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Goodwill and Other Intangible Assets | 9 Months Ended
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Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill and Other Intangible Assets | Goodwill and Other Intangible Assets The changes in the net carrying amount of goodwill for the nine months ended September 30, 2021 are as follows:
Balance as of December 31, 2020 | $ | 618,440 |
Foreign currency translation | (789) |
Balance as of September 30, 2021 | $ | 617,651 |
Assets and liabilities of acquired businesses are recorded at their estimated fair values as of the date of acquisition. Goodwill represents costs in excess of fair values assigned to the underlying net assets of acquired businesses. Other intangible assets consist of the following:
| September 30, 2021 |  | December 31, 2020
| Weighted Average Amortization Period (Years) | Gross Carrying Amount |  | Accumulated Amortization |  | Gross Carrying Amount |  | Accumulated Amortization
Intangible assets with definite lives: | 22 |  |  |  |  |  |  |
Customer and distributor relationships | 24 | $ | 342,501 |  |  | $ | (148,330) |  |  | $ | 342,639 |  |  | $ | (134,555) |
Sales representation, marketing and promotional rights | 25 | 149,376 |  |  | (58,500) |  |  | 149,376 |  |  | (54,000) |
Developed technology | 16 | 106,604 |  |  | (24,801) |  |  | 106,604 |  |  | (19,705) |
Patents and other intangible assets | 16 | 75,836 |  |  | (50,369) |  |  | 73,516 |  |  | (48,882) |
Intangible assets with indefinite lives: |  |  |  |  |  |  |  |
Trademarks and tradenames |  | 86,544 |  |  | — |  |  | 86,544 |  |  | — |
|  | $ | 760,861 |  |  | $ | (282,000) |  |  | $ | 758,679 |  |  | $ | (257,142) |
Customer and distributor relationships, trademarks and tradenames, developed technology and patents and other intangible assets primarily represent allocations of purchase price to identifiable intangible assets of acquired businesses. Sales representation, marketing and promotional rights represent intangible assets created under our agreement with Musculoskeletal Transplant Foundation (“MTF”). Amortization expense related to intangible assets which are subject to amortization totaled $8.3 million and $8.6 million in the three months ended September 30, 2021 and 2020, respectively, and $24.9 million and $25.6 million in the nine months ended September 30, 2021 and 2020, respectively, and is included as a reduction of revenue (for amortization related to our sales representation, marketing and promotional rights) and in selling and administrative expense (for all other intangible assets) in the consolidated condensed statements of comprehensive income (loss). Included in developed technology is $3.5 million of earn-out consideration that was paid during the third quarter of 2021 and an additional accrual of $2.4 million of earn-out consideration that is considered probable as of September 30, 2021 associated with a prior asset acquisition. This is recorded in other current liabilities at September 30, 2021. The estimated intangible asset amortization expense remaining for the year ending December 31, 2021 and for each of the five succeeding years is as follows:
| Amortization included in expense |  | Amortization recorded as a reduction of revenue |  | Total
Remaining, 2021 | $ | 7,187 |  |  | $ | 1,500 |  |  | $ | 8,687 |
2022 | 26,554 |  |  | 6,000 |  |  | 32,554 |
2023 | 25,679 |  |  | 6,000 |  |  | 31,679 |
2024 | 24,929 |  |  | 6,000 |  |  | 30,929 |
2025 | 25,145 |  |  | 6,000 |  |  | 31,145 |
2026 | 24,652 |  |  | 6,000 |  |  | 30,652 |

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- Definition The entire disclosure for goodwill and intangible assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -URI http://asc.fasb.org/topic&trid=2144416 + Details
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