0001127537-24-000024 | 10-K | XBRL Viewer

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Net Loss per Share Attributable to Common Stockholders - Computation of Basic and Diluted Net Loss per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Numerator
Net loss attributable to common stockholders, basic	$ (60,843)	$ (58,923)
Net loss attributable to common stockholders, diluted	$ (60,843)	$ (58,923)
Denominator
Weighted-average common stock outstanding (in shares)	37,998,509	37,248,292
Less: weighted-average common shares subject to repurchase (in shares)	(23,942)	(151,751)
Weighted-average shares used in computing net loss per share attributable to common stockholders, basic (in shares)	37,974,567	37,096,541
Weighted-average shares used in computing net loss per share attributable to common stockholders, diluted (in shares)	37,974,567	37,096,541
Net loss per share attributable to common stockholders, basic (in dollars per share)	$ (1.60)	$ (1.59)
Net loss per share attributable to common stockholders, diluted (in dollars per share)	$ (1.60)	$ (1.59)

Revenue Recognition (Details) - USD ($) $ in Millions	12 Months Ended
Revenue Recognition (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Deferred revenue	$ 0.1	$ 0.1	$ 0.2
Revenue recognized	$ 0.1	$ 0.2

Fair Value Measurements

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Fair Value Measurements

Assets and liabilities recorded at fair value in the consolidated financial statements are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Hierarchical levels which are directly related to the amount of subjectivity associated with the inputs to the valuation of these assets or liabilities are as follows:

Level 1—Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date.

Level 2—Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities.

Level 3—Unobservable inputs for the asset or liability only used when there is little, if any, market activity for the asset or liability at the measurement date. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value.

Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis—Financial assets and liabilities held by the Company measured at fair value on a recurring basis include money market funds and marketable securities.

Assets and Liabilities Measured and Recorded at Fair Value on a Nonrecurring Basis—The Company determines the fair value of long-lived assets held and used, such as intangible assets, by reference to independent appraisals, quoted market prices (e.g. an offer to purchase) and other factors. An impairment charge is recorded when the carrying value of the asset exceeds its fair value. As noted above, there have been no impairment charges recorded

to date. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates the fair value. The fair value of the term loan is estimated using Level 2 inputs.

Assets and liabilities measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires management to make judgments and consider factors specific to the asset or liability.

The following tables summarizes the types of assets and liabilities measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands):


	December 31, 2023
	Level 1		Level 2		Level 3		Total
Assets:
Cash equivalents:
Money market funds	$	25,129	$	—	$	—	$	25,129
Total cash equivalents	25,129		—		—		25,129
Marketable securities:
U.S. Government agency bonds	5,798		29,466		—		35,264
Commercial paper	—		12,681		—		12,681
Total marketable securities	5,798		42,147		—		47,945
Total financial assets	$	30,927	$	42,147	$	—	$	73,074


	December 31, 2022
	Level 1		Level 2		Level 3		Total
Assets:
Cash equivalents:
Money market funds	$	4,647	$	—	$	—	$	4,647
Total cash equivalents	4,647		—		—		4,647
Marketable securities:
U.S. Government agency bonds	14,743		15,872		—		30,615
Commercial paper	—		14,711		—		14,711
Total marketable securities	14,743		30,583		—		45,326
Total financial assets	$	19,390	$	30,583	$	—	$	49,973

There were no liabilities measured at fair value on a recurring and non-recurring basis as of December 31, 2023 and December 31, 2022.

The following table summarizes the cost, unrealized gains and losses and fair value of marketable securities (in thousands):


	December 31, 2023
	Amortized Cost		Unrealized Losses		Unrealized Gains		Fair Value
U.S. Government agency bonds	$	35,194	$	(26)	$	96	$	35,264
Commercial paper	12,667		(1)		15		12,681
Total	$	47,861	$	(27)	$	111	$	47,945


	December 31, 2022
	Amortized Cost		Unrealized Losses		Unrealized Gains		Fair Value
U.S. Government agency bonds	$	30,897	$	(282)	$	—	$	30,615
Commercial paper	14,740		(31)		2		14,711
Total	$	45,637	$	(313)	$	2	$	45,326

The following table summarizes the marketable securities with unrealized losses as of December 31, 2023 and December 31, 2022, aggregated by major security type and the length of time that individual securities have been in a continuous loss position (in thousands):


	December 31, 2023
	Less than 12 months				12 months or greater				Total
	Fair Value		Unrealized Losses		Fair Value		Unrealized Losses		Fair Value		Unrealized Losses
U.S. Government agency bonds	$	11,888	$	(23)	$	1,745	$	(3)	$	13,633	$	(26)
Commercial paper	996		(1)		—		—		996		(1)
Total	$	12,884	$	(24)	$	1,745	$	(3)	$	14,629	$	(27)


	December 31, 2022
	Less than 12 months				12 months or greater				Total
	Fair Value		Unrealized Losses		Fair Value		Unrealized Losses		Fair Value		Unrealized Losses
U.S. Government agency bonds	$	19,768	$	(139)	$	10,847	$	(143)	$	30,615	$	(282)
Commercial paper	11,818		(31)		—		—		11,818		(31)
Total	$	31,586	$	(170)	$	10,847	$	(143)	$	42,433	$	(313)

The unrealized losses for marketable securities relate to changes in interest rates. During the years ended December 31, 2023 and December 31, 2022, the Company did not consider any of its marketable securities to be other-than-temporarily impaired. No allowance for credit losses was recorded as of December 31, 2023 and December 31, 2022, and no impairment losses were recognized for the years ended December 31, 2023 and December 31, 2022.

