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Intangible Assets, Net | 12 Months Ended
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Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract] |
Intangible Assets, Net | Intangible Assets, Net Intangible assets consist of the following:
|  | December 31, 2022 |  | December 31, 2021
(in thousands) |  | Gross Carrying Amount |  | Accumulated Amortization |  | Net Carrying Amount |  | Gross Carrying Amount |  | Accumulated Amortization |  | Net Carrying Amount
Amortizable intangible assets: |  |  |  |  |  |  |  |  |  |  |  |
Patents |  | $ | 3,792 |  |  | $ | (621) |  |  | $ | 3,170 |  |  | $ | 2,469 |  |  | $ | (234) |  |  | $ | 2,235 |
License agreements |  | 1,101 |  |  | (1,014) |  |  | 87 |  |  | 1,101 |  |  | (852) |  |  | 249 |
Total amortizable intangible assets |  | 4,893 |  |  | (1,635) |  |  | 3,258 |  |  | 3,570 |  |  | (1,086) |  |  | 2,484 |
Unamortized intangible assets: |  |  |  |  |  |  |  |  |  |  |  |
Trademarks |  | 391 |  |  | — |  |  | 391 |  |  | 375 |  |  | — |  |  | 375 |
Total intangible assets |  | $ | 5,284 |  |  | $ | (1,635) |  |  | $ | 3,649 |  |  | $ | 3,945 |  |  | $ | (1,086) |  |  | $ | 2,859 |
The amortization expense is as follows for the years ended:
| December 31,
| 2022 |  | 2021 |  | 2020
Amortization expense | $ | 265 |  |  | 202 |  |  | 153 |
As of December 31, 2022, future amortization of patents and license agreements are as follows:
Year Ending December 31, | (in thousands)
2023 | $ | 250 |
2024 | 181 |
2025 | 181 |
2026 | 180 |
2027 | 176 |
Thereafter | 2,290 |
Total | $ | 3,258 |
License Agreements The Company has multiple license agreements with the University of Florida Research Foundation and the University of Texas at Austin (the "License Agreements") in which the Company acquired exclusive worldwide licenses for underlying technology used in repairing and regenerating nerves. The licensed technologies include the rights to issued patents and patents pending in the U.S. and international markets. The effective term of the License Agreements extends through the term of the related patents. The Company pays royalty fees ranging from 1% to 3% under the License Agreements based on net sales of licensed products. Also, when the Company pays royalties to more than one licensor for sales of the same product, a royalty stack cap applies, capping total royalties at 3.75%. Royalty fees included in sales and marketing on the consolidated statement of operations are as follows for the years ended:
| December 31,
| 2022 |  | 2021 |  | 2020
Royalty fees | $ | 3,103 |  |  | $ | 2,715 |  |  | $ | 2,289 |

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- Definition The entire disclosure for all or part of the information related to intangible assets. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -URI https://asc.fasb.org/subtopic&trid=2144471 + Details
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