probability of milestone payment	50.0%
				Projected year of payment	2024-2030	2030


	Fair value at
	December 31,		Valuation			Weighted
Contingent consideration liability	2023		technique	Unobservable inputs	Range	Average⁽¹⁾
Revenue-based royalty payments contingent liability	$	2,945	Discounted cash flow	Discount rate	12.0% - 16.0%	14.6%
				Projected year of payments	2024-2034	2028

Revenue milestones contingent liability	$	93	Monte Carlo simulation	Discount rate	13.0%
				Projected year of payments	2024-2039	2039

Regulatory approval contingent liability	$	409	Scenario-based method	Discount rate	5.5%
				Probability of milestone payment	50.0%
				Projected year of payment	2024-2030	2030

(1)	Unobservable inputs were weighted by the relative fair value of the instruments. No weighted average is reported for contingent consideration liabilities without a range of unobservable inputs.

The contingent consideration liability is re-measured to fair value each reporting period. Significant increases or decreases in projected revenues, based on our most recent internal operational budgets and long-range strategic plans, discount rates or the time until payment is made would have resulted in a significantly lower or higher fair value measurement. Our determination of the fair value of the contingent consideration liability could change in future periods based upon our ongoing evaluation of these significant unobservable inputs. We intend to record any such change in fair value to operating expenses in our consolidated statements of income.

Fair Value of Other Assets (Liabilities)

The carrying amount of cash and cash equivalents, receivables, and trade payables approximate fair value because of the immediate, short-term maturity of these financial instruments. Our long-term debt under our Amended Fourth A&R Credit Agreement re-prices frequently due to variable rates and entails no significant changes in credit risk and, as a result, we believe the fair value of long-term debt approximates carrying value. We believe the fair value our long-term debt under our Convertible Notes approximates carrying value as the notes were issued in December 2023. The fair value of assets and liabilities whose carrying value approximates fair value is determined using Level 2 inputs, with the exception of cash and cash equivalents, which use Level 1 inputs.

We recognize or disclose the fair value of certain assets, such as non-financial assets, primarily property and equipment, right-of-use operating lease assets, equity investments, intangible assets and goodwill in connection with impairment evaluations. Such assets are reported at carrying value and are not subject to recurring fair value measurements. We review our long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Fair value is generally determined based on discounted future cash flow. All our nonrecurring valuations use significant unobservable inputs and therefore fall under Level 3 of the fair value hierarchy.

Our equity investments in privately-held companies were $22.6 million and $19.1 million at June 30, 2024 and December 31, 2023, respectively, which are included within other long-term assets in our consolidated balance sheets. We analyze our investments in privately-held companies to determine if they should be accounted for using the equity method based on our ability to exercise significant influence over operating and financial policies of the investment. Investments not accounted for under the equity method of accounting are accounted for at cost minus impairment, if applicable, plus or minus changes in valuation resulting from observable transactions for identical or similar investments. During the six-month period ended June 30, 2023, we recorded impairment charges of $0.3 million associated with our previously-held equity investment in Bluegrass in connection with the asset acquisition completed on May 4, 2023 (see Note 4). During the six-month period ended June 30, 2024, we recorded no impairment charges related to our equity investments.

Current Expected Credit Losses

Our outstanding long-term notes receivable, including accrued interest and an allowance for current expected credit losses, were $8.7 million and $3.2 million as of June 30, 2024 and December 31, 2023, respectively. Long-term notes receivable issued were $6.2 million for the six-month period ended June 30, 2024 and were related to loans issued to Selio Medical Limited (“Selio”) of $1.7 million, Solo Pace Inc. (“Solo Pace”) of $1.5 million and Fluidx of $3.0 million. As of June 30, 2024 and December 31, 2023, we had an allowance for current expected credit losses of $1.4 million and $0.6 million, respectively, associated with these notes receivable. We assess the allowance for current expected credit losses on an individual security basis, due to the limited number of securities, using a probability of default model, which is based on relevant information about past events, including historical experience, current conditions and reasonable and supportable forecasts that affect the expected collectability of securities, and other security specific factors.

The table below presents a roll-forward of the allowance for current expected credit losses on our notes receivable for the three and six-month periods ended June 30, 2024 and 2023 (in thousands):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Beginning balance	$	1,388	$	290	$	568	$	281
Provision for credit loss expense		18		6		838		15
Ending balance	$	1,406	$	296	$	1,406	$	296

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

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+ Details

Stock-Based Compensation Expense - PSUs Fair Value Calculation Assumptions (Details) - Stock-Settled Performance-Based Restricted Stock Units	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum		3.90%
Risk-free interest rate, maximum		4.60%
Risk-free interest rate	4.40%
Expected option term / Performance Period	2 years 9 months 18 days	2 years 9 months 18 days
Expected dividend yield	0.00%	0.00%
Expected price volatility, minimum		31.40%
Expected price volatility, maximum		32.60%
Expected price volatility	31.10%

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 63,966	$ 40,948
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	47,690	42,316
Loss on sale or abandonment of property and equipment	79	4,677
Write-off of certain intangible assets and other long-term assets	280	328
Acquired in-process research and development		1,550
Amortization of right-of-use operating lease assets	6,063	5,935
Fair value adjustments related to contingent consideration liabilities	189	1,615
Amortization of deferred credits	(52)	(52)
Amortization of long-term debt issuance costs	2,954	462
Stock-based compensation expense	12,245	9,549
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Trade receivables	(6,901)	(5,980)
Other receivables	(499)	287
Inventories	3,119	(35,502)
Prepaid expenses and other current assets	(2,306)	78
Income tax refund receivables	(3,621)	(3,577)
Other assets	(2,968)	(1,558)
Trade payables	(7,096)	(7,253)
Accrued expenses	(2,804)	(10,295)
Income taxes payable	(3,869)	(4,896)
Deferred compensation payable	1,421	1,154
Operating lease liabilities	(5,962)	(5,711)
Other long-term obligations	2,794	(2,244)
Total adjustments	40,756	(9,117)
Net cash, cash equivalents, and restricted cash provided by operating activities	104,722	31,831
Capital expenditures for:
Property and equipment	(22,309)	(18,556)
Intangible assets	(1,576)	(1,047)
Proceeds from the sale of property and equipment	2	201
Issuance of note receivables	(6,162)
Cash paid in acquisitions and investments, net of cash acquired	(8,493)	(138,349)
Net cash, cash equivalents, and restricted cash used in investing activities	(38,538)	(157,751)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	10,931	9,463
Proceeds from issuance of long-term debt		460,283
Payments on long-term debt	(24,063)	(318,471)
Long-term debt issuance costs		(5,240)
Contingent payments related to acquisitions	(142)	(3,434)
Payment of taxes related to an exchange of common stock	(1,592)	(1,592)
Net cash, cash equivalents, and restricted cash (used in) provided by financing activities	(14,866)	141,009
Effect of exchange rates on cash, cash equivalents, and restricted cash	(1,750)	(1,497)
Net increase in cash, cash equivalents and restricted cash	49,568	13,592
CASH, CASH EQUIVALENTS AND RESTRICTED CASH:
Beginning of period	589,144	60,558
End of period	638,712	74,150
RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH TO THE CONSOLIDATED BALANCE SHEETS:
Cash and cash equivalents	636,658	72,084
Restricted cash reported in prepaid expenses and other current assets	$ 2,054	$ 2,066
Restricted Cash and Cash Equivalents, Current, Statement of Financial Position [Extensible Enumeration]	Prepaid Expense and Other Assets, Current	Prepaid Expense and Other Assets, Current
Total cash, cash equivalents and restricted cash	$ 638,712	$ 74,150
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $428 and $597, respectively)	4,404	3,681
Income taxes	22,619	17,787
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Property and equipment purchases in accounts payable	5,411	4,291
Acquisition purchases in accrued expenses and other long-term obligations	4,553	3,635
Right-of-use operating lease assets obtained in exchange for operating lease liabilities	$ 8,167	$ 3,399

Debt - Financial Covenants (Details) - Credit Agreement	6 Months Ended
Debt - Financial Covenants (Details) - Credit Agreement	Jun. 30, 2024
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	5.0
Consolidated Senior Secured Net Leverage Ratio	3.0
Consolidated Interest Coverage Ratio	3.0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Acquisitions

6 Months Ended

Jun. 30, 2024

Business Combinations [Abstract]

Acquisitions

4. Acquisitions and Investments. On May 17, 2024, Merit Medical Ireland Limited (“MM Ireland”), our indirect wholly-owned subsidiary, entered into a Subscription and Shareholder Agreement (the “CrannMed Agreement”) with CrannMed Limited, a company organized under the laws of Ireland (“CrannMed”). Pursuant to the terms of the CrannMed Agreement, MM Ireland paid €3.0 million to purchase preferred shares of CrannMed. At CrannMed’s election at any time after August 16, 2024, MM Ireland is obligated to pay an additional €3.0 million to acquire additional preferred shares of CrannMed, subject to certain conditions (the “Second Tranche Investment”). Additionally, upon the request of CrannMed and subject to the completion of the Second Tranche Investment and other conditions, MM Ireland may pay to CrannMed up to an additional €2.0 million in the form of equity, debt or other investment for the purpose of funding clinical trial activities of CrannMed. MM Ireland’s investment in CrannMed has been recorded as an equity investment accounted for at cost and reflected within other assets in the accompanying consolidated balance sheets because MM Ireland is not able to exercise significant influence over the operations of CrannMed. MM Ireland’s total current investment in CrannMed represented an ownership interest of approximately 10.8% of the outstanding capital stock of CrannMed at the date of the initial purchase.

On March 8, 2024, we entered into an asset purchase agreement with Scholten Surgical Instruments, Inc. (“SSI”) to acquire the assets associated with the Bioptome, Novatome, and Sensatome devices. The total purchase price of the SSI assets included an up-front payment of $3 million, and three deferred payments, including (i) $1 million payable upon the earlier of (a) the first anniversary of the closing date or (b) the date on which Merit can independently manufacture the purchased devices (“Deferred Payment Date”), (ii) $1 million payable upon the first anniversary of the Deferred Payment Date, and (iii) $1 million payable upon the second anniversary of the Deferred Payment Date. We have accounted for this transaction as an asset purchase, and recorded the amount paid and deferred payments as a developed technology intangible asset, which we are amortizing over eight years.

During March 2024, we paid $0.3 million to acquire additional Series A Preferred Stock of Fluidx Medical Technology, Inc. ("Fluidx"), owner of certain technology proposed to be used in the development of embolic and adhesive agents for use in arterial, venous, vascular graft and cardiovascular applications inside and outside the heart and related appendages. We had previously purchased and continue to hold $4.7 million of participating preferred shares of Fluidx. Our investment has been recorded as an equity investment accounted for at cost and reflected within other assets in the accompanying consolidated balance sheets because we are not able to exercise significant influence over the operations of Fluidx. Our total current investment in Fluidx represented an ownership interest of approximately 19.9% of the outstanding capital stock of Fluidx at the date of this investment.

On June 8, 2023, we entered into an asset purchase agreement with AngioDynamics, Inc. (“AngioDynamics”) to acquire the assets associated with a portfolio of dialysis catheter products and the BioSentry® Biopsy Tract Sealant System for a purchase price of $100 million. We accounted for this transaction under the acquisition method of accounting as a business combination. The sales related to the acquisition have been included in our cardiovascular segment since the acquisition date and were $11.6 million and $0.9 million for the six-month periods ended June 30, 2024 and 2023, respectively. It is not practical to separately report earnings related to the acquisition, as we began to immediately integrate the acquisition into the existing operations, sales distribution networks and management structure of our cardiovascular business segment. Acquisition-related costs associated with the AngioDynamics acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income included in the 2023 Annual Report on Form 10-K, were approximately $4.9 million. The purchase price was allocated as follows (in thousands):


Assets Acquired
Prepaid expenses	$	2,000
Inventories		5,254
Property and equipment		108
Intangible assets
Developed technology		65,200
Trademarks		4,000
Customer list		5,800
Goodwill		17,638
Total net assets acquired	$	100,000

We are amortizing the AngioDynamics developed technology intangible assets over ten years, the trademark intangible assets over 11 years, and the customer list intangible asset on an accelerated basis over ten years. We have estimated the weighted average life of the intangible assets acquired from AngioDynamics to be 10.5 years. The goodwill consists largely of the synergies expected from combining operations and is expected to be deductible for income tax purposes. The pro forma effects to our consolidated results of operations of the AngioDynamics acquisition are not material in relation to reported sales and it was deemed impracticable to obtain information to determine earnings associated with the acquired product lines which represent only a small portion of the product lines of a large, consolidated company without standalone financial information.