At December 31, 2023 and December 31, 2022, accrued interest receivable on marketable securities of $0.4 million and $0.1 million was included in prepaid expenses and other current assets on the consolidated balance sheets, respectively. The Company elected to exclude accrued interest receivable from the estimation of expected credit losses on its marketable securities and reverse accrued interest receivable through interest income (expense) when

amounts are determined to be uncollectible. The Company did not write off any accrued interest receivable during the years ended December 31, 2023 and December 31, 2022.

The following table summarizes the contractual maturities of the Company’s marketable securities (in thousands):


	December 31, 2023
	Amortized Cost		Fair Value
Due within one year	$	33,551	$	33,555
Due in one year to five years	$	14,310	$	14,390
Total	$	47,861	$	47,945

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Long Term Debt - CIBC Loan Narrative (Details)		1 Months Ended					12 Months Ended
Long Term Debt - CIBC Loan Narrative (Details)	Feb. 20, 2020 USD ($)	Feb. 28, 2023 USD ($)	Oct. 31, 2022 USD ($)	Oct. 31, 2021	Mar. 31, 2021 USD ($)	Apr. 30, 2020 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Mar. 31, 2022 payment
Debt Instrument [Line Items]
Proceeds from borrowing under term loan							$ 20,000,000	$ 0
Payment of fees to lender and third parties (less than)							0	53,000
Amortization of debt discount and debt issuance costs							48,000	$ 56,000
Medium-term Notes \| CIBC Agreement
Debt Instrument [Line Items]
Revenue threshold for interest period extension term option			$ 5,000,000
CIBC Agreement \| Medium-term Notes
Debt Instrument [Line Items]
Debt instrument, face amount including accordion feature	$ 32,000,000
Proceeds from borrowing under term loan		$ 20,000,000
Debt term	5 years
Interest payments term	24 months			24 months
Principal and interest payments term	36 months			36 months
Fee amount						$ 200,000
Gain (loss) on amendment of debt instrument			0		$ 0
Number of periodic payments \| payment									36
Payment of fees to lender and third parties (less than)			$ 100,000		$ 100,000		$ 500,000
Increase in loan interest rate				0
New interest only period			24 months
New interest only extension period			12 months
Cash and cash equivalents trigger for revenue requirement		$ 100,000,000
Minimum percentage of revenue requirement, trailing period of revenue		3 months
Minimum percentage of revenue requirement, trailing period of revenue		80.00%
Cash and cash equivalents trigger for revenue requirement (less than)		$ 20,000,000
Unrestricted cash requirement period		6 months
Effective interest rate (as a percent)							10.10%	9.10%
Amortization of debt discount and debt issuance costs							$ 100,000	$ 100,000
Interest expense							$ 3,200,000	$ 1,100,000
CIBC Agreement \| Medium-term Notes \| Repaid During First Year After Third Amendment's Effective Date
Debt Instrument [Line Items]
Prepayment fee, percent of principal amount		2.00%
CIBC Agreement \| Medium-term Notes \| Repaid During Second Year After Third Amendment's Effective Date
Debt Instrument [Line Items]
Prepayment fee, percent of principal amount		1.00%
CIBC Agreement \| Medium-term Notes \| Prime Rate
Debt Instrument [Line Items]
Basis spread on variable rate		1.00%
CIBC Agreement, Tranche A \| Medium-term Notes
Debt Instrument [Line Items]
Proceeds from borrowing under term loan	$ 17,000,000
CIBC Agreement, Tranche B \| Medium-term Notes
Debt Instrument [Line Items]
Accordion feature on face amount of debt	8,000,000		$ 20,000,000
Gain (loss) on amendment of debt instrument						$ 0
CIBC Agreement, Tranche C \| Medium-term Notes
Debt Instrument [Line Items]
Accordion feature on face amount of debt	$ 7,000,000		$ 10,000,000

Long Term Debt - Credit Agreement Narrative (Details) - Line of Credit - Pulmonx International Sarl	12 Months Ended
	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Apr. 01, 2023	Mar. 31, 2022 installment	May 31, 2020 USD ($)	May 31, 2020 CHF (SFr)
Debt Instrument [Line Items]
Repayments of debt \| $	$ 100,000	$ 100,000
COVID-19 Credit Agreement
Debt Instrument [Line Items]
Maximum borrowing capacity					$ 500,000	SFr 500,000
Stated interest rate			1.50%
Number of installments \| installment				12

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Stockholders' Equity - Restricted Stock Unit Activity (Details) - Restricted Stock Units (RSUs) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Number of Shares Underlying Outstanding Restricted Stock
Unvested, beginning of period (in shares)	998,473	442,428
Granted (in shares)	2,042,593	937,400
Vested (in shares)	(672,180)	(251,133)
Canceled (in shares)	(123,983)	(130,222)
Unvested, end of period (in shares)	2,244,903	998,473
Weighted Average Grant Date Fair Value
Unvested, beginning of period (in dollars per share)	$ 27.72	$ 42.36
Granted (in dollars per share)	11.48	23.63
Vested (in dollars per share)	19.93	35.09
Canceled (in dollars per share)	19.29	33.85
Unvested, end of period (in dollars per share)	$ 15.74	$ 27.72

