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Business Segment and Geographic Areas | 12 Months Ended
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Dec. 31, 2024
Segment Reporting [Abstract] |
Business Segment and Geographic Areas | Business Segment and Geographic Areas We account and report for our business as a single operating segment entity engaged in the development, manufacturing and sale on a global basis of surgical devices and related equipment. The Company derives revenue globally and manages the business on a consolidated basis due to shared infrastructure and resources. Our chief operating decision maker ("CODM"), the President and Chief Executive Officer, evaluates the various global product portfolios on a net sales basis and evaluates profitability, investment, cash flow metrics and allocates resources on a consolidated worldwide basis. Our product lines consist of orthopedic surgery and general surgery. Orthopedic surgery consists of sports medicine and lower extremities instrumentation and implants, small bone, large bone and specialty powered surgical instruments as well as imaging systems for use in minimally invasive surgical procedures and fees related to sales representation, promotion and marketing of sports medicine allograft tissue. General surgery consists of a complete line of endo-mechanical instrumentation for minimally invasive laparoscopic and gastrointestinal procedures, smoke evacuation devices, a line of cardiac monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales and primary geographic market where the products are sold, are as follows for the years ended December 31, 2024, 2023 and 2022:
| 2024
| Orthopedic Surgery |  | General Surgery |  | Total
Primary Geographic Markets |  |  |  |  |
United States | $ | 210,670 |  |  | $ | 537,554 |  |  | $ | 748,224 |
Europe, Middle East & Africa | 132,106 |  |  | 110,958 |  |  | 243,064 |
Asia Pacific | 119,766 |  |  | 74,918 |  |  | 194,684 |
Americas (excluding the United States) | 81,446 |  |  | 39,597 |  |  | 121,043 |
Total sales from contracts with customers | $ | 543,988 |  |  | $ | 763,027 |  |  | $ | 1,307,015 |
| 2023
| Orthopedic Surgery |  | General Surgery |  | Total
Primary Geographic Markets |  |  |  |  |
United States | $ | 199,568 |  |  | $ | 500,592 |  |  | $ | 700,160 |
Europe, Middle East & Africa | 127,637 |  |  | 98,616 |  |  | 226,253 |
Asia Pacific | 123,043 |  |  | 74,358 |  |  | 197,401 |
Americas (excluding the United States) | 82,910 |  |  | 38,020 |  |  | 120,930 |
Total sales from contracts with customers | $ | 533,158 |  |  | $ | 711,586 |  |  | $ | 1,244,744 |
| 2022
| Orthopedic Surgery |  | General Surgery |  | Total
Primary Geographic Markets |  |  |  |  |
United States | $ | 173,176 |  |  | $ | 405,777 |  |  | $ | 578,953 |
Europe, Middle East & Africa | 113,649 |  |  | 84,288 |  |  | 197,937 |
Asia Pacific | 103,353 |  |  | 59,124 |  |  | 162,477 |
Americas (excluding the United States) | 71,350 |  |  | 34,755 |  |  | 106,105 |
Total sales from contracts with customers | $ | 461,528 |  |  | $ | 583,944 |  |  | $ | 1,045,472 |
Sales are attributed to countries based on the location of the customer. We held $139.9 million and $127.3 million of long-lived assets in the United States at December 31, 2024 and 2023, respectively. We held $22.9 million and $18.3 million of long-lived assets in Mexico at December 31, 2024 and 2023, respectively. There were no significant investments in long-lived assets in other countries outside the United States at December 31, 2024 and 2023. No single customer represented over 10% of our consolidated net sales for the years ended December 31, 2024, 2023 and 2022. The accounting policies of our single operating segment are the same as those described in Note 1. The CODM assesses performance for the single operating segment and decides how to allocate resources and make investment decisions based on net income (loss), consistent with what is reported on the consolidated statements of comprehensive income (loss). Net income is used to monitor budget versus actual results. The CODM also uses net income in competitive analysis by benchmarking to CONMED’s competitors. The competitive analysis along with the monitoring of budgeted versus actual results are used in assessing performance of the single segment. The following table includes significant segment expenses for the years ended December 31, 2024, 2023 and 2022:
| Years Ended
| December 31,
| 2024 |  | 2023 |  | 2022
Net sales | $ | 1,307,015 |  |  | $ | 1,244,744 |  |  | $ | 1,045,472 |
Cost of sales | 573,983 |  |  | 568,499 |  |  | 474,227 |
Salesforce and commission expense | 225,886 |  |  | 215,799 |  |  | 186,596 |
Marketing expense | 65,338 |  |  | 60,918 |  |  | 56,027 |
Distribution expense | 50,183 |  |  | 53,701 |  |  | 44,874 |
General and administrative expense | 117,463 |  |  | 111,235 |  |  | 96,108 |
Stock-based compensation expense | 25,558 |  |  | 24,257 |  |  | 21,729 |
Amortization expense | 28,629 |  |  | 29,068 |  |  | 27,791 |
Non-cash adjustments to fair value of contingent consideration liability | (41,048) |  |  | (2,421) |  |  | 2,518 |
Research and development expense | 54,426 |  |  | 52,602 |  |  | 47,152 |
Interest expense | 37,297 |  |  | 39,775 |  |  | 28,905 |
Loss on convertible notes and related hedge transactions(b) | — |  |  | — |  |  | 112,011 |
Provision for income taxes | 30,606 |  |  | 16,369 |  |  | 9,720 |
Other segment items(a) | 6,271 |  |  | 10,483 |  |  | 18,396 |
Net income (loss) | $ | 132,423 |  |  | $ | 64,459 |  |  | $ | (80,582) |
(a)Other segment items consist of restructuring and related costs in 2024, 2023 and 2022; third party services pertaining to review of potential issues with certain royalty payments to surgeons involved in design teams in 2024; income/expense related to the termination of a distributor agreement in 2024 and 2023; lease impairment costs in 2024; acquisition and integration costs in 2023 and 2022; software implementation costs in 2023 and 2022; and a legal settlement in 2022. (b)Loss on convertible notes and related hedge transactions consists of loss on early extinguishment of debt, loss on convertible notes conversion premium and loss on convertible notes hedge transactions settlement in 2022. Total assets for the Company's single operating segment are the same as presented on the Company's consolidated balance sheet, which is used to measure segment performance.

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- Definition The entire disclosure for reporting segments including data and tables. 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