On May 4, 2023, we entered into an asset purchase agreement to acquire the assets associated with the Surfacer® Inside-Out® Access Catheter System from Bluegrass Vascular Technologies, Inc. (“Bluegrass”), for a purchase price of $32.7 million. Prior to the acquisition, we held an equity investment of 1,251,878 Bluegrass common shares, representing an approximately 19.5% ownership interest in Bluegrass. The fair value of this previously-held equity investment of approximately $245,000 is included in the purchase price allocation. We accounted for this transaction under the acquisition method of accounting as a business combination. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the Bluegrass acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income included in the 2023 Annual Report on Form 10-K, were not material. The purchase price was allocated as follows (in thousands):


Assets Acquired
Inventories	$	175
Intangible assets
Developed technology		28,000
Trademarks		900
Goodwill		3,898
Total net assets acquired	$	32,973

We are amortizing the Bluegrass developed technology intangible asset over 15 years and the related trademarks over 13 years. We have estimated the weighted average life of the intangible assets acquired from Bluegrass to be 14.9 years. The goodwill consists largely of the synergies expected from combining operations and is expected to be deductible for income tax purposes. The pro forma effects to our consolidated results of operations of the Bluegrass acquisition are not material.

Earnings Per Common Share (EPS) - Basic EPS (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Earnings Per Share [Abstract]
Net income	$ 35,726	$ 28,240	$ 20,245	$ 20,703	$ 63,966	$ 40,948
Average common shares outstanding (in shares)	58,139		57,537		58,049	57,445
Basic EPS (in dollars per share)	$ 0.61		$ 0.35		$ 1.10	$ 0.71

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References

+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

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+ Details

Goodwill and Intangible Assets - Future Amortization Expense (Details) $ in Thousands	Jun. 30, 2024 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remaining 2024	$ 31,367
2025	60,826
2026	49,776
2027	46,440
2028	$ 45,024

Earnings Per Common Share (EPS) - Convertible Noes (Details) - $ / shares	Jun. 30, 2024	Dec. 31, 2023
Convertible Notes \| Senior unsecured convertible notes \| Common Stock
Debt Instrument [Line Items]
Conversion price	$ 86.83	$ 86.83

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Goodwill and Intangible Assets

6 Months Ended

Jun. 30, 2024

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

6. Goodwill and Intangible Assets. The change in the carrying amount of goodwill for the six-month period ended June 30, 2024 is detailed as follows (in thousands):


	2024
Goodwill balance at January 1	$	382,240
Effect of foreign exchange		(807)
Goodwill balance at June 30	$	381,433

Total accumulated goodwill impairment losses aggregated to $8.3 million as of June 30, 2024 and December 31, 2023, respectively. We did not have any goodwill impairments for the six-month periods ended June 30, 2024 or 2023. The total goodwill balances as of June 30, 2024 and December 31, 2023 were related to our cardiovascular segment.

Other intangible assets at June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	June 30, 2024
	Gross Carrying		Accumulated		Net Carrying
	Amount		Amortization		Amount
Patents	$	30,163	$	(11,876)	$	18,287
Distribution agreements		3,250		(2,956)		294
License agreements		11,094		(8,759)		2,335
Trademarks		35,123		(22,343)		12,780
Customer lists		40,225		(34,694)		5,531
Total	$	119,855	$	(80,628)	$	39,227


	December 31, 2023
	Gross Carrying		Accumulated		Net Carrying
	Amount		Amortization		Amount
Patents	$	28,877	$	(10,916)	$	17,961
Distribution agreements		3,250		(2,919)		331
License agreements		11,142		(8,327)		2,815
Trademarks		35,135		(20,804)		14,331
Customer lists		40,367		(33,921)		6,446
Total	$	118,771	$	(76,887)	$	41,884

Aggregate amortization expense for the three and six-month periods ended June 30, 2024 was $14.8 million and $29.4 million, respectively. Aggregate amortization expense for the three and six-month periods ended June 30, 2023 was $13.4 million and $25.7 million, respectively.

We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows is largely independent of the cash flows of other assets and liabilities. We determine the fair value of our amortizing assets based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. We did not identify indicators of impairment for our intangible assets based on our consideration of triggering events for the six-month periods ended June 30, 2024 and 2023, respectively.

Estimated amortization expense for developed technology and other intangible assets for the next five years consisted of the following as of June 30, 2024 (in thousands):


	Estimated Amortization Expense
Remaining 2024	$	31,367
2025		60,826
2026		49,776
2027		46,440
2028		45,024

Cover Page - shares	6 Months Ended
Cover Page - shares	Jun. 30, 2024	Jul. 30, 2024
Cover page.
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Jun. 30, 2024
Entity File Number	0-18592
Entity Registrant Name	MERIT MEDICAL SYSTEMS INC
Entity Incorporation, State or Country Code	UT
Entity Central Index Key	0000856982
Entity Tax Identification Number	87-0447695
Entity Address, Address Line One	1600 West Merit Parkway
Entity Address, City or Town	South Jordan
Entity Address, State or Province	UT
Entity Address, Postal Zip Code	84095
City Area Code	801
Local Phone Number	253-1600
Title of 12(b) Security	Common Stock, no par value
Trading Symbol	MMSI
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		58,208,536
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Amendment Flag	false

Goodwill and Intangible Assets - Goodwill (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2024 USD ($)
Goodwill [Roll Forward]
Goodwill balance at beginning of period	$ 382,240
Effect of foreign exchange	807
Goodwill balance at end of period	$ 381,433

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

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+ Details

Debt - Future Minimum Payments on Long-term Debt (Details) $ in Thousands	Jun. 30, 2024 USD ($)
Debt Disclosure [Abstract]
2028	$ 75,000
Thereafter	747,500
Total future minimum principal payments	$ 822,500

Fair Value Measurements - Financial Assets and (Liabilities) Carried at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 61	$ 78
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contract asset, current	254	1,503
Foreign currency contract assets, current and long-term	4,946	3,105
Foreign currency contract liabilities, current and long-term	(2,250)	(3,860)
Fair Value, Inputs, Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	(3,435)	(3,447)
Estimate of Fair Value, Fair Value Disclosure
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	61	78
Interest rate contract asset, current	254	1,503
Foreign currency contract assets, current and long-term	4,946	3,105
Foreign currency contract liabilities, current and long-term	(2,250)	(3,860)
Contingent consideration liabilities	$ (3,435)	$ (3,447)

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
Net income	$ 35,726	$ 20,245	$ 63,966	$ 40,948
Other comprehensive income (loss):
Cash flow hedges	(1,711)	3,422	1,261	1,731
Income tax benefit (expense)	404	(821)	(298)	(415)
Foreign currency translation adjustment	(1,688)	(1,201)	(5,092)	724
Income tax benefit (expense)	22	(15)	34	(34)
Total other comprehensive income (loss)	(2,973)	1,385	(4,095)	2,006
Total comprehensive income	$ 32,753	$ 21,630	$ 59,871	$ 42,954

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Amount after tax and reclassification adjustments of other comprehensive income (loss).

+ References

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+ Details

Stock-Based Compensation Expense - Option Granted Fair Value Calculation Assumptions (Details) - Employee Stock Option	6 Months Ended
	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	3.60%
Risk-free interest rate, maximum	4.50%
Expected option term / Performance Period	4 years
Expected price volatility, minimum	46.70%
Expected price volatility, maximum	47.10%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Jun. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Earnings Per Common Share (EPS)

6 Months Ended

Jun. 30, 2024

Earnings Per Share [Abstract]

Earnings Per Common Share (EPS)

11. Earnings Per Common Share (EPS). The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the three and six-month periods ended June 30, 2024 and 2023 consisted of the following (in thousands, except per share amounts):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Net income	$	35,726	$	20,245	$	63,966	$	40,948
Average common shares outstanding		58,139		57,537		58,049		57,445
Basic EPS	$	0.61	$	0.35	$	1.10	$	0.71

Average common shares outstanding		58,139		57,537		58,049		57,445
Effect of dilutive stock awards		601		936		604		884
Total potential shares outstanding		58,740		58,473		58,653		58,329
Diluted EPS	$	0.61	$	0.35	$	1.09	$	0.70

Equity awards excluded as the impact was anti-dilutive ⁽¹⁾		802		1,114		1,009		1,014

(1)	Does not reflect the impact of incremental repurchases under the treasury stock method.

Convertible Notes

For our Convertible Notes, the dilutive effect is calculated using the if-converted method. Upon surrender of the Convertible Notes for conversion, Merit will pay cash up to the aggregate principal amount of the Notes to be converted and pay or deliver, as the case may be, cash, shares of Common Stock or a combination of cash and shares of Common Stock, at Merit’s election, in respect of the remainder, if any, of Merit’s conversion obligation in excess of the aggregate principal amount of the Convertible Notes being converted. Under the if-converted method, we include the number of shares required to satisfy the remaining conversion obligation, assuming all the Convertible Notes were converted. The average closing price of the Common Stock for the period ended June 30, 2024 was used as the basis for determining the dilutive effect on EPS. The average closing price for the Common Stock on June 30, 2024 did not exceed the conversion price of $86.83, and therefore all associated shares were deemed anti-dilutive.

Inventories (Tables)

6 Months Ended

Jun. 30, 2024

Inventory Disclosure [Abstract]

Schedule of Inventory

Inventories at June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	June 30, 2024		December 31, 2023
Finished goods	$	152,180	$	158,893
Work-in-process		38,049		25,420
Raw materials		107,995		119,558
Total inventories	$	298,224	$	303,871

Segment Reporting - Operating Income (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Segment Reporting Information [Line Items]
Net sales	$ 338,003		$ 320,056		$ 661,511	$ 617,621
Income from operations	45,946		28,812		81,868	55,195
Total other expense - net	(103)		(3,912)		(1,677)	(4,795)
Income tax expense	10,117		4,655		16,225	9,452
Net income	35,726	$ 28,240	20,245	$ 20,703	63,966	40,948
Cardiovascular
Segment Reporting Information [Line Items]
Net sales	327,815		311,275		641,189	599,251
Income from operations	42,912		26,464		75,819	50,398
Endoscopy
Segment Reporting Information [Line Items]
Net sales	10,188		8,781		20,322	18,370
Income from operations	$ 3,034		$ 2,348		$ 6,049	$ 4,797

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

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+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