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Schedule of Assets and Liabilities Measured at Fair Value on a Recurring Basis

The following tables summarizes the types of assets and liabilities measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands):


	December 31, 2023
	Level 1		Level 2		Level 3		Total
Assets:
Cash equivalents:
Money market funds	$	25,129	$	—	$	—	$	25,129
Total cash equivalents	25,129		—		—		25,129
Marketable securities:
U.S. Government agency bonds	5,798		29,466		—		35,264
Commercial paper	—		12,681		—		12,681
Total marketable securities	5,798		42,147		—		47,945
Total financial assets	$	30,927	$	42,147	$	—	$	73,074


	December 31, 2022
	Level 1		Level 2		Level 3		Total
Assets:
Cash equivalents:
Money market funds	$	4,647	$	—	$	—	$	4,647
Total cash equivalents	4,647		—		—		4,647
Marketable securities:
U.S. Government agency bonds	14,743		15,872		—		30,615
Commercial paper	—		14,711		—		14,711
Total marketable securities	14,743		30,583		—		45,326
Total financial assets	$	19,390	$	30,583	$	—	$	49,973

Schedule of Marketable Securities

The following table summarizes the cost, unrealized gains and losses and fair value of marketable securities (in thousands):


	December 31, 2023
	Amortized Cost		Unrealized Losses		Unrealized Gains		Fair Value
U.S. Government agency bonds	$	35,194	$	(26)	$	96	$	35,264
Commercial paper	12,667		(1)		15		12,681
Total	$	47,861	$	(27)	$	111	$	47,945


	December 31, 2022
	Amortized Cost		Unrealized Losses		Unrealized Gains		Fair Value
U.S. Government agency bonds	$	30,897	$	(282)	$	—	$	30,615
Commercial paper	14,740		(31)		2		14,711
Total	$	45,637	$	(313)	$	2	$	45,326

The following table summarizes the contractual maturities of the Company’s marketable securities (in thousands):


	December 31, 2023
	Amortized Cost		Fair Value
Due within one year	$	33,551	$	33,555
Due in one year to five years	$	14,310	$	14,390
Total	$	47,861	$	47,945

Schedule of Debt Securities, Available-for-Sale, Unrealized Loss Position, Fair Value


	December 31, 2023
	Less than 12 months				12 months or greater				Total
	Fair Value		Unrealized Losses		Fair Value		Unrealized Losses		Fair Value		Unrealized Losses
U.S. Government agency bonds	$	11,888	$	(23)	$	1,745	$	(3)	$	13,633	$	(26)
Commercial paper	996		(1)		—		—		996		(1)
Total	$	12,884	$	(24)	$	1,745	$	(3)	$	14,629	$	(27)


	December 31, 2022
	Less than 12 months				12 months or greater				Total
	Fair Value		Unrealized Losses		Fair Value		Unrealized Losses		Fair Value		Unrealized Losses
U.S. Government agency bonds	$	19,768	$	(139)	$	10,847	$	(143)	$	30,615	$	(282)
Commercial paper	11,818		(31)		—		—		11,818		(31)
Total	$	31,586	$	(170)	$	10,847	$	(143)	$	42,433	$	(313)

- Definition

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

+ References

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-Topic 320
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-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

+ Details

Income Taxes - Components of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Current:
Federal	$ 0	$ 0
State	62	66
Foreign	483	232
Total current expense	545	298
Deferred:
Federal	7	32
State	10	14
Foreign	9	9
Total deferred expense	26	55
Total income tax expense	$ 571	$ 353

Stockholders' Equity - Options Vested and Expected to Vest (Details)	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Number of Shares
Options vested (in shares) \| shares	1,751,674
Options vested and expected to vest (in shares) \| shares	3,142,981
Weighted Average Exercise Price
Options vested (in dollars per share) \| $ / shares	$ 15.34
Options vested and expected to vest (in dollars per share) \| $ / shares	$ 16.40
Weighted Average Contractual Life (in Years)
Options vested	6 years 8 months 12 days
Options vested and expected to vest	7 years 5 months 19 days

Leases, Lease Commitments and Contingencies - Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Operating lease cost	$ 2,884	$ 2,893
Short-term lease cost	38	35
Variable lease cost	652	599
Total lease cost	$ 3,574	$ 3,527

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Auditor Information [Abstract]
Auditor Firm ID	243
Auditor Name	BDO USA, P.C.
Auditor Location	San Francisco, California

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred tax assets:
Net operating loss carryforwards	$ 57,420	$ 50,316
Tax credit carryforwards	6,493	7,169
Accruals and reserves	2,287	1,900
Depreciation	243	183
Intangible assets	4,049	4,394
Right of use liability	920	1,443
Capitalized research costs	5,749	2,838
Other	3,371	1,739
Gross deferred tax assets	80,532	69,982
Less: valuation allowance	(79,362)	(68,427)
Deferred tax assets	1,170	1,555
Deferred tax liabilities:
Right of use asset	(739)	(1,147)
Goodwill	(545)	(502)
Net deferred tax liabilities	$ (114)	$ (94)

