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Equity Incentive Plans
 9 Months Ended
Sep. 30, 2025
Share-Based Payment Arrangement [Abstract]  
Equity Incentive Plans Equity Incentive Plans
Stock-based Compensation
The Company recorded stock-based compensation cost for the periods presented as follows (in thousands):
Three Months Ended
September 30,		Nine Months Ended
September 30,
2025202420252024
Cost of revenue$2,011 $2,169 $6,481 $6,127 
Research and development11,318 15,978 38,037 50,728 
Selling, general and administrative11,935 15,763 39,067 51,354 
Total stock-based compensation expense$25,264 $33,910 $83,585 $108,209 
Restricted Stock Units
Restricted stock units (“RSUs”) activity for the nine months ended September 30, 2025 is as follows:
Restricted Stock
Units		Weighted-Average
Grant Date Fair Value
(per share)
Outstanding as of December 31, 20246,493,387 $35.55 
Granted5,579,963 10.49 
Vested(2,267,488)32.54 
Cancelled(1,339,829)28.24 
Outstanding as of September 30, 20258,466,033 $21.00 
Stock Options
Stock option activity for the nine months ended September 30, 2025 is as follows:
Stock OptionsWeighted-Average
Exercise Price
Outstanding as of December 31, 20244,594,582 $45.37 
Exercised(433,463)2.54 
Cancelled and forfeited(460,484)66.32 
Outstanding as of September 30, 20253,700,635 $47.78 
Performance Stock Awards
In March 2025, the Company granted 561,603 performance stock units (“PSUs”) under the 2019 Omnibus Incentive Plan (“2019 plan”) to certain members of management which are subject to the achievement of certain performance conditions established by the Company’s Compensation Committee of the Board of Directors as described below:

i.50% of target PSUs earned will be based on the Company’s compound annual growth rate (“CAGR”) of the Company’s Revenue over a two-year performance period from January 1, 2025 to December 31, 2026. Holders may earn from 0% to 200% of the target amount of shares and earned PSUs will then be subject to service-based vesting; and

ii.50% of target PSUs earned will be based on the relative Total Shareholder Return (“TSR”) of the Company’s Class A common stock as compared to the TSR of the members of the Russell 3000 Medical Equipment and Services Sector Index over a three-year performance period from January 1, 2025 to December 31, 2027. Depending on the results relative to the TSR market condition, the holders may earn from 0% to 200% of the target amount of shares which will vest at the end of the performance period.
The PSUs will be forfeited if the performance conditions are not achieved at the end of the relative performance periods as described above. The vesting of the PSUs can also be triggered upon certain change in control events or in the event of death or disability.
The weighted-average grant date fair values of the PSUs relating to CAGR and TSR components were $10.76 and $13.94 per share, respectively. Stock-based compensation expense recognized for the PSUs relating to TSR components were approximately $0.3 million and $0.7 million for the three and nine months ended September 30, 2025, respectively. The PSUs relating to CAGR components were not deemed probable of vesting as of September 30, 2025, and no expenses were recognized for 2025.
The Company estimated the fair values of shares granted under the market-based TSR PSUs using a Monte Carlo simulation model with the following assumptions:
Expected volatility 67%
Risk-free interest rate4.0%
Expected dividend yield—%
In March 2024, the Company granted 219,168 PSUs under the 2019 Plan to certain members of management, which are subject to the achievement of certain market-condition and performance-condition goals established by the Company’s Compensation Committee of the Board of Directors.
As of September 30, 2025, the measurement periods for the 2025 and 2024 PSUs were not completed and the market and performance criteria for the stock awards was not met and therefore no shares vested or became exercisable.
2019 Employee Stock Purchase Plan
A total of 4,909,589 shares of Class A common stock were reserved for issuance under the 2019 Employee Stock Purchase Plan (“ESPP”). The price at which Class A common stock is purchased under the ESPP is equal to 85% of the fair market value of the common stock on the first day of the offering period or purchase date, whichever is lower.
During the nine months ended September 30, 2025 and 2024, 446,766 and 192,869 shares of Class A common stock, respectively, were issued under the ESPP. There were no shares of Class A common stock issued under the ESPP during the three months ended September 30, 2025 and 2024. As of September 30, 2025, there were 3,481,248 shares available for issuance under the ESPP.