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+ Details

Basis of Presentation and Other Items (Policies)	6 Months Ended
Basis of Presentation and Other Items (Policies)	Jun. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Other Items	1. Basis of Presentation and Other Items. The interim consolidated financial statements of Merit Medical Systems, Inc. ("Merit," "we" or "us") for the three and six-month periods ended June 30, 2024 and 2023 are not audited. Our consolidated financial statements are prepared in accordance with the requirements for unaudited interim periods and, consequently, do not include all disclosures required to be made in conformity with accounting principles generally accepted in the United States of America. In the opinion of our management, the accompanying consolidated financial statements contain all adjustments, consisting of normal recurring accruals, necessary for a fair presentation of our financial position as of June 30, 2024 and December 31, 2023, and our results of operations and cash flows for the three and six-month periods ended June 30, 2024 and 2023. The results of operations for the three and six-month periods ended June 30, 2024 and 2023 are not necessarily indicative of the results for a full-year period. Amounts presented in this report are rounded, while percentages and earnings per share amounts presented are calculated from the underlying amounts. These interim consolidated financial statements should be read in conjunction with the financial statements and risk factors included in our Annual Report on Form 10-K for the year ended December 31, 2023 (the “2023 Annual Report on Form 10-K”).
Recently Issued Accounting Standards	2. Recently Issued Accounting Standards. In November 2023, the Financial Accounting Standards Board (“FASB’) issued Accounting Standard Update (“ASU”) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, which requires a public entity to disclose significant segment expenses and other segment items on an annual and interim basis and to provide in interim periods all disclosures about reportable segment’s profit or loss and assets that are currently required annually. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The provisions of this update must be applied retrospectively to all periods presented in the financial statements. We are currently assessing the anticipated impact of this standard on our consolidated financial statements. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, to improve annual basis income tax disclosures related to (1) rate reconciliation, (2) income taxes paid, and (3) other disclosures related to pretax income (or loss) and income tax expense (or benefit) from continuing operations. ASU 2023-09 is effective for fiscal years beginning after December 15, 2025, with early adoption permitted. These amendments are to be applied on a prospective basis. Retrospective application is permitted. We are currently evaluating the impact this standard will have on our consolidated financial statement disclosures. We currently believe there are no other issued and not yet effective accounting standards that are materially relevant to our financial statements.
Revenue from Contracts with Customers	Revenue from Contracts with Customers. We recognize revenue when a customer obtains control of promised goods. The amount of revenue recognized reflects the consideration we expect to receive in exchange for these goods. Our revenue recognition policies have not changed from those disclosed in Note 1 to our consolidated financial statements in Item 8 of the 2023 Annual Report on Form 10-K.
Derivatives	Derivatives. General. Our earnings and cash flows are subject to fluctuations due to changes in interest rates and foreign currency exchange rates, and we seek to mitigate a portion of the risks attributable to those fluctuations by entering into derivative contracts. The derivative instruments we use are interest rate swaps and foreign currency forward contracts. We recognize derivative instruments as either assets or liabilities at fair value in the accompanying consolidated balance sheets, regardless of whether hedge accounting is applied. We report cash flows arising from our hedging instruments consistent with the classification of cash flows from the underlying hedged items. Accordingly, cash flows associated with our derivative contracts are classified as operating activities in the accompanying consolidated statements of cash flows. We formally document, designate and assess the effectiveness of transactions that receive hedge accounting treatment initially and on an ongoing basis. For qualifying hedges, the change in fair value is deferred in accumulated other comprehensive income, a component of stockholders’ equity in the accompanying consolidated balance sheets, and recognized in earnings at the same time the hedged item affects earnings. Changes in the fair value of derivative instruments not designated as hedging instruments are recorded in earnings throughout the term of the derivative. Interest Rate Risk. Our debt bears interest at variable interest rates. Therefore, we are subject to variability in the cash payable for interest expense. In order to mitigate a portion of the risk attributable to such variability, we use a hedging strategy to reduce the variability of cash flows in the interest payments associated with a portion of the variable-rate debt outstanding under our Amended Fourth A&R Credit Agreement that varies in accordance with changes in the benchmark interest rate. Derivatives Designated as Cash Flow Hedges On December 23, 2019, we entered into a pay-fixed, receive-variable interest rate swap with a notional amount of $75 million with Wells Fargo. In June 2023, certain terms under the swap agreement were amended to reflect the transition from LIBOR to SOFR, an alternative reference rate. Under the interest rate swap agreement, we fixed the one-month SOFR rate on that portion of our borrowings under the Amended Fourth A&R Credit Agreement at 1.64% for the period from June 1, 2023 to July 31, 2024. The variable portion of the interest rate swap is tied to the one-month SOFR rate (the benchmark interest rate). On a monthly basis, the interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid. On June 30, 2024 and December 31, 2023, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap as of June 30, 2024 was an asset of $0.3 million, which was partially offset by $0.1 million in deferred taxes. The fair value of our interest rate swap as of December 31, 2023 was an asset of $1.5 million, partially offset by $0.4 million in deferred taxes. Foreign Currency Risk. We operate on a global basis and are exposed to the risk that our financial condition, results of operations, and cash flows could be adversely affected by changes in foreign currency exchange rates. To reduce the potential effects of foreign currency exchange rate movements on net earnings, we enter into derivative financial instruments in the form of foreign currency exchange forward contracts with major financial institutions. Our policy is to enter into foreign currency derivative contracts with maturities of up to two years. We are exposed to foreign currency exchange rate risk with respect to transactions and balances denominated in various currencies, with our most significant exposure related to transactions and balances denominated in Chinese Renminbi and Euros, among others. We do not use derivative financial instruments for trading or speculative purposes. We do not believe we are subject to any credit risk contingent features related to our derivative contracts, and we seek to manage counterparty risk by allocating derivative contracts among several major financial institutions. Derivatives Designated as Cash Flow Hedges For derivative instruments that are designated and qualify as cash flow hedges, the gain or loss on the derivative instrument is temporarily reported as a component of other comprehensive income and then reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. We entered into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating expenses in various international markets. The objective of the forward contracts is to reduce the variability of cash flows associated with the forecasted purchase or sale of the foreign currencies. Derivatives Not Designated as Cash Flow Hedges We forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. Balance Sheet Presentation of Derivative Instruments. As of June 30, 2024 and December 31, 2023, all derivative instruments, both those designated as hedging instruments and those that were not designated as hedging instruments, were recorded at fair value on a gross basis on our consolidated balance sheets. We are not subject to any master netting agreements.

- Definition

Disclosure of accounting policy for revenue from contract with customer.

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+ Details

Accumulated Other Comprehensive Income (Loss) (Tables)

6 Months Ended

Jun. 30, 2024

Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest [Abstract]

Schedule of Components of Accumulated Other Comprehensive Income (Loss)

The changes in each component of accumulated other comprehensive income (loss) for the three and six-month periods ended June 30, 2024 and 2023 were as follows:


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of April 1, 2024	$	3,932	$	(16,388)	$	(12,456)

Other comprehensive loss		(228)		(1,688)		(1,916)
Income taxes		404		22		426
Reclassifications to:
Revenue		(427)				(427)
Cost of sales		(357)				(357)
Interest expense		(699)				(699)
Net other comprehensive loss		(1,307)		(1,666)		(2,973)

Balance as of June 30, 2024	$	2,625	$	(18,054)	$	(15,429)


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of April 1, 2023	$	3,081	$	(14,010)	$	(10,929)

Other comprehensive income (loss)		5,044		(1,201)		3,843
Income taxes		(821)		(15)		(836)
Reclassifications to:
Revenue		(658)				(658)
Cost of sales		(333)				(333)
Interest expense		(631)				(631)
Net other comprehensive income (loss)		2,601		(1,216)		1,385

Balance as of June 30, 2023	$	5,682	$	(15,226)	$	(9,544)


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of January 1, 2024	$	1,662	$	(12,996)	$	(11,334)

Other comprehensive income (loss)		4,286		(5,092)		(806)
Income taxes		(298)		34		(264)
Reclassifications to:
Revenue		(840)				(840)
Cost of sales		(784)				(784)
Interest expense		(1,401)				(1,401)
Net other comprehensive income (loss)		963		(5,058)		(4,095)

Balance as of June 30, 2024	$	2,625	$	(18,054)	$	(15,429)


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of January 1, 2023	$	4,366	$	(15,916)	$	(11,550)

Other comprehensive income		5,164		724		5,888
Income taxes		(415)		(34)		(449)
Reclassifications to:
Revenue		(1,985)				(1,985)
Cost of sales		(283)				(283)
Interest expense		(1,165)				(1,165)
Net other comprehensive income		1,316		690		2,006

Balance as of June 30, 2023	$	5,682	$	(15,226)	$	(9,544)

Acquisitions - CrannMed Limited (Details) - MM Ireland - CrannMed € in Millions	May 17, 2024 EUR (€)
Business Acquisition [Line Items]
Payments to acquire shares	€ 3.0
Ownership percentage	10.80%
Commitment to Invest in Preference Shares
Business Acquisition [Line Items]
Additional funding commitment	€ 3.0
Additional Funding
Business Acquisition [Line Items]
Additional funding commitment	€ 2.0

Debt (Tables)

6 Months Ended

Jun. 30, 2024

Debt Disclosure [Abstract]

Schedule of Long-term Debt Instruments

Principal balances outstanding under our long-term debt obligations as of June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	June 30, 2024		December 31, 2023
Term loans	$	75,000	$	99,063
Convertible notes		747,500		747,500
Less unamortized debt issuance costs		(21,179)		(23,550)
Total long-term debt		801,321		823,013
Less current portion		—		—
Long-term portion	$	801,321	$	823,013

Schedule of Maturities of Long-term Debt

Future minimum principal payments on our long-term debt, as of June 30, 2024, were as follows (in thousands):


Years Ending	Future Minimum
December 31,	Principal Payments
Remaining 2024	$	—
2025		—
2026		—
2027		—
2028		75,000
Thereafter		747,500
Total future minimum principal payments	$	822,500

Schedule of Long-term Debt Covenants

The Amended Fourth A&R Credit Agreement is collateralized by substantially all of our assets. The Amended Fourth A&R Credit Agreement contains affirmative and negative covenants, representations and warranties, events of default and other terms customary for loans of this nature. In particular, the Amended Fourth A&R Credit Agreement requires that we maintain certain financial covenants, as follows:


	Covenant Requirement
Consolidated Total Net Leverage Ratio ⁽¹⁾		5.0 to 1.0
Consolidated Senior Secured Net Leverage Ratio ⁽²⁾		3.0 to 1.0
Consolidated Interest Coverage Ratio ⁽³⁾		3.0 to 1.0

(1)	Maximum Consolidated Total Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end.

(2)	Maximum Consolidated Senior Secured Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end.

(3)	Minimum ratio of Consolidated EBITDA (as defined in the Amended Fourth A&R Credit Agreement and adjusted for certain expenditures) to Consolidated Interest Expense (as defined in the Amended Fourth A&R Credit Agreement) for any period of four consecutive fiscal quarters.

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

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-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
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+ Details

Fair Value Measurements - Liability Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Contingent Consideration - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 3,225	$ 16,000	$ 3,447	$ 18,073
Contingent consideration expense	$ 305	$ 1,094	$ 188	$ 1,615
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit	Business Combination, Contingent Consideration Arrangements, Contingent Consideration Benefit
Contingent payments made	$ (95)	$ (13,513)	$ (200)	$ (16,107)
Ending balance	$ 3,435	$ 3,581	$ 3,435	$ 3,581

Debt

6 Months Ended

Jun. 30, 2024

Debt Disclosure [Abstract]

Debt

8. Debt. Principal balances outstanding under our long-term debt obligations as of June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	June 30, 2024		December 31, 2023
Term loans	$	75,000	$	99,063
Convertible notes		747,500		747,500
Less unamortized debt issuance costs		(21,179)		(23,550)
Total long-term debt		801,321		823,013
Less current portion		—		—
Long-term portion	$	801,321	$	823,013

Future minimum principal payments on our long-term debt, as of June 30, 2024, were as follows (in thousands):


Years Ending	Future Minimum
December 31,	Principal Payments
Remaining 2024	$	—
2025		—
2026		—
2027		—
2028		75,000
Thereafter		747,500
Total future minimum principal payments	$	822,500

Fourth Amended and Restated Credit Agreement

On June 6, 2023, we entered into a Fourth Amended and Restated Credit Agreement (the "Fourth A&R Credit Agreement"). The Fourth A&R Credit Agreement is a syndicated loan agreement with Wells Fargo Bank, National Association and other parties. The Fourth A&R Credit Agreement amended and restated in its entirety our previously outstanding Third Amended and Restated Credit Agreement and all amendments thereto. The Fourth A&R Credit Agreement provides for a term loan of $150 million and a revolving credit commitment of up to an aggregate amount of $700 million, inclusive of sub-facilities for multicurrency borrowings, standby letters of credit and swingline loans. On June 6, 2028, all principal, interest and other amounts outstanding under the Fourth Amended Credit Agreement are payable in full. At any time prior to the maturity date, we may repay any amounts owing under all term loans and revolving credit loans in whole or in part, without premium or penalty.

On December 5, 2023, we executed an amendment to the Fourth Amended Credit Agreement (as amended, the "Amended Fourth A&R Credit Agreement") to facilitate the issuance of our Convertible Notes described below. Among other things, the amendment also updated the definition of the “Applicable Margin” as used in the Amended Fourth A&R Credit Agreement to determine the interest rates and amended the financial covenants, all as described below.

Term loans made under the Amended Fourth A&R Credit Agreement bear interest, at our election, at either (i) the Base Rate plus the Applicable Margin (as defined in the Amended Fourth A&R Credit Agreement) or, (ii) Adjusted Term SOFR plus the Applicable Margin (as defined in the Amended Fourth A&R Credit Agreement). Revolving credit loans bear interest, at our election, at either (a) the Base Rate plus the Applicable Margin, (b) Adjusted Term SOFR plus the Applicable Margin, (c) Adjusted Eurocurrency Rate plus the Applicable Margin (as defined in the Amended Fourth A&R Credit Agreement), or (d) Adjusted Daily Simple SONIA plus the Applicable Margin (as defined in the Amended Fourth A&R Credit Agreement). Swingline loans bear interest at the Base Rate plus the Applicable Margin. Interest on each loan featuring the Base Rate and each Daily Simple SONIA Loan is due and payable on the last business day of each calendar month; interest on each loan featuring the Eurocurrency Rate and each Term SOFR Loan is due and payable on the last day of each interest period applicable thereto, and if such interest period extends over three months, at the end of each three-month interval during such interest period.