Balance Sheet Components - Inventory (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 2,924	$ 3,820
Work in process	427	386
Finished goods	15,972	15,641
Total inventory	19,323	19,847
Inventory	16,743	14,564
Long-term inventory	$ 2,580	$ 5,283

Leases, Lease Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Right of use assets	$ 3,406	$ 5,806
Weighted average remaining lease term (years)	1 year 4 months 6 days	2 years 29 days
Weighted average discount rate	6.70%	6.00%

Fair Value Measurements - Cost, Unrealized Gains and Losses and Fair Value (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale, Fair Value to Amortized Cost
Amortized Cost	$ 47,861	$ 45,637
Unrealized Losses	(27)	(313)
Unrealized Gains	111	2
Fair Value	47,945	45,326
U.S. Government agency bonds
Debt Securities, Available-for-sale, Fair Value to Amortized Cost
Amortized Cost	35,194	30,897
Unrealized Losses	(26)	(282)
Unrealized Gains	96	0
Fair Value	35,264	30,615
Commercial paper
Debt Securities, Available-for-sale, Fair Value to Amortized Cost
Amortized Cost	12,667	14,740
Unrealized Losses	(1)	(31)
Unrealized Gains	15	2
Fair Value	$ 12,681	$ 14,711

Long Term Debt - CIBC Loan Components Of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Term loan	$ 45,749
Less: debt issuance costs	(152)
Term loan	37,244
Long-term debt	35,089	$ 17,234
CIBC Agreement \| Medium-term Notes
Debt Instrument [Line Items]
Term loan	37,000	17,000
Less: debt issuance costs	(152)	(127)
Term loan	36,848	16,873
Short-term debt	2,056	0
Long-term debt	$ 34,792	$ 16,873

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities
Net loss	$ (60,843)	$ (58,923)
Adjustments to reconcile net loss to net cash used in operating activities
Stock-based compensation expense	22,101	16,445
(Gain) loss on disposal of fixed assets	(15)	7
Change in allowance for credit losses	(59)	54
Inventory write-downs	507	485
Depreciation and amortization expense	1,548	1,513
Amortization of debt discount and debt issuance costs	48	56
Net accretion of discounts on marketable securities	(1,025)	(204)
Non-cash lease expense	2,686	2,498
Net changes in operating assets and liabilities:
Accounts receivable	(3,104)	(2,190)
Inventory	918	(3,638)
Prepaid expenses and other current assets	(57)	780
Other assets	(36)	(49)
Accounts payable	(345)	247
Accrued liabilities	3,176	149
Income taxes payable	68	(124)
Lease liabilities	(3,182)	(2,197)
Deferred tax liability	24	49
Deferred revenue	(20)	(41)
Net cash used in operating activities	(37,610)	(45,083)
Cash flows from investing activities
Purchases of investments	(46,200)	(47,187)
Maturities of investments	45,000	44,280
Purchases of property and equipment	(807)	(1,318)
Net cash used in investing activities	(2,007)	(4,225)
Cash flows from financing activities
Proceeds from borrowing under term loan	20,000	0
Repayment of credit agreement	(94)	(87)
Payments of debt issuance cost	0	(53)
Proceeds from exercise of common stock options	310	644
Proceeds from issuance of common stock under the employee stock purchase plan	1,184	1,942
Payments for the repurchase of early exercised common stock options	0	(27)
Net cash provided by financing activities	21,400	2,419
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	34	145
Net decrease in cash, cash equivalents, and restricted cash	(18,183)	(46,744)
Cash, cash equivalents, and restricted cash at beginning of year	101,967	148,711
Cash, cash equivalents, and restricted cash at end of year	83,784	101,967
Reconciliation of cash, cash equivalents, and restricted cash to consolidated balance sheets:
Cash and cash equivalents	83,547	101,736
Restricted cash	237	231
Cash, cash equivalents, and restricted cash in consolidated balance sheets	83,784	101,967
Supplemental non-cash items:
Lapse in repurchase rights of common stock	144	227
Purchases of property and equipment in accounts payable and accrued liabilities	109	425
Amount receivable from exercise of common stock options	3	0
Supplemental disclosure of cash flow information:
Cash paid for income taxes	471	398
Cash paid for interest	$ 2,984	$ 847

Balance Sheet Components - Future Amortization Expense (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Year Ending December 31,
2024	$ 31
Net Carrying Value	$ 31	$ 154

Long Term Debt (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Schedule of Long-term Debt Instruments

The CIBC Loan consists of the following (in thousands):


	December 31,
	2023		2022
Term loan	$	37,000	$	17,000
Less: debt issuance costs	(152)		(127)
Term loan	$	36,848	$	16,873
Reported as:
Short-term debt	$	2,056	$	—
Long-term debt	34,792		16,873
Total term loan	$	36,848	$	16,873

Schedule of Contractual Maturities of Financing Obligations

As of December 31, 2023, the aggregate future payments under the CIBC Loan and Credit Agreement (including interest payments) are as follows (in thousands):


