v3.25.0.1
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash flows from operating activities:      
Net income $ 102,984 $ 122,873 $ 190,169
Adjustments to reconcile net income to net cash provided by operating activities:      
Acquired in-process research and development 12,613   150
Depreciation and amortization 254,024 144,733 68,252
Amortization of premiums on marketable securities (635) 793 5,389
Provision for excess and obsolete inventory 23,359 10,959 6,400
Amortization of inventory fair value step up 215,420 71,656  
Amortization of 2025 Notes fair value step up 26,630 8,176  
Stock-based compensation expense 54,191 52,742 32,810
Allowance for expected credit losses 16,986 3,658 (1)
Change in fair value of business acquisition liabilities 26,521 17,434 5,132
Change in deferred income taxes (125,902) (57,789) (22,223)
(Gain)/loss on disposal of assets, net 5,552 1,541 299
Payment of business acquisition-related liabilities (18,763) (3,005) (2,647)
Net (gain)/loss from foreign currency adjustment 25,212 (13,674)  
(Increase) decrease in:      
Accounts receivable (78,062) (49,914) (50,843)
Inventories (29,860) (70,328) (61,745)
Prepaid expenses and other assets 1,059 1,148 (10,292)
Increase (decrease) in:      
Accounts payable 17,663 (14,223) 14,418
Accrued expenses and other liabilities 5,023 17,127 6,087
Income taxes payable/receivable (13,377) (408) (2,887)
Net cash provided by/(used in) operating activities 520,638 243,499 178,468
Cash flows from investing activities:      
Purchases of marketable securities (113,504) (100,643) (419,534)
Maturities of marketable securities 58,666 240,190 312,221
Sales of marketable securities 11,851 537,723 102,433
Purchases of property and equipment (115,429) (78,274) (74,047)
Acquisition of businesses, net of cash acquired and purchases of intangible and other assets (17,635) (296,028) (31,435)
Net cash provided by/(used in) investing activities (176,051) 302,968 (110,362)
Cash flows from financing activities:      
Payment of business acquisition-related liabilities (45,619) (8,039) (7,185)
Net proceeds from exercise of stock options 110,439 12,397 41,716
Payments related to tax withholdings for share-based compensation (6,729) (10,617)  
Repurchase of common stock (85,787) (225,562) (144,493)
Net cash provided by/(used in) financing activities (27,696) (231,821) (109,962)
Effect of foreign exchange rates on cash 255 2,180 (747)
Net increase/(decrease) in cash and cash equivalents 317,146 316,826 (42,603)
Cash and cash equivalents at beginning of period 467,292 150,466 193,069
Cash and cash equivalents at end of period 784,438 467,292 150,466
Supplemental disclosures of cash flow information:      
Income taxes paid, net 158,508 100,593 77,823
Non-cash investing and financing activities:      
Equity issued in conjunction with the NuVasive Merger   2,153,860  
Accrued purchases of property and equipment $ 9,281 $ 7,100 $ 7,423