	Covenant Requirement
Consolidated Total Net Leverage Ratio ⁽¹⁾		5.0 to 1.0
Consolidated Senior Secured Net Leverage Ratio ⁽²⁾		3.0 to 1.0
Consolidated Interest Coverage Ratio ⁽³⁾		3.0 to 1.0

(1)	Maximum Consolidated Total Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end.

(2)	Maximum Consolidated Senior Secured Net Leverage Ratio (as defined in the Amended Fourth A&R Credit Agreement) as of any fiscal quarter end.

(3)	Minimum ratio of Consolidated EBITDA (as defined in the Amended Fourth A&R Credit Agreement and adjusted for certain expenditures) to Consolidated Interest Expense (as defined in the Amended Fourth A&R Credit Agreement) for any period of four consecutive fiscal quarters.

We believe we were in compliance with all covenants set forth in the Amended Fourth A&R Credit Agreement as of June 30, 2024.

As of June 30, 2024, we had outstanding borrowings of $75.0 million and issued letter of credit guarantees of $2.4 million under the Amended Fourth A&R Credit Agreement, with additional available borrowings of approximately $680 million, based on the maximum net leverage ratio and the aggregate revolving credit commitment pursuant to the Amended Fourth A&R Credit Agreement. Our interest rate as of June 30, 2024 was a fixed rate of 3.39% with respect to the outstanding principal amount as a result of an interest rate swap (see Note 9). Our interest rate as of December 31, 2023 was a fixed rate of 3.39% on $75 million as a result of an interest rate swap and a variable floating rate of 7.21% on $24.1 million. The foregoing fixed rates do not reflect potential future changes in the Applicable Margin.

Convertible Notes

In December 2023, we issued convertible notes which bear interest at 3.00% per year, payable semi-annually in arrears on February 1 and August 1 of each year, beginning on August 1, 2024 (the “Convertible Notes”). The Convertible Notes are senior unsecured obligations (as defined in the indenture governing the Convertible Notes (the “Indenture”)) of Merit and will mature on February 1, 2029, unless repurchased, redeemed or converted in accordance with their terms prior to such date. The net proceeds from the sale of the Convertible Notes were approximately $724.8 million after deducting offering and issuance costs and before the costs of the Capped Call Transactions, as described below.

The initial conversion rate of the notes will be 11.5171 shares of our common stock (the “Common Stock”) per $1,000 principal amount of notes, which equates to an initial conversion price of approximately $86.83 per share of Common Stock, subject to adjustments as provided in the Indenture upon the occurrence of certain specified events. In addition, holders of the Convertible Notes (“Holders”) will have the right to require Merit to repurchase all or a part of their notes upon the occurrence of a “fundamental change” (as defined in the Indenture) in cash at a fundamental change repurchase price of 100% of their principal amount plus accrued and unpaid interest up to, but excluding, the fundamental change repurchase date.

Conversion can occur at the option of the Holders at any time on or after October 1, 2028. Prior to October 1, 2028, Holders may only elect to convert the Convertible Notes under the following circumstances: (1) During the five business day period after any ten consecutive trading day period in which, for each day of that period, the trading price per $1,000 principal amount of the Convertible Notes for such trading day was less than 98% of the product of the last reported sale price of the Common Stock and the applicable conversion rate on such trading day; (2) Merit issues to common stockholders any rights, options, or warrants, entitling them, for a period of not more than 60 days, to purchase shares of Common Stock at a price per share less than the average closing sale price of 10 consecutive trading days, or Merit’s election to make a distribution to common stockholders exceeding 10% of the previous day’s closing sale price; (3) Upon the occurrence of a Fundamental Change, as set forth in the Indenture; (4) During any calendar quarter (and only during such calendar quarter) beginning after March 31, 2024, if, the last reported sale price per share of the Common Stock exceeds 130% of the applicable conversion price on each applicable trading day for at least 20 trading days (whether or not consecutive) in the period of the 30 consecutive trading day period ending on, and including, the last trading day of the immediately preceding calendar quarter; or (5) Prior to the related redemption date if Merit calls any Convertible Notes for redemption. As of June 30, 2024, none of the conditions permitting the Holders to convert their Convertible Notes early had been met. Therefore, the Convertible Notes are classified as long-term debt obligations.

On or after February 7, 2027, we may redeem for cash all or part of the Convertible Notes, at our option, if the last reported sales price of Common Stock has been at least 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive), including the trading day immediately preceding the date on which we provide notice of redemption, during any 30 consecutive trading days ending on, and including, the trading day immediately before the date we send the related notice of the redemption.

Upon conversion, Merit will (1) pay cash up to the aggregate principal amount of the Convertible Notes to be converted and (2) pay or deliver, as the case may be, cash, shares of Common Stock, or a combination of cash and shares of Common Stock, at Merit’s election, in respect of the remainder, if any, of its conversion obligation in excess of the aggregate principal amount of the Convertible Notes being converted.

Capped Call Transactions

In December 2023, in connection with the pricing of the Convertible Notes, Merit entered into privately negotiated capped call transactions (“Capped Call Transactions”) with certain of the initial purchasers and/or their respective affiliates and certain other financial institutions. The Capped Call Transactions cover, subject to customary anti-dilution adjustments, the number of shares of Common Stock initially underlying the Convertible Notes and are generally expected to reduce potential dilution to the Common Stock upon any conversion of Convertible Notes and/or offset any cash payments Merit is required to make in excess of the principal amount of converted Convertible Notes, as the case may be, with such reduction and/or offset subject to a cap, based on a cap price initially equal to approximately $114.68 per share of Common Stock, subject to certain adjustments under the terms of the Capped Call Transactions. The cost of the Capped Call Transactions was approximately $66.5 million. The Capped Call Transactions do not meet the criteria for separate accounting as a derivative as they are indexed to the Common Stock. The premiums paid for the Capped Call Transactions have been included as a net reduction to Common Stock within stockholders' equity.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481544/470-10-50-6

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481544/470-10-50-6

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/470/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 835
-SubTopic 30
-Name Accounting Standards Codification
-Section 45
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482925/835-30-45-2

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1C

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1C

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Paragraph 1C
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1C

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1E

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

+ Details

Derivatives - Narrative (Details) - USD ($) $ in Millions	6 Months Ended
Derivatives - Narrative (Details) - USD ($) $ in Millions	Jun. 30, 2024	Dec. 31, 2023	Dec. 23, 2019
Revenue and cost of sales
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income (loss) to earnings in next twelve months, gross	$ 2.9
Amount expected to be reclassified from accumulated other comprehensive income to earnings (loss) in next twelve months, net of tax	2.2
Interest expense
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income (loss) to earnings in next twelve months, gross	0.3
Amount expected to be reclassified from accumulated other comprehensive income to earnings (loss) in next twelve months, net of tax	0.2
Interest rate swap \| Designated as hedging instrument
Derivative [Line Items]
Fair value of derivative asset	0.3	$ 1.5
Deferred tax liability used to offset fair value of interest rate swap	$ (0.1)	$ (0.4)
Interest rate swap \| Wells Fargo 1.71% one-month LIBOR \| Designated as hedging instrument
Derivative [Line Items]
Notional amount of derivative			$ 75.0
Fixed rate			1.64%
Investment, Variable Interest Rate, Type [Extensible Enumeration]			us-gaap:SecuredOvernightFinancingRateSofrMember
Foreign currency forward contracts
Derivative [Line Items]
Maturity of derivative contract (up to)	2 years

Accumulated Other Comprehensive Income (Loss)

6 Months Ended

Jun. 30, 2024

Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest [Abstract]

Accumulated Other Comprehensive Income (Loss)

15. Accumulated Other Comprehensive Income (Loss). The changes in each component of accumulated other comprehensive income (loss) for the three and six-month periods ended June 30, 2024 and 2023 were as follows:


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of April 1, 2024	$	3,932	$	(16,388)	$	(12,456)

Other comprehensive loss		(228)		(1,688)		(1,916)
Income taxes		404		22		426
Reclassifications to:
Revenue		(427)				(427)
Cost of sales		(357)				(357)
Interest expense		(699)				(699)
Net other comprehensive loss		(1,307)		(1,666)		(2,973)

Balance as of June 30, 2024	$	2,625	$	(18,054)	$	(15,429)


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of April 1, 2023	$	3,081	$	(14,010)	$	(10,929)

Other comprehensive income (loss)		5,044		(1,201)		3,843
Income taxes		(821)		(15)		(836)
Reclassifications to:
Revenue		(658)				(658)
Cost of sales		(333)				(333)
Interest expense		(631)				(631)
Net other comprehensive income (loss)		2,601		(1,216)		1,385

Balance as of June 30, 2023	$	5,682	$	(15,226)	$	(9,544)


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of January 1, 2024	$	1,662	$	(12,996)	$	(11,334)

Other comprehensive income (loss)		4,286		(5,092)		(806)
Income taxes		(298)		34		(264)
Reclassifications to:
Revenue		(840)				(840)
Cost of sales		(784)				(784)
Interest expense		(1,401)				(1,401)
Net other comprehensive income (loss)		963		(5,058)		(4,095)

Balance as of June 30, 2024	$	2,625	$	(18,054)	$	(15,429)


	Cash Flow Hedges		Foreign Currency Translation		Total
Balance as of January 1, 2023	$	4,366	$	(15,916)	$	(11,550)

Other comprehensive income		5,164		724		5,888
Income taxes		(415)		(34)		(449)
Reclassifications to:
Revenue		(1,985)				(1,985)
Cost of sales		(283)				(283)
Interest expense		(1,165)				(1,165)
Net other comprehensive income		1,316		690		2,006

Balance as of June 30, 2023	$	5,682	$	(15,226)	$	(9,544)

Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Jun. 08, 2023	May 04, 2023
Assets Acquired
Goodwill	$ 381,433	$ 382,240
Angio Dynamics Inc
Assets Acquired
Prepaid expenses			$ 2,000
Inventories			5,254
Property and equipment			108
Goodwill			17,638
Total net assets acquired			100,000
Angio Dynamics Inc \| Developed technology
Assets Acquired
Intangible assets			65,200
Angio Dynamics Inc \| Trade Names
Assets Acquired
Intangible assets			4,000
Angio Dynamics Inc \| Customer Lists
Assets Acquired
Intangible assets			$ 5,800
Bluegrass Vascular Technologies, Inc
Assets Acquired
Inventories				$ 175
Goodwill				3,898
Total net assets acquired				32,973
Bluegrass Vascular Technologies, Inc \| Developed technology
Assets Acquired
Intangible assets				28,000
Bluegrass Vascular Technologies, Inc \| Trade Names
Assets Acquired
Intangible assets				$ 900

Fair Value Measurements - Fair Value Inputs, Liabilities, Quantitative Information (Details) - Fair Value, Inputs, Level 3 $ in Thousands	Jun. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)
Revenue-based royalty
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 2,937	$ 2,945
Revenue milestones
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	91	93
Regulatory approval
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration liabilities	$ 407	$ 409
Discount rate \| Revenue-based royalty \| Minimum \| Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.12	0.120
Discount rate \| Revenue-based royalty \| Maximum \| Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.16	0.160
Discount rate \| Revenue-based royalty \| Weighted Average \| Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.146	0.146
Discount rate \| Revenue milestones \| Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.130
Discount rate \| Revenue milestones \| Minimum \| Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability		0.130
Discount rate \| Regulatory approval \| Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.061	0.055
Probability of milestone payment \| Regulatory approval \| Discounted Cash Flow
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable inputs, contingent liability	0.500	0.500

Subsequent Events

6 Months Ended

Jun. 30, 2024

Subsequent Events [Abstract]

Subsequent Events

16. Subsequent Events. On July 1, 2024, we entered into an Asset Purchase Agreement (the “EGS Purchase Agreement”) with EndoGastric Solutions, Inc., a Delaware corporation (“EGS”), pursuant to which we acquired the EsophyX® Z+ device and various assets related thereto (collectively, the “EGS Acquisition”), which are designed to deliver a durable, minimally invasive non-pharmacological treatment option for patients suffering from gastroesophageal reflux disease. We acquired the purchased assets identified under the EGS Purchase Agreement for a purchase price of $105 million, which amount we financed at closing through current borrowings under our long-term debt obligations, plus the assumption or reimbursement of certain liabilities of EGS. We are currently evaluating the accounting treatment of the EGS Acquisition, as well as performing the valuation of the assets acquired and the related purchase price allocation.