Fiscal Year Ending December 31,	Amount
2024	$	5,666
2025	15,217
2026	14,043
2027	10,823
Total	$	45,749
Less: unamortized debt discount	(152)
Less: interest	(8,353)
Term loan and credit agreement	$	37,244

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

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+ Details

Formation and Business of the Company	12 Months Ended
Formation and Business of the Company	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Formation and Business of the Company	Formation and Business of the Company The Company Pulmonx Corporation (the “Company”) was incorporated in the state of California in December 1995 as Pulmonx and reincorporated in the state of Delaware in December 2013. The Company is a commercial-stage medical technology company that provides a minimally invasive treatment for patients with severe emphysema, a form of chronic obstructive pulmonary disease (“COPD”). The Company’s solution, which is comprised of the Zephyr Endobronchial Valve (“Zephyr Valve”), the Chartis Pulmonary Assessment System (“Chartis System”) and the StratX Lung Analysis Platform (“StratX Platform”), is designed to treat a broad pool of patients for whom medical management has reached its limits and either do not want or are ineligible for surgical approaches. The Company has subsidiaries in Germany, Switzerland, Australia, the United Kingdom, Italy, France, Hong Kong and Japan. Liquidity and Going Concern The Company has incurred operating losses and negative cash flows from operations to date and has an accumulated deficit of $411.2 million as of December 31, 2023. During the years ended December 31, 2023 and 2022, the Company used $37.6 million and $45.1 million of cash in its operating activities, respectively. As of December 31, 2023, the Company had cash, cash equivalents and marketable securities of $131.5 million. Historically, the Company’s activities have been financed through the sale of equity securities, debt financing arrangements and sales of its products. The Company’s consolidated financial statements have been prepared on the basis of the Company continuing as a going concern for the next 12 months. Management believes that the Company’s existing cash, cash equivalents and marketable securities will allow the Company to continue its planned operations for at least the next 12 months from the date of the issuance of these consolidated financial statements.

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Stockholders’ Equity
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	200,000,000	200,000,000
Common stock, shares issued (in shares)	38,516,383	37,555,565
Common stock, shares outstanding (in shares)	38,516,383	37,555,565

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Income Before the Provision for Income Taxes

Income before the provision for income taxes consists of the following (in thousands):


	Years Ended December 31,
	2023		2022
Domestic	$	(60,503)	$	(59,361)
Foreign	231		791
Total loss before provision for taxes	$	(60,272)	$	(58,570)

Schedule of Components of Income Tax Expense

The components of income tax expense are as follows (in thousands):


	Years Ended December 31,
	2023		2022
Current:
Federal	$	—	$	—
State	62		66
Foreign	483		232
Total current expense	$	545	$	298

Deferred:
Federal	$	7	$	32
State	10		14
Foreign	9		9
Total deferred expense	26		55
Total income tax expense	$	571	$	353

Schedule of Reconciliation Between Federal Statutory Rate and Effective Rate

The reconciliation between the federal statutory rate and the Company’s effective tax rate is summarized below:


	Years Ended December 31,
	2023		2022
Federal statutory rate	21.0	%	21.0	%
State taxes, net of federal benefit	(0.1)	%	(0.1)	%
Foreign earnings at different rates	(0.5)	%	(0.1)	%
Tax credits	(0.9)	%	1.8	%
Permanent differences	(4.6)	%	(4.6)	%
Prior year true-up	0.6	%	(0.8)	%
Change in valuation allowance	(16.4)	%	(17.8)	%
Effective tax rate	(0.9)	%	(0.6)	%

Schedule of Significant Components Deferred Tax Assets and Liabilities


	December 31,
	2023		2022
Deferred tax assets:
Net operating loss carryforwards	$	57,420	$	50,316
Tax credit carryforwards	6,493		7,169
Accruals and reserves	2,287		1,900
Depreciation	243		183
Intangible assets	4,049		4,394
Right of use liability	920		1,443
Capitalized research costs	5,749		2,838
Other	3,371		1,739
Gross deferred tax assets	80,532		69,982
Less: valuation allowance	(79,362)		(68,427)
Deferred tax assets	$	1,170	$	1,555
Deferred tax liabilities:
Right of use asset	$	(739)	$	(1,147)
Goodwill	(545)		(502)
Net deferred tax liabilities	$	(114)	$	(94)

Schedule of Unrecognized Tax Benefits

The following table summarizes the activity related to the Company’s gross unrecognized tax benefits (in thousands):


Balance at December 31, 2021	$	8,489
Additions for tax positions related to prior year	106
Decreases for tax positions related to prior year	(153)
Additions for tax positions related to current year	200
Balance at December 31, 2022	$	8,642
Additions for tax positions related to prior year	144
Decreases for tax positions related to prior year	(162)
Additions for tax positions related to current year	38
Balance at December 31, 2023	$	8,662

Summary of Significant Accounting Policies	12 Months Ended
Summary of Significant Accounting Policies	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The Company’s consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“U.S. GAAP”). Any reference in these notes to applicable guidance is meant to refer to the authoritative United States generally accepted accounting principles as found in the Accounting Standards Codification (“ASC”) and Accounting Standards Updates (“ASU”) of the Financial Accounting Standards Board (“FASB”). Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting periods. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, actual results may ultimately materially differ from these estimates and assumptions. Significant estimates and assumptions include reserves and write-downs related to inventories, classification of short-term and long-term inventories, the recoverability of long term assets, stock-based compensation, intangible assets, goodwill, deferred tax assets and related valuation allowances, and impact of contingencies. Fair Value of Financial Instruments The carrying amounts of the Company’s financial instruments consisting of cash and cash equivalents, accounts receivable, accounts payable and accrued liabilities approximate fair value due to their relatively short maturities. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates their fair value. The fair value of marketable debt securities is estimated using Level 1 and Level 2 inputs (Note 4). Cash and Cash Equivalents The Company considers all highly liquid investments with an original maturity of three months or less at the time of purchase to be cash equivalents, which include money market funds, commercial paper and corporate bonds. Restricted Cash Restricted cash is comprised of cash that is restricted as to withdrawal or use under the terms of certain contractual agreements. Restricted cash for years ended December 31, 2023 and December 31, 2022 consists of collateral for letters of credit issued in connection with the real estate lease in Redwood City, California. Marketable Securities The Company determines the appropriate classification of its investments in marketable securities at the time of purchase and reevaluates such designation at each balance sheet date. The Company has classified and accounted for its marketable securities as available-for-sale. After consideration of the Company’s risk versus reward objectives and liquidity requirements, the Company may sell these securities prior to their stated maturities. As the Company views these securities as available to support current operations, the Company classifies highly liquid securities with original maturities greater than three months at the time of purchase, and remaining maturities of less than one year, as short-term marketable securities and those with remaining maturities greater than twelve months as long-term marketable securities on the consolidated balance sheets. These securities are carried at fair value as determined based upon quoted market prices or pricing models for similar securities. Unrealized gains and losses on available for sale marketable securities, which consist of debt securities, if any, are excluded from earnings and are reported as a component of other comprehensive income (loss). The amortized cost of debt securities is adjusted for amortization of premiums and accretion of discounts to maturity, which is included in interest income on the consolidated statements of operations and comprehensive loss. Realized gains and losses, if any, on available-for-sale securities are included in other income (expense), net. The cost of securities sold is based on the specific identification method. Interest and dividends on securities classified as available-for-sale are included in interest income. For marketable securities in an unrealized loss position, the Company periodically assesses its portfolio for impairment. The assessment first considers the intent or requirement to sell the marketable security. If either of these criteria are met, the amortized cost basis is written down to fair value through earnings. Upon the adoption of ASU 2016-13, Financial Instruments – Credit Losses, on January 1, 2023, if the criteria above are not met, the Company evaluates whether the decline resulted from credit losses or other factors by considering the extent to which fair value is less than amortized cost, any changes to the rating of the marketable security by a rating agency, and any adverse conditions specifically related to the marketable security, among other factors. If this assessment indicates that a credit loss exists, the present value of cash flows expected to be collected from the marketable security is compared to the amortized cost basis of the marketable security. If the present value of cash flows expected to be collected is less than the amortized cost basis, a credit loss exists and an allowance for credit losses is recorded, limited by the amount that the fair value is less than the amortized cost basis. Any impairment that has not been recorded through an allowance for credit losses is recognized in other comprehensive loss. Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents and accounts receivable. The Company maintains its cash and cash equivalents balances with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation (“FDIC”) insured limits. As of December 31, 2023 and December 31, 2022, the Company also had cash on deposit with foreign banks of approximately $4.7 million and $4.5 million, respectively, that was not federally insured. The Company earns revenue primarily from the sale of its products to hospitals and other customers such as distributors. Sales of Zephyr Valves and delivery catheters accounted for most of the Company’s revenue for the years ended December 31, 2023 and December 31, 2022. The Company’s accounts receivable are derived from revenue earned from customers. The Company performs ongoing credit evaluations of its customers’ financial conditions and generally requires no collateral from its customers. As of December 31, 2023 and December 31, 2022, no customer accounted for more than 10% of accounts receivable. For the years ended December 31, 2023 and December 31, 2022, no customer accounted for more than 10% of revenue. The Company relies on single source suppliers for the components, sub-assemblies and materials for its products. These components, sub-assemblies and materials are critical and there are no or relatively few alternative sources of supply. The Company’s suppliers have generally met the Company’s demand for their products and services on a timely basis in the past. Accounts Receivable and Allowances Accounts receivable are recorded at the amounts billed less estimated allowances for credit losses for any potential uncollectible amounts. The Company continually monitors customer payments and maintains an allowance for estimated losses resulting from a customer’s inability to make required payments. The Company considers factors such as historical experience, credit quality, age of the accounts receivable balances, geographic related risks and economic conditions that may affect a customer’s ability to pay. Accounts receivable are written-off and charged against an allowance for credit losses when the Company has exhausted collection efforts without success. As of December 31, 2023 and December 31, 2022, accounts receivable is presented net of an allowance for credit losses of $0 and $0.1 million, respectively. Inventories Inventories are valued at the lower of cost to purchase or manufacture the inventory