Derivatives - Forward Notional Contracts (Details) - Foreign currency forward contracts - USD ($) $ in Millions	Jun. 30, 2024	Dec. 31, 2023
Designated as hedging instrument \| Derivatives designated as cash flow hedges
Derivative [Line Items]
Aggregate notional amount of derivative	$ 134.0	$ 141.1
Not designated as hedging instrument \| Fair Value Hedging
Derivative [Line Items]
Aggregate notional amount of derivative	$ 110.8	$ 108.4

Revenue from Contracts with Customers - Disaggregation of Revenue (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) item segment	Jun. 30, 2023 USD ($)
Disaggregation of Revenue [Line Items]
Number of operating segments \| segment			2
Net sales	$ 338,003	$ 320,056	$ 661,511	$ 617,621
United States
Disaggregation of Revenue [Line Items]
Net sales	194,664	179,582	380,758	350,942
International
Disaggregation of Revenue [Line Items]
Net sales	143,339	140,474	$ 280,753	266,679
Cardiovascular
Disaggregation of Revenue [Line Items]
Number of product categories \| item			4
Net sales	327,815	311,275	$ 641,189	599,251
Cardiovascular \| Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	139,247	125,909	273,873	239,692
Cardiovascular \| Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	93,863	93,775	184,551	179,103
Cardiovascular \| Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	50,416	49,384	99,210	97,085
Cardiovascular \| OEM
Disaggregation of Revenue [Line Items]
Net sales	44,289	42,207	83,555	83,371
Cardiovascular \| United States
Disaggregation of Revenue [Line Items]
Net sales	185,152	171,388	361,697	333,723
Cardiovascular \| United States \| Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	82,356	71,973	161,615	140,640
Cardiovascular \| United States \| Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	36,840	35,690	72,183	69,995
Cardiovascular \| United States \| Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	30,496	29,155	59,790	55,954
Cardiovascular \| United States \| OEM
Disaggregation of Revenue [Line Items]
Net sales	35,460	34,570	68,109	67,134
Cardiovascular \| International
Disaggregation of Revenue [Line Items]
Net sales	142,663	139,887	279,492	265,528
Cardiovascular \| International \| Peripheral Intervention
Disaggregation of Revenue [Line Items]
Net sales	56,891	53,936	112,258	99,052
Cardiovascular \| International \| Cardiac Intervention
Disaggregation of Revenue [Line Items]
Net sales	57,023	58,085	112,368	109,108
Cardiovascular \| International \| Custom Procedural Solutions
Disaggregation of Revenue [Line Items]
Net sales	19,920	20,229	39,420	41,131
Cardiovascular \| International \| OEM
Disaggregation of Revenue [Line Items]
Net sales	8,829	7,637	15,446	16,237
Endoscopy
Disaggregation of Revenue [Line Items]
Net sales	10,188	8,781	20,322	18,370
Endoscopy \| Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	10,188	8,781	20,322	18,370
Endoscopy \| United States \| Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	9,512	8,194	19,061	17,219
Endoscopy \| International \| Endoscopy Devices
Disaggregation of Revenue [Line Items]
Net sales	$ 676	$ 587	$ 1,261	$ 1,151

Inventories

6 Months Ended

Jun. 30, 2024

Inventory Disclosure [Abstract]

Inventories

5. Inventories. Inventories at June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	June 30, 2024		December 31, 2023
Finished goods	$	152,180	$	158,893
Work-in-process		38,049		25,420
Raw materials		107,995		119,558
Total inventories	$	298,224	$	303,871

Fair Value Measurements (Tables)

6 Months Ended

Jun. 30, 2024

Fair Value Disclosures [Abstract]

Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis

Our financial assets and (liabilities) carried at fair value and measured on a recurring basis as of June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


			Fair Value Measurements Using
	Total Fair		Quoted prices in		Significant other		Significant
	Value at		active markets		observable inputs		unobservable inputs
	June 30, 2024		(Level 1)		(Level 2)		(Level 3)
Marketable securities ⁽¹⁾	$	61	$	61	$	—	$	—
Interest rate contract asset, current ⁽²⁾	$	254	$	—	$	254	$	—
Foreign currency contract assets, current and long-term ⁽³⁾	$	4,946	$	—	$	4,946	$	—
Foreign currency contract liabilities, current and long-term ⁽⁴⁾	$	(2,250)	$	—	$	(2,250)	$	—
Contingent consideration liabilities	$	(3,435)	$	—	$	—	$	(3,435)


			Fair Value Measurements Using
	Total Fair		Quoted prices in		Significant other		Significant
	Value at		active markets		observable inputs		unobservable inputs
	December 31, 2023		(Level 1)		(Level 2)		(Level 3)
Marketable securities ⁽¹⁾	$	78	$	78	$	—		—
Interest rate contract asset, current ⁽²⁾	$	1,503	$	—	$	1,503	$	—
Foreign currency contract assets, current and long-term ⁽³⁾	$	3,105	$	—	$	3,105	$	—
Foreign currency contract liabilities, current and long-term ⁽⁴⁾	$	(3,860)	$	—	$	(3,860)	$	—
Contingent consideration liabilities	$	(3,447)	$	—	$	—	$	(3,447)

(1)	Our marketable securities, which consist entirely of available-for-sale equity securities, are valued using market prices in active markets. Level 1 instrument valuations are obtained from real-time quotes for transactions in active exchange markets involving identical assets.

(2)	The fair value of the interest rate contract is determined using Level 2 fair value inputs and is recorded as prepaid and other current assets in the consolidated balance sheets.

(3)

(4)

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

Changes in the fair value of our contingent consideration liabilities during the three and six-month periods ended June 30, 2024 and 2023 consisted of the following (in thousands):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Beginning balance	$	3,225	$	16,000	$	3,447	$	18,073
Contingent consideration expense		305		1,094		188		1,615
Contingent payments made		(95)		(13,513)		(200)		(16,107)
Ending balance	$	3,435	$	3,581	$	3,435	$	3,581

Fair Value Inputs, Liabilities, Quantitative Information

The recurring Level 3 measurement of our contingent consideration liabilities included the following significant unobservable inputs at June 30, 2024 and December 31, 2023 (amounts in thousands):


	Fair value at
	June 30,		Valuation			Weighted
Contingent consideration liability	2024		technique	Unobservable inputs	Range	Average⁽¹⁾
Revenue-based royalty payments contingent liability	$	2,937	Discounted cash flow	Discount rate	12% - 16%	14.6%
				Projected year of payments	2024-2034	2028

Revenue milestones contingent liability	$	91	Monte Carlo simulation	Discount rate	13.0%
				Projected year of payments	2024-2040	2040

Regulatory approval contingent liability	$	407	Scenario-based method	Discount rate	6.1%
				Probability of milestone payment	50.0%
				Projected year of payment	2024-2030	2030


	Fair value at
	December 31,		Valuation			Weighted
Contingent consideration liability	2023		technique	Unobservable inputs	Range	Average⁽¹⁾
Revenue-based royalty payments contingent liability	$	2,945	Discounted cash flow	Discount rate	12.0% - 16.0%	14.6%
				Projected year of payments	2024-2034	2028

Revenue milestones contingent liability	$	93	Monte Carlo simulation	Discount rate	13.0%
				Projected year of payments	2024-2039	2039

Regulatory approval contingent liability	$	409	Scenario-based method	Discount rate	5.5%
				Probability of milestone payment	50.0%
				Projected year of payment	2024-2030	2030

(1)	Unobservable inputs were weighted by the relative fair value of the instruments. No weighted average is reported for contingent consideration liabilities without a range of unobservable inputs.

Schedule of Rollforward of Allowance for Credit Losses

The table below presents a roll-forward of the allowance for current expected credit losses on our notes receivable for the three and six-month periods ended June 30, 2024 and 2023 (in thousands):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Beginning balance	$	1,388	$	290	$	568	$	281
Provision for credit loss expense		18		6		838		15
Ending balance	$	1,406	$	296	$	1,406	$	296

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Mar. 31, 2024	Dec. 31, 2023	May 03, 2023	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Payments related to the settlement of the contingent consideration liability, Financing activities			$ 142	$ 3,434
Payments related to the settlement of the contingent consideration liability, Operating activities			100	12,700
Impairment of equity method investment			0
Impairment of intangible assets			0	0
Interest income	$ 7,561	$ 221	14,837	352
Investments in privately held companies	22,600		22,600			$ 19,100
Long-term notes receivable, net	8,700		8,700			3,200
Long-term notes receivable issued			6,200
Allowance for expected credit losses	1,406	$ 296	1,406	296	$ 1,388	568		$ 290	$ 281
Solo Pace
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term notes receivable issued			1,500
Fluidx
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Ownership percentage					19.90%
Long-term notes receivable issued			3,000
Bluegrass Vascular Technologies, Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of equity method investment				$ 300
Ownership percentage							19.50%
Equity method investment							$ 245
Selio
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term notes receivable issued			1,700
Allowance for expected credit losses	1,400		1,400			600
Other long-term obligations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, noncurrent	3,000		3,000			3,000
Accrued expenses
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, current	$ 400		$ 400			$ 400

Stock-Based Compensation Expense (Tables)

6 Months Ended

Jun. 30, 2024

Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]

Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs

Stock-based compensation expense before income tax expense for the three and six-month periods ended June 30, 2024 and 2023 consisted of the following (in thousands):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Cost of sales
Nonqualified stock options	$	363	$	432	$	725	$	873
Research and development
Nonqualified stock options		345		413		781		841
Selling, general and administrative
Nonqualified stock options		1,565		1,851		3,247		3,221
Performance-based restricted stock units		2,897		1,817		4,764		2,632
Restricted stock units		1,131		467		1,718		911
Cash-settled performance-based awards		710		600		1,010		1,071
Total selling, general and administrative		6,303		4,735		10,739		7,835

Stock-based compensation expense before taxes	$	7,011	$	5,580	$	12,245	$	9,549

Employee Stock Option

Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]

Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions


	Six Months Ended
	June 30,
	2023
Risk-free interest rate	3.6% - 4.5%
Expected option term	4.0 years
Expected dividend yield	—
Expected price volatility	46.7% - 47.1%

Stock-Settled Performance-Based Restricted Stock Units

Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]

Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions


	Six Months Ended
	June 30,
	2024	2023
Risk-free interest rate	4.4%	3.9% - 4.6%
Performance period	2.8 years	2.8 years
Expected dividend yield	—	—
Expected price volatility	31.1%	31.4% - 32.6%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 119,855	$ 118,771
Accumulated Amortization	(80,628)	(76,887)
Net Carrying Amount	39,227	41,884
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	30,163	28,877
Accumulated Amortization	(11,876)	(10,916)
Net Carrying Amount	18,287	17,961
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	3,250	3,250
Accumulated Amortization	(2,956)	(2,919)
Net Carrying Amount	294	331
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,094	11,142
Accumulated Amortization	(8,759)	(8,327)
Net Carrying Amount	2,335	2,815
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	35,123	35,135
Accumulated Amortization	(22,343)	(20,804)
Net Carrying Amount	12,780	14,331
Customer Lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	40,225	40,367
Accumulated Amortization	(34,694)	(33,921)
Net Carrying Amount	$ 5,531	$ 6,446

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets:
Trade receivables, allowances	$ 9,276	$ 9,023
Stockholders' equity:
Preferred stock shares authorized (in shares)	5,000	5,000
Preferred stock shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0	$ 0
Common stock shares authorized (in shares)	100,000	100,000
Common stock shares issued (in shares)	58,192	57,858
Common stock shares outstanding (in shares)	58,192	57,858
Developed technology
Other assets:
Intangibles, accumulated amortization	$ 346,763	$ 321,488
Other
Other assets:
Intangibles, accumulated amortization	$ 80,628	$ 76,887

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Common Stock	Retained Earnings	Accumulated Other Comprehensive Loss	Total
Beginning balance at Dec. 31, 2022	$ 675,174	$ 480,773	$ (11,550)	$ 1,144,397
Beginning balance (in shares) at Dec. 31, 2022	57,306
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		20,703		20,703
Other comprehensive income (loss)			621	621
Stock-based compensation expense	$ 3,498			3,498
Options exercised	$ 3,726			3,726
Options exercised (in shares)	123
Issuance of common stock under Employee Stock Purchase Plan	$ 302			302
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4
Shares issued from time-vested restricted stock units (in shares)	61
Shares surrendered in exchange for payment of payroll tax liabilities	$ (1,592)			(1,592)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(22)
Ending balance at Mar. 31, 2023	$ 681,108	501,476	(10,929)	1,171,655
Ending balance (in shares) at Mar. 31, 2023	57,472
Beginning balance at Dec. 31, 2022	$ 675,174	480,773	(11,550)	1,144,397
Beginning balance (in shares) at Dec. 31, 2022	57,306
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income				40,948
Other comprehensive income (loss)				2,006
Ending balance at Jun. 30, 2023	$ 691,523	521,721	(9,544)	1,203,700
Ending balance (in shares) at Jun. 30, 2023	57,634
Beginning balance at Mar. 31, 2023	$ 681,108	501,476	(10,929)	1,171,655
Beginning balance (in shares) at Mar. 31, 2023	57,472
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		20,245		20,245
Other comprehensive income (loss)			1,385	1,385
Stock-based compensation expense	$ 4,980			4,980
Options exercised	$ 5,154			5,154
Options exercised (in shares)	128
Issuance of common stock under Employee Stock Purchase Plan	$ 281			281
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4
Shares issued from time-vested restricted stock units (in shares)	30
Ending balance at Jun. 30, 2023	$ 691,523	521,721	(9,544)	1,203,700
Ending balance (in shares) at Jun. 30, 2023	57,634
Beginning balance at Dec. 31, 2023	$ 638,150	575,184	(11,334)	$ 1,202,000
Beginning balance (in shares) at Dec. 31, 2023	57,858			57,858
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		28,240		$ 28,240
Other comprehensive income (loss)			(1,122)	(1,122)
Stock-based compensation expense	$ 4,934			4,934
Options exercised	$ 7,394			7,394
Options exercised (in shares)	213
Issuance of common stock under Employee Stock Purchase Plan	$ 336			336
Issuance of common stock under Employee Stock Purchase Plan (in shares)	5
Shares issued from time-vested restricted stock units (in shares)	47
Shares surrendered in exchange for payment of payroll tax liabilities	$ (1,592)			(1,592)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)	(21)
Ending balance at Mar. 31, 2024	$ 649,222	603,424	(12,456)	1,240,190
Ending balance (in shares) at Mar. 31, 2024	58,102
Beginning balance at Dec. 31, 2023	$ 638,150	575,184	(11,334)	$ 1,202,000
Beginning balance (in shares) at Dec. 31, 2023	57,858			57,858
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income				$ 63,966
Other comprehensive income (loss)				(4,095)
Ending balance at Jun. 30, 2024	$ 658,724	639,150	(15,429)	$ 1,282,445
Ending balance (in shares) at Jun. 30, 2024	58,192			58,192
Beginning balance at Mar. 31, 2024	$ 649,222	603,424	(12,456)	$ 1,240,190
Beginning balance (in shares) at Mar. 31, 2024	58,102
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income		35,726		35,726
Other comprehensive income (loss)			(2,973)	(2,973)
Stock-based compensation expense	$ 6,301			6,301
Options exercised	$ 2,913			2,913
Options exercised (in shares)	66
Issuance of common stock under Employee Stock Purchase Plan	$ 288			288
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4
Shares issued from time-vested restricted stock units (in shares)	20
Ending balance at Jun. 30, 2024	$ 658,724	$ 639,150	$ (15,429)	$ 1,282,445
Ending balance (in shares) at Jun. 30, 2024	58,192			58,192

Revenue from Contracts with Customers

6 Months Ended

Jun. 30, 2024

Revenue from Contract with Customer [Abstract]

Revenue from Contracts with Customers

3. Revenue from Contracts with Customers. We recognize revenue when a customer obtains control of promised goods. The amount of revenue recognized reflects the consideration we expect to receive in exchange for these goods. Our revenue recognition policies have not changed from those disclosed in Note 1 to our consolidated financial statements in Item 8 of the 2023 Annual Report on Form 10-K.

Disaggregation of Revenue

Our revenue is disaggregated based on reporting segment, product category and geographic region. We design, develop, manufacture and market medical products for interventional, diagnostic and therapeutic procedures. For financial reporting purposes, we report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of four product categories: peripheral intervention, cardiac intervention, custom procedural solutions, and original equipment manufacturer (“OEM”). Within these product categories, we sell a variety of products, including cardiology and radiology devices (which assist in diagnosing and treating coronary arterial disease, peripheral vascular disease and other non-vascular diseases), as well as embolotherapeutic, cardiac rhythm management, electrophysiology, critical care, breast cancer localization and guidance, biopsy, and interventional oncology and spine devices. Our endoscopy segment consists of gastroenterology and pulmonology devices which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures.

The following table presents revenue from contracts with customers by reporting segment, product category and geographic region for the three and six-month periods ended June 30, 2024 and 2023 (in thousands):


	Three Months Ended						Three Months Ended
	June 30, 2024						June 30, 2023
	United States		International		Total		United States		International		Total
Cardiovascular
Peripheral Intervention	$	82,356	$	56,891	$	139,247	$	71,973	$	53,936	$	125,909
Cardiac Intervention		36,840		57,023		93,863		35,690		58,085		93,775
Custom Procedural Solutions		30,496		19,920		50,416		29,155		20,229		49,384
OEM		35,460		8,829		44,289		34,570		7,637		42,207
Total		185,152		142,663		327,815		171,388		139,887		311,275

Endoscopy
Endoscopy Devices		9,512		676		10,188		8,194		587		8,781

Total	$	194,664	$	143,339	$	338,003	$	179,582	$	140,474	$	320,056


	Six Months Ended						Six Months Ended
	June 30, 2024						June 30, 2023
	United States		International		Total		United States		International		Total
Cardiovascular
Peripheral Intervention	$	161,615	$	112,258	$	273,873	$	140,640	$	99,052	$	239,692
Cardiac Intervention		72,183		112,368		184,551		69,995		109,108		179,103
Custom Procedural Solutions		59,790		39,420		99,210		55,954		41,131		97,085
OEM		68,109		15,446		83,555		67,134		16,237		83,371
Total		361,697		279,492		641,189		333,723		265,528		599,251

Endoscopy
Endoscopy Devices		19,061		1,261		20,322		17,219		1,151		18,370

Total	$	380,758	$	280,753	$	661,511	$	350,942	$	266,679	$	617,621

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org/606/tableOfContent

+ Details

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 35,726	$ 28,240	$ 20,245	$ 20,703	$ 63,966	$ 40,948

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

Derivatives (Tables)

6 Months Ended

Jun. 30, 2024

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Derivative Instruments in Statement of Financial Position, Fair Value

The fair value of derivative instruments on a gross basis was as follows on the dates indicated (in thousands):


Fair Value of Derivative Instruments Designated as Hedging Instruments	Balance Sheet Location	June 30, 2024		December 31, 2023
Assets
Interest rate swap	Prepaid expenses and other assets	$	254	$	1,503
Foreign currency forward contracts	Prepaid expenses and other assets		2,877		2,061
Foreign currency forward contracts	Other assets (long-term)		497		216

(Liabilities)
Foreign currency forward contracts	Accrued expenses		(954)		(1,898)
Foreign currency forward contracts	Other long-term obligations		(343)		(499)

Fair Value of Derivative Instruments Not Designated as Hedging Instruments	Balance Sheet Location	June 30, 2024		December 31, 2023
Assets
Foreign currency forward contracts	Prepaid expenses and other assets	$	1,572	$	828

(Liabilities)
Foreign currency forward contracts	Accrued expenses		(953)		(1,463)

Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)

Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income (“OCI”), accumulated other comprehensive income (“AOCI”), and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands):


	Amount of Gain/(Loss)					Consolidated Statements				Amount of Gain/(Loss)
	Recognized in OCI					of Income				Reclassified from AOCI
	Three Months Ended June 30,					Three Months Ended June 30,				Three Months Ended June 30,
Derivative instrument	2024		2023		Location in statements of income	2024			2023	2024			2023
Interest rate swap	$	(197)	$	719	Interest expense	$	(7,679)	$	(3,682)	$	699	$	631
Foreign currency forward contracts		(31)		4,325	Revenue		338,003		320,056		427		658
					Cost of sales		(176,903)		(167,274)		357		333


	Amount of Gain/(Loss)					Consolidated Statements				Amount of Gain/(Loss)
	Recognized in OCI					of Income				Reclassified from AOCI
	Six Months Ended June 30,					Six Months Ended June 30,				Six Months Ended June 30,
Derivative instrument	2024		2023		Location in statements of income	2024			2023	2024			2023
Interest rate swap	$	151	$	600	Interest expense	$	(15,725)	$	(5,693)	$	1,401	$	1,165
Foreign currency forward contracts		4,135		4,564	Revenue		661,511		617,621		840		1,985
					Cost of sales		(348,696)		(326,477)		784		283

Derivative Instruments, Gain (Loss)

The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the periods presented (in thousands):


		Three Months Ended June 30,				Six Months Ended June 30,
Derivative Instrument	Location in statements of income	2024		2023		2024		2023
Foreign currency forward contracts	Other income (expense) — net	$	645	$	2,141	$	1,528	$	3,200

Acquisitions - Angio Dynamics, Inc (Details) - Angio Dynamics Inc - USD ($) $ in Millions		6 Months Ended		12 Months Ended
	Jun. 08, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Asset Acquisition [Line Items]
Total purchase price	$ 100.0
Net sales related to acquisition		$ 11.6	$ 0.9
Acquisition-related costs				$ 4.9
Weighted Average
Asset Acquisition [Line Items]
Amortization period	10 years 6 months
Developed technology
Asset Acquisition [Line Items]
Amortization period	10 years
Trade Names
Asset Acquisition [Line Items]
Amortization period	11 years
Customer Lists
Asset Acquisition [Line Items]
Amortization period	10 years

Income Taxes

6 Months Ended

Jun. 30, 2024

Income Tax Disclosure [Abstract]

Income Taxes

7. Income Taxes. Our provision for income taxes for the three-month periods ended June 30, 2024 and 2023 was a tax expense of $10.1 million and $4.7 million, respectively, which resulted in an effective tax rate of 22.1% and 18.7%, respectively. Our provision for income taxes for the six-month periods ended June 30, 2024 and 2023 was a tax expense of $16.2 million and $9.5 million, respectively, which resulted in an effective tax rate of 20.2% and 18.8%, respectively. The increase in the effective income tax rate for the three and six-month periods ended June 30, 2024, when compared to the prior-year periods, was primarily due to decreased benefit from discrete items such as share-based compensation and deferred compensation and decreased foreign tax credit utilization. The increase in the income tax expense for the six-month period ended June 30, 2024, when compared to the prior-year period, was primarily due to increased pre-tax book income. Our effective tax rate differs from the U.S. statutory rate primarily due to the impact of global intangible low-taxed income (“GILTI”) inclusions, state income taxes, foreign taxes, other nondeductible permanent items and discrete items (such as share-based compensation).

The Organization for Economic Cooperation and Development (“OECD”) Pillar Two global minimum tax rules, which generally provide for a minimum effective tax rate of 15%, are intended to apply for tax years beginning in 2024. On February 2, 2023, the OECD issued administrative guidance providing transition and safe harbor rules around the implementation of the Pillar Two global minimum tax. Under a transitional safe harbor released July 17, 2023, the undertaxed profits rule top-up tax in the jurisdiction of a company's ultimate parent entity will be zero for each fiscal year of the transition period, if that jurisdiction has a corporate tax rate of at least 20%. The safe harbor transition period will apply to fiscal years beginning on or before December 31, 2025 and ending before December 31, 2026. While we expect our effective income tax rate and cash income tax payments could increase in future years as a result of the global minimum tax, we do not anticipate a material impact to our fiscal 2024 consolidated results of operations. Our assessment could be affected by legislative guidance and future enactment of additional provisions within the Pillar Two framework. We are closely monitoring developments and evaluating the impact these new rules are anticipated to have on our tax rate, including eligibility to qualify for these safe harbor rules.

- Definition

The entire disclosure for income tax.

+ References

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+ Details

Derivatives - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Designated as hedging instrument \| Interest rate swap
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	$ 300	$ 1,500
Designated as hedging instrument \| Interest rate swap \| Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	254	1,503
Designated as hedging instrument \| Foreign currency forward contracts \| Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	2,877	2,061
Designated as hedging instrument \| Foreign currency forward contracts \| Other assets (long-term)
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	497	216
Designated as hedging instrument \| Foreign currency forward contracts \| Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(954)	(1,898)
Designated as hedging instrument \| Foreign currency forward contracts \| Other long-term obligations
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(343)	(499)
Not designated as hedging instrument \| Foreign currency forward contracts \| Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Fair value of derivative asset	1,572	828
Not designated as hedging instrument \| Foreign currency forward contracts \| Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	$ (953)	$ (1,463)

Segment Reporting

6 Months Ended

Jun. 30, 2024

Segment Reporting [Abstract]

Segment Reporting

13. Segment Reporting. We report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of four product categories: peripheral intervention, cardiac intervention, custom procedural solutions, and OEM. Within these product categories, we sell a variety of products, including cardiology and radiology devices (which assist in diagnosing and treating coronary arterial disease, peripheral vascular disease and other non-vascular diseases), as well as embolotherapeutic, cardiac rhythm management, electrophysiology, critical care, breast cancer localization and guidance, biopsy, and interventional oncology and spine devices. Our endoscopy segment consists of gastroenterology and pulmonology devices which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures. Our chief operating decision maker is our Chief Executive Officer. We evaluate the performance of our operating segments based on net sales and income from operations.

Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the three and six-month periods ended June 30, 2024 and 2023, were as follows (in thousands):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Net sales
Cardiovascular	$	327,815	$	311,275	$	641,189	$	599,251
Endoscopy		10,188		8,781		20,322		18,370
Total net sales		338,003		320,056		661,511		617,621

Income from operations
Cardiovascular		42,912		26,464		75,819		50,398
Endoscopy		3,034		2,348		6,049		4,797
Total income from operations		45,946		28,812		81,868		55,195

Total other expense — net		(103)		(3,912)		(1,677)		(4,795)
Income tax expense		10,117		4,655		16,225		9,452

Net income	$	35,726	$	20,245	$	63,966	$	40,948

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

Debt - Principal Balances under Long-term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Long-term debt	$ 822,500
Less unamortized debt issuance costs	(21,179)	$ (23,550)
Total long-term debt	801,321	823,013
Long-term portion	801,321	823,013
Term Loan
Debt Instrument [Line Items]
Long-term debt	75,000	99,063
Convertible Notes
Debt Instrument [Line Items]
Long-term debt	$ 747,500	$ 747,500

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Subsequent Events (Details) $ in Millions	Jul. 01, 2024 USD ($)
Subsequent Event \| EGS Purchase Agreement
Subsequent Event [Line Items]
Purchase price	$ 105

Goodwill and Intangible Assets (Tables)

6 Months Ended

Jun. 30, 2024

Goodwill and Intangible Assets Disclosure [Abstract]

Changes in carrying amount of goodwill

The change in the carrying amount of goodwill for the six-month period ended June 30, 2024 is detailed as follows (in thousands):


	2024
Goodwill balance at January 1	$	382,240
Effect of foreign exchange		(807)
Goodwill balance at June 30	$	381,433

Other intangible assets

Other intangible assets at June 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	June 30, 2024
	Gross Carrying		Accumulated		Net Carrying
	Amount		Amortization		Amount
Patents	$	30,163	$	(11,876)	$	18,287
Distribution agreements		3,250		(2,956)		294
License agreements		11,094		(8,759)		2,335
Trademarks		35,123		(22,343)		12,780
Customer lists		40,225		(34,694)		5,531
Total	$	119,855	$	(80,628)	$	39,227


	December 31, 2023
	Gross Carrying		Accumulated		Net Carrying
	Amount		Amortization		Amount
Patents	$	28,877	$	(10,916)	$	17,961
Distribution agreements		3,250		(2,919)		331
License agreements		11,142		(8,327)		2,815
Trademarks		35,135		(20,804)		14,331
Customer lists		40,367		(33,921)		6,446
Total	$	118,771	$	(76,887)	$	41,884

Estimated amortization expense

Estimated amortization expense for developed technology and other intangible assets for the next five years consisted of the following as of June 30, 2024 (in thousands):


	Estimated Amortization Expense
Remaining 2024	$	31,367
2025		60,826
2026		49,776
2027		46,440
2028		45,024

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

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+ Details

Acquisitions - Bluegrass Vascular Technologies (Details) - USD ($) $ in Thousands	May 04, 2023	May 03, 2023
Bluegrass Vascular Technologies, Inc
Business Acquisition [Line Items]
Total purchase price	$ 32,700
Bluegrass Vascular Technologies, Inc \| Weighted Average
Business Acquisition [Line Items]
Amortization period	14 years 10 months 24 days
Bluegrass Vascular Technologies, Inc \| Developed technology
Business Acquisition [Line Items]
Amortization period	15 years
Bluegrass Vascular Technologies, Inc \| Trademarks
Business Acquisition [Line Items]
Amortization period	13 years
Bluegrass Vascular Technologies, Inc
Business Acquisition [Line Items]
Ownership percentage		19.50%
Investment of common shares		1,251,878
Equity method investment		$ 245

Acquisitions (Tables)

6 Months Ended

Jun. 30, 2024

Angio Dynamics Inc

Business Acquisition [Line Items]

Schedule of Purchase price allocation

The purchase price was allocated as follows (in thousands):


Assets Acquired
Prepaid expenses	$	2,000
Inventories		5,254
Property and equipment		108
Intangible assets
Developed technology		65,200
Trademarks		4,000
Customer list		5,800
Goodwill		17,638
Total net assets acquired	$	100,000

Bluegrass Vascular Technologies, Inc

Business Acquisition [Line Items]

Schedule of Purchase price allocation

The purchase price was allocated as follows (in thousands):


Assets Acquired
Inventories	$	175
Intangible assets
Developed technology		28,000
Trademarks		900
Goodwill		3,898
Total net assets acquired	$	32,973

CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
CONSOLIDATED STATEMENTS OF CASH FLOWS
Net capitalized interest	$ 428	$ 597

Earnings Per Common Share (EPS) (Tables)

6 Months Ended

Jun. 30, 2024

Earnings Per Share [Abstract]

Schedule of Earnings (Loss) Per Share, Basic and Diluted

The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the three and six-month periods ended June 30, 2024 and 2023 consisted of the following (in thousands, except per share amounts):


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2024		2023		2024		2023
Net income	$	35,726	$	20,245	$	63,966	$	40,948
Average common shares outstanding		58,139		57,537		58,049		57,445
Basic EPS	$	0.61	$	0.35	$	1.10	$	0.71

Average common shares outstanding		58,139		57,537		58,049		57,445
Effect of dilutive stock awards		601		936		604		884
Total potential shares outstanding		58,740		58,473		58,653		58,329
Diluted EPS	$	0.61	$	0.35	$	1.09	$	0.70

Equity awards excluded as the impact was anti-dilutive ⁽¹⁾		802		1,114		1,009		1,014

(1)	Does not reflect the impact of incremental repurchases under the treasury stock method.

Derivatives

6 Months Ended

Jun. 30, 2024

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivatives

9. Derivatives.

General. Our earnings and cash flows are subject to fluctuations due to changes in interest rates and foreign currency exchange rates, and we seek to mitigate a portion of the risks attributable to those fluctuations by entering into derivative contracts. The derivative instruments we use are interest rate swaps and foreign currency forward contracts. We recognize derivative instruments as either assets or liabilities at fair value in the accompanying consolidated balance sheets, regardless of whether hedge accounting is applied. We report cash flows arising from our hedging instruments consistent with the classification of cash flows from the underlying hedged items. Accordingly, cash flows associated with our derivative contracts are classified as operating activities in the accompanying consolidated statements of cash flows.

We formally document, designate and assess the effectiveness of transactions that receive hedge accounting treatment initially and on an ongoing basis. For qualifying hedges, the change in fair value is deferred in accumulated other comprehensive income, a component of stockholders’ equity in the accompanying consolidated balance sheets, and recognized in earnings at the same time the hedged item affects earnings. Changes in the fair value of derivative instruments not designated as hedging instruments are recorded in earnings throughout the term of the derivative.

Interest Rate Risk. Our debt bears interest at variable interest rates. Therefore, we are subject to variability in the cash payable for interest expense. In order to mitigate a portion of the risk attributable to such variability, we use a hedging strategy to reduce the variability of cash flows in the interest payments associated with a portion of the variable-rate debt outstanding under our Amended Fourth A&R Credit Agreement that varies in accordance with changes in the benchmark interest rate.

Derivatives Designated as Cash Flow Hedges

On December 23, 2019, we entered into a pay-fixed, receive-variable interest rate swap with a notional amount of $75 million with Wells Fargo. In June 2023, certain terms under the swap agreement were amended to reflect the transition from LIBOR to SOFR, an alternative reference rate. Under the interest rate swap agreement, we fixed the one-month SOFR rate on that portion of our borrowings under the Amended Fourth A&R Credit Agreement at 1.64% for the period from June 1, 2023 to July 31, 2024. The variable portion of the interest rate swap is tied to the one-month SOFR rate (the benchmark interest rate). On a monthly basis, the interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid.

On June 30, 2024 and December 31, 2023, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap as of June 30, 2024 was an asset of $0.3 million, which was partially offset by $0.1 million in deferred taxes. The fair value of our interest rate swap as of December 31, 2023 was an asset of $1.5 million, partially offset by $0.4 million in deferred taxes.

Foreign Currency Risk. We operate on a global basis and are exposed to the risk that our financial condition, results of operations, and cash flows could be adversely affected by changes in foreign currency exchange rates. To reduce the potential effects of foreign currency exchange rate movements on net earnings, we enter into derivative financial instruments in the form of foreign currency exchange forward contracts with major financial institutions. Our policy is to enter into foreign currency derivative contracts with maturities of up to two years. We are exposed to foreign currency exchange rate risk with respect to transactions and balances denominated in various currencies, with our most significant exposure related to transactions and balances denominated in Chinese Renminbi and Euros, among others. We do not use derivative financial instruments for trading or speculative purposes. We do not believe we are subject to any credit risk contingent features related to our derivative contracts, and we seek to manage counterparty risk by allocating derivative contracts among several major financial institutions.

Derivatives Designated as Cash Flow Hedges

For derivative instruments that are designated and qualify as cash flow hedges, the gain or loss on the derivative instrument is temporarily reported as a component of other comprehensive income and then reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. We entered into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating expenses in various international markets. The objective of the forward contracts is to reduce the variability of cash flows associated with the forecasted purchase or sale of the foreign currencies. As of June 30, 2024 and December 31, 2023, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with aggregate notional amounts of $134.0 million and $141.1 million, respectively.

Derivatives Not Designated as Cash Flow Hedges

We forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. As of June 30, 2024 and December 31, 2023, we had entered into foreign currency forward contracts related to those balance sheet accounts with aggregate notional amounts of $110.8 million and $108.4 million, respectively.

Balance Sheet Presentation of Derivative Instruments. As of June 30, 2024 and December 31, 2023, all derivative instruments, both those designated as hedging instruments and those that were not designated as hedging instruments, were recorded at fair value on a gross basis on our consolidated balance sheets. We are not subject to any master netting agreements.

The fair value of derivative instruments on a gross basis was as follows on the dates indicated (in thousands):


Fair Value of Derivative Instruments Designated as Hedging Instruments	Balance Sheet Location	June 30, 2024		December 31, 2023
Assets
Interest rate swap	Prepaid expenses and other assets	$	254	$	1,503
Foreign currency forward contracts	Prepaid expenses and other assets		2,877		2,061
Foreign currency forward contracts	Other assets (long-term)		497		216

(Liabilities)
Foreign currency forward contracts	Accrued expenses		(954)		(1,898)
Foreign currency forward contracts	Other long-term obligations		(343)		(499)

Fair Value of Derivative Instruments Not Designated as Hedging Instruments	Balance Sheet Location	June 30, 2024		December 31, 2023
Assets
Foreign currency forward contracts	Prepaid expenses and other assets	$	1,572	$	828

(Liabilities)
Foreign currency forward contracts	Accrued expenses		(953)		(1,463)

Income Statement Presentation of Derivative Instruments.

Derivative Instruments Designated as Cash Flow Hedges


	Amount of Gain/(Loss)					Consolidated Statements				Amount of Gain/(Loss)
	Recognized in OCI					of Income				Reclassified from AOCI
	Three Months Ended June 30,					Three Months Ended June 30,				Three Months Ended June 30,
Derivative instrument	2024		2023		Location in statements of income	2024			2023	2024			2023
Interest rate swap	$	(197)	$	719	Interest expense	$	(7,679)	$	(3,682)	$	699	$	631
Foreign currency forward contracts		(31)		4,325	Revenue		338,003		320,056		427		658
					Cost of sales		(176,903)		(167,274)		357		333


	Amount of Gain/(Loss)					Consolidated Statements				Amount of Gain/(Loss)
	Recognized in OCI					of Income				Reclassified from AOCI
	Six Months Ended June 30,					Six Months Ended June 30,				Six Months Ended June 30,
Derivative instrument	2024		2023		Location in statements of income	2024			2023	2024			2023
Interest rate swap	$	151	$	600	Interest expense	$	(15,725)	$	(5,693)	$	1,401	$	1,165
Foreign currency forward contracts		4,135		4,564	Revenue		661,511		617,621		840		1,985
					Cost of sales		(348,696)		(326,477)		784		283

As of June 30, 2024, $2.9 million, or $2.2 million after taxes, was expected to be reclassified from AOCI to earnings in revenue and cost of sales over the succeeding twelve months. As of June 30, 2024, $0.3 million, or $0.2 million after taxes, was expected to be reclassified from AOCI to earnings in interest expense over the succeeding twelve months.