or net realizable value. Cost is determined using the first-in, first-out method (“FIFO”) for all inventories. Net realizable value is determined as the estimated selling prices in the ordinary course of business, less reasonably predictable costs of completion, disposal and transportation. The Company records write-downs of inventories which are obsolete or in excess of anticipated demand or market value based on consideration of product lifecycle stage, technology trends, product development plans and assumptions about future demand and market conditions. Inventory write-downs reduce the carrying value of inventory to its net realizable value. The Company reviews its inventories for classification purposes. The value of inventories not expected to be realized in cash, sold or consumed during the next 12 months are classified as long-term inventory. Internal-Use Software The Company capitalizes certain costs in connection with obtaining or developing software for internal use. Amortization of such costs begins when the project is substantially complete and ready for its intended use. Capitalized software development costs are classified as property and equipment, net on the consolidated balance sheets and are amortized using the straight-line method over the estimated useful life of the applicable software. Property and Equipment, Net Property and equipment are stated at cost less accumulated depreciation and amortization. Depreciation and amortization are computed using the straight-line method over the estimated useful lives of the assets, generally between three to five years. Leasehold improvements are amortized using the straight-line method over the shorter of the lease term or useful economic life of the asset. When assets are retired or otherwise disposed of, the cost and accumulated depreciation are removed from the balance sheet, and any resulting gain or loss is reflected in operations in the period realized. Impairment of Long-lived Assets The Company evaluates its long-lived assets for indicators of possible impairment by comparison of the carrying amounts to future net undiscounted cash flows expected to be generated by such assets when events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Should an impairment exist, the impairment loss would be measured based on the excess carrying value of the asset over the asset’s fair value or discounted estimates of future cash flows. The Company has not identified any such impairment losses to date. Goodwill Goodwill represents the excess of the purchase price over the fair value of net tangible and identified intangible assets acquired in a business combination. Goodwill is not amortized but is evaluated at least annually for impairment or when a change in facts and circumstances indicate that the fair value of the goodwill may be below its carrying value. The Company tests goodwill for impairment at the reporting unit level (“reporting unit”). The Company has determined that it has one operating segment and one reporting unit. The operating results are reviewed only on a consolidated basis to make decisions about resources to be allocated and assess performance. Prior to performing the impairment test, the Company assesses qualitative factors to determine whether the existence of events or circumstances would indicate that it is more likely than not that the fair value of the reporting unit was less than the carrying amount. If after assessing the totality of events or circumstances, the Company were to determine that it is more likely than not that the fair value of the reporting unit is less than the carrying amount, then the Company would perform a quantitative impairment test. The quantitative impairment test involves comparing the fair value of the reporting unit to the carrying value. If the fair value of the reporting unit exceeds the carrying value of the net assets, goodwill is not impaired, and no further testing is required. If the fair value of the reporting unit is less than the carrying value, the Company measures the amount of impairment loss, if any, as the excess of the carrying value over the fair value of the reporting unit. Estimations and assumptions regarding the future performance and results of the Company’s operations, including estimates related to future sales growth, gross margin and operating expenses, and the fair value of the Company’s common stock are used in the impairment assessment. Circumstances that could reasonably be expected to negatively affect the key assumptions related to the impairment assessment include but are not limited to, (1) a significant adverse change in legal factors affecting our existing and future products or in business climate, (2) unanticipated competition, (3) an adverse action or assessment by a regulator, or (4) an adverse change in market conditions that are indicative of a decline in the fair value of the assets. Intangible Assets Intangible assets consist of developed technology and trademarks. Intangible assets were recorded at their fair values at the date of acquisition and are amortized using the straight-line method over a 15-year useful life (Note 5). Leases The Company leases facilities and vehicles and meets the requirements to account for these leases as operating leases. The Company recognizes rent expense on a straight-line basis over the non-cancelable lease term. Where leases contain escalation clauses, rent abatements or concessions, such as rent holidays and landlord or tenant incentives or allowances, the Company applies them in the determination of straight-line rent expense over the lease term. The Company determined if an arrangement is a lease, or contains a lease, at inception. The asset component of the Company’s operating leases is recorded as right-of-use assets, and the liability component is recorded as current lease liabilities and long-term lease liabilities in the Company’s consolidated balance sheets. As of December 31, 2023 and 2022, the Company did not record any finance leases. ROU assets and lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate, which is the estimated rate the Company would be required to pay for a fully collateralized borrowing equal to the total lease payments over the term of the lease, to determine the present value of future minimum lease payments. The ROU asset also includes any lease payments made to the lessor at or before the commencement date, minus lease incentives received, and initial direct costs incurred. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. For lease agreements entered into or reassessed after the adoption of ASC 842, the Company combines lease and non-lease components. Variable lease payments are expenses as incurred. The Company does not recognize lease liabilities and ROU assets for short-term leases with terms of twelve months or less. Assumptions made by the Company at the commencement date are re-evaluated upon occurrence of certain events, including a lease modification. A lease modification results in a separate contract when the modification grants the lessee an additional right of use not included in the original lease and when lease payments increase commensurate with the standalone price for the additional right of use. When a lease modification results in a separate contract, it is accounted for in the same manner as a new lease. Revenue Recognition The Company’s revenue is generated primarily from the sale of its products to hospitals and distributors in the United States and international markets. Under ASC 606, revenue is recognized when the customer obtains controls of promised goods or services, in an amount