Derivative Instruments Not Designated as Hedging Instruments

The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the periods presented (in thousands):


		Three Months Ended June 30,				Six Months Ended June 30,
Derivative Instrument	Location in statements of income	2024		2023		2024		2023
Foreign currency forward contracts	Other income (expense) — net	$	645	$	2,141	$	1,528	$	3,200

Stock-Based Compensation Expense - Narrative (Details) - USD ($) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Restricted stock units granted (in shares)			20,358
Employee Stock Option
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Options granted in period (in shares)		0	327,294
Compensation cost not yet recognized	$ 15.4	$ 15.4
Compensation cost not yet recognized, period of recognition		2 years
Stock-Settled Performance-Based Restricted Stock Units
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Compensation cost not yet recognized	20.3	$ 20.3
Compensation cost not yet recognized, period of recognition		2 years 1 month 6 days
Award vesting period		1 year
Stock-Settled Performance-Based Restricted Stock Units \| Maximum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock units granted in period (in shares)		364,810	286,863
Cash-Settled Performance-Based Share-Based Awards (Liability Awards)
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Target cash incentive		$ 1.6	$ 1.3
Compensation cost not yet recognized	4.4	$ 4.4
Compensation cost not yet recognized, period of recognition		2 years
Fair value of awards	$ 3.4	$ 3.4		$ 3.4
Cash-Settled Performance-Based Share-Based Awards (Liability Awards) \| Maximum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Target cash incentive		$ 4.4	$ 4.4
Multiplying factor		250.00%	250.00%
Restricted Stock Units
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Restricted stock units granted (in shares)	158,719
Compensation cost not yet recognized	$ 10.2	$ 10.2
Compensation cost not yet recognized, period of recognition		3 years 3 months 18 days
Restricted Stock Units \| Employee
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Award vesting period		4 years
Restricted Stock Units \| Non-employee members
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Award vesting period		1 year

Derivatives - Gain (Loss) in the Consolidated Statements of Income (Details) - Not designated as hedging instrument - Foreign currency forward contracts - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Derivative [Line Items]
Gain (loss) on derivative	$ 645	$ 2,141	$ 1,528	$ 3,200
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Accumulated goodwill impairment losses	$ 8.3		$ 8.3		$ 8.3
Goodwill impairment loss			0.0	$ 0.0
Aggregate amortization expense	$ 14.8	$ 13.4	29.4	25.7
Impairment of intangible assets			$ 0.0	$ 0.0

Acquisitions - SSI (Details) - SSI $ in Millions	Mar. 08, 2024 USD ($) item
Asset Acquisition [Line Items]
Purchase price	$ 3
Number of annual payments \| item	3
Amortization period	8 years
First Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	$ 1
Second Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	1
Third Payment
Asset Acquisition [Line Items]
Additional payments upon the achievement of specified milestones	$ 1

Revenue from Contracts with Customers (Tables)

6 Months Ended

Jun. 30, 2024

Revenue from Contract with Customer [Abstract]

Schedule of Disaggregation of Revenue


	Three Months Ended						Three Months Ended
	June 30, 2024						June 30, 2023
	United States		International		Total		United States		International		Total
Cardiovascular
Peripheral Intervention	$	82,356	$	56,891	$	139,247	$	71,973	$	53,936	$	125,909
Cardiac Intervention		36,840		57,023		93,863		35,690		58,085		93,775
Custom Procedural Solutions		30,496		19,920		50,416		29,155		20,229		49,384
OEM		35,460		8,829		44,289		34,570		7,637		42,207
Total		185,152		142,663		327,815		171,388		139,887		311,275

Endoscopy
Endoscopy Devices		9,512		676		10,188		8,194		587		8,781

Total	$	194,664	$	143,339	$	338,003	$	179,582	$	140,474	$	320,056


	Six Months Ended						Six Months Ended
	June 30, 2024						June 30, 2023
	United States		International		Total		United States		International		Total
Cardiovascular
Peripheral Intervention	$	161,615	$	112,258	$	273,873	$	140,640	$	99,052	$	239,692
Cardiac Intervention		72,183		112,368		184,551		69,995		109,108		179,103
Custom Procedural Solutions		59,790		39,420		99,210		55,954		41,131		97,085
OEM		68,109		15,446		83,555		67,134		16,237		83,371
Total		361,697		279,492		641,189		333,723		265,528		599,251

Endoscopy
Endoscopy Devices		19,061		1,261		20,322		17,219		1,151		18,370

Total	$	380,758	$	280,753	$	661,511	$	350,942	$	266,679	$	617,621

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Income Statement [Abstract]
Net sales	$ 338,003	$ 320,056	$ 661,511	$ 617,621
Cost of sales	176,903	167,274	348,696	326,477
Gross profit	161,100	152,782	312,815	291,144
Operating expenses:
Selling, general and administrative	94,585	100,927	189,013	191,071
Research and development	20,263	20,129	41,745	41,443
Impairment charges		270		270
Contingent consideration expense	306	1,094	189	1,615
Acquired in-process research and development		1,550		1,550
Total operating expenses	115,154	123,970	230,947	235,949
Income from operations	45,946	28,812	81,868	55,195
Other income (expense):
Interest income	7,561	221	14,837	352
Interest expense	(7,679)	(3,682)	(15,725)	(5,693)
Other income (expense) - net	15	(451)	(789)	546
Total other expense - net	(103)	(3,912)	(1,677)	(4,795)
Income before income taxes	45,843	24,900	80,191	50,400
Income tax expense	10,117	4,655	16,225	9,452
Net income	$ 35,726	$ 20,245	$ 63,966	$ 40,948
Earnings per common share
Basic (in dollars per share)	$ 0.61	$ 0.35	$ 1.10	$ 0.71
Diluted (in dollars per share)	$ 0.61	$ 0.35	$ 1.09	$ 0.70
Weighted average shares outstanding
Basic (in shares)	58,139	57,537	58,049	57,445
Diluted (in shares)	58,740	58,473	58,653	58,329

Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Finished goods	$ 152,180	$ 158,893
Work-in-process	38,049	25,420
Raw materials	107,995	119,558
Total Inventories	$ 298,224	$ 303,871

Stock-Based Compensation Expense - Allocation of Recognized Period Costs (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 7,011	$ 5,580	$ 12,245	$ 9,549
Cost of sales \| Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	363	432	725	873
Research and development \| Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	345	413	781	841
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	6,303	4,735	10,739	7,835
Selling, general and administrative \| Employee Stock Option
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	1,565	1,851	3,247	3,221
Selling, general and administrative \| Stock-Settled Performance-Based Restricted Stock Units
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	2,897	1,817	4,764	2,632
Selling, general and administrative \| Restricted Stock Units
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	1,131	467	1,718	911
Selling, general and administrative \| Cash-Settled Performance-Based Share-Based Awards (Liability Awards)
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 710	$ 600	$ 1,010	$ 1,071

Debt - Narrative (Details)	1 Months Ended
Debt - Narrative (Details)	Dec. 31, 2023 USD ($) $ / shares $ / derivative shares	Jun. 30, 2024 USD ($) $ / shares	Jun. 06, 2023 USD ($)
Debt Instrument [Line Items]
Outstanding borrowings		$ 822,500,000
Credit Agreement
Debt Instrument [Line Items]
Outstanding borrowings		75,000,000.0
Letter of credit guarantees		2,400,000
Available borrowing capacity		$ 680,000,000
Fixed interest rate percent	3.39%	3.39%
Debt subject to fixed interest rate	$ 75,000,000
Variable interest rate percent	7.21%
Debt subject to variable interest rate	$ 24,100,000
Term Loan
Debt Instrument [Line Items]
Outstanding borrowings	$ 99,063,000	$ 75,000,000
Term Loan \| Credit Agreement
Debt Instrument [Line Items]
Debt instrument, face amount			$ 150,000,000
Revolving Credit Facility \| Credit Agreement
Debt Instrument [Line Items]
Maximum borrowing capacity			$ 700,000,000
Senior unsecured convertible notes \| Convertible debt
Debt Instrument [Line Items]
Interest rate	3.00%
Net proceeds from convertible notes	$ 724,800,000
Shares issued upon conversion \| shares	11.5171
Debt instrument conversion ratio multiple of principal	$ 1,000
Repurchase percentage on principal, accrued and unpaid interest	100.00%
Number of business days period after consecutive trading days	5 days
Consecutive trading days, trading price per share after which to be observed for conversion	10 days
Percentage of sale price	98.00%
Common stock at a price per share less than the average closing sale price	60 days
Purchase shares of common stock at a price per share less than the average closing sale price of consecutive trading days	10 days
Percentage of distribution to common stockholders	10.00%
Percentage of applicable conversion price	130.00%
Percentage of applicable conversion price on each applicable trading day	20 days
Consecutive trading day period ending	30 days
Senior unsecured convertible notes \| Convertible debt \| Call option
Debt Instrument [Line Items]
Cap price \| $ / derivative	114.68
Capped call transaction cost	$ 66,500,000
Senior unsecured convertible notes \| Convertible debt \| Common Stock
Debt Instrument [Line Items]
Conversion price \| $ / shares	$ 86.83	$ 86.83
Senior unsecured convertible notes \| Convertible debt \| Minimum
Debt Instrument [Line Items]
Reported sales price of common stock	130.00%
Conversion price then in effect for at least number of trading days	20 days

Income Taxes - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
Income Taxes - Narrative (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Income tax expense	$ 10,117	$ 4,655	$ 16,225	$ 9,452
Effective tax rate	22.10%	18.70%	20.20%	18.80%

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References

+ Details

Accumulated Other Comprehensive Income (Loss) - Changes in AOCI (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Accumulated other comprehensive income (loss)
Beginning balance	$ 1,240,190	$ 1,171,655	$ 1,202,000	$ 1,144,397
Reclassifications to:
Cost of sales	(176,903)	(167,274)	(348,696)	(326,477)
Interest expense	(7,679)	(3,682)	(15,725)	(5,693)
Ending balance	1,282,445	1,203,700	1,282,445	1,203,700
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss)
Beginning balance	(12,456)	(10,929)	(11,334)	(11,550)
Other comprehensive income (loss)	(1,916)	3,843	(806)	5,888
Income taxes	426	(836)	(264)	(449)
Reclassifications to:
Net other comprehensive income (loss)	(2,973)	1,385	(4,095)	2,006
Ending balance	(15,429)	(9,544)	(15,429)	(9,544)
Accumulated Other Comprehensive Loss \| Reclassification out of Accumulated Other Comprehensive Income
Reclassifications to:
Revenue	(427)	(658)	(840)	(1,985)
Cost of sales	(357)	(333)	(784)	(283)
Interest expense	(699)	(631)	(1,401)	(1,165)
Cash Flow Hedges
Accumulated other comprehensive income (loss)
Beginning balance	3,932	3,081	1,662	4,366
Other comprehensive income (loss)	(228)	5,044	4,286	5,164
Income taxes	404	(821)	(298)	(415)
Reclassifications to:
Net other comprehensive income (loss)	(1,307)	2,601	963	1,316
Ending balance	2,625	5,682	2,625	5,682
Cash Flow Hedges \| Reclassification out of Accumulated Other Comprehensive Income
Reclassifications to:
Revenue	(427)	(658)	(840)	(1,985)
Cost of sales	(357)	(333)	(784)	(283)
Interest expense	(699)	(631)	(1,401)	(1,165)
Foreign Currency Translation
Accumulated other comprehensive income (loss)
Beginning balance	(16,388)	(14,010)	(12,996)	(15,916)
Other comprehensive income (loss)	(1,688)	(1,201)	(5,092)	724
Income taxes	22	(15)	34	(34)
Reclassifications to:
Net other comprehensive income (loss)	(1,666)	(1,216)	(5,058)	690
Ending balance	$ (18,054)	$ (15,226)	$ (18,054)	$ (15,226)