that reflects consideration which the entity expects to receive in exchange for those goods or services. The Company determines revenue recognition by applying the following five steps as prescribed by ASC 606: (i)identify the contract(s) with a customer; (ii)identify the performance obligations in the contract; (iii)determine the transaction price; (iv)allocate the transaction price to the performance obligations in the contract; and (v)recognize revenue when (or as) the entity satisfies performance obligations. A contract with a customer exists when (i) the Company enters into a legally enforceable contract with a customer that defines each party’s rights regarding the products or services to be transferred and identifies the payment terms related to these products or services, (ii) the contract has commercial substance and, (iii) the Company determines that collection of substantially all consideration for products or services that are transferred is probable based on the customer’s intent and ability to pay the promised consideration. The Company identifies performance obligations in contracts with customers, which may include its products and implied promises to provide free products and analysis services for patient scans. The transaction price is determined based on the amount expected to be entitled to in exchange for transferring the promised services or product to the customer. The Company is entitled to the total consideration for the products ordered by customers, net of early pay discounts, volume rebate adjustments and other transaction price adjustments. The Company’s payment terms to customers generally range from 30 to 60 days. Payment terms fall within the one-year guidance for the practical expedient which allows the Company to forgo adjustment of the promised amount of consideration for the effects of a significant financing component. The Company excludes taxes assessed by governmental authorities on revenue-producing transactions from the measurement of the transaction price. Assuming all other revenue recognition criteria are met, revenue is recognized when control of the Company’s products transfers to the customer. For sales where the Company’s sales representative hand delivers product directly to the hospital or medical center, control transfers to the customer upon this delivery. For sales where products are shipped, control is transferred either upon shipment or delivery of the products to the customer, depending on the shipping terms and conditions. For consignment sales, control is transferred when the products are used by the customer in procedures. The Company defers revenue relating to any remaining performance obligations by the Company to the customer after delivery, such as free products and free analysis services of patient scans to determine suitability of the patients for the treatment using the Company’s Zephyr Valves. As permitted under the practical expedient, the Company does not disclose the value of unsatisfied performance obligations for contracts with an original expected length of one year or less. The Company accepts product returns at its discretion or if the product is defective as manufactured. Historically, the actual product returns have been immaterial to the Company’s financial statements. The Company elected to treat shipping and handling costs as a fulfillment cost and include them in the cost of goods sold as incurred. In those cases where the Company bills shipping and handling costs to customers, it will classify the amounts billed within revenue. The Company disaggregates its revenue by major geographic region, which is disclosed in Note 12, “Segment Information”. Costs associated with product sales include commissions. The Company applies the practical expedient and recognizes commissions as expense when incurred because the expense is incurred at a point in time and the amortization period is less than one year. Commissions are recorded as selling expense. Cost of Goods Sold The Company manufactures certain products at its facility and purchases other products from third party manufacturers. Cost of goods sold consists primarily of costs related to materials, components and subassemblies, third-party costs, manufacturing overhead costs, direct labor, reserves for excess, obsolete and non-sellable inventories and distribution-related expenses. A significant portion of the Company’s cost of goods sold currently consists of manufacturing overhead costs. These overhead costs include the cost of quality assurance, material procurement, inventory control, facilities, equipment and operations supervision and management. Cost of goods sold also includes depreciation expense for production equipment and certain direct costs such as shipping costs. Research and Development Research and development expenses consist of compensation costs, stock-based compensation, engineering and research expenses, clinical trials and related expenses, regulatory expenses, manufacturing expenses incurred to build products for testing, allocated facilities costs, consulting fees and other expenses incurred to sustain the Company’s overall research and development programs. All research and development costs are expensed as incurred. Clinical trial costs are a significant component of the Company’s research and development expenses. The Company has a history of contracting with third parties that perform various clinical trial activities on the Company’s behalf in the ongoing development of its product candidates. The financial terms of these contracts are subject to negotiations and may vary from contract to contract and may result in uneven payment flow. The Company accrues and expenses costs for its clinical trial activities performed by third parties, including clinical research organizations and other service providers, based upon estimates of the work completed over the life of the individual study in accordance with associated agreements. The Company determines these estimates through discussion with internal personnel and outside service providers as to progress or stage of completion of trials or services pursuant to contracts with clinical research organizations and other service providers and the agreed-upon fee to be paid for such services. Advertising Costs The Company expenses the costs of advertising as incurred. Advertising expenses were $4.8 million and $6.1 million for the years ended December 31, 2023 and December 31, 2022, respectively. Foreign Currency Translation and Transaction Gains and Losses The functional currencies of the Company’s wholly owned subsidiaries in Switzerland, Germany, Australia, the United Kingdom, France and Hong Kong are the Swiss franc. The functional currency of the Company’s subsidiaries in Italy and Japan is the Euro and Yen, respectively. Accordingly, asset and liability accounts of Switzerland, France, Germany, Australia, the United Kingdom, Italy, Hong Kong and Japan operations are translated into U.S. dollars using the current exchange rate in effect at the balance sheet date and equity accounts are translated into U.S. dollars using historical rates. The revenues and expenses are translated using the average exchange rates in effect during the period, and gains and losses from foreign currency translation adjustments are included as a component of accumulated other comprehensive income in the consolidated balance sheet. Foreign currency translation adjustments are recorded in other comprehensive income (loss) in the consolidated statements of operations and comprehensive loss and was $0.7 million and $0.2 million during the years ended December 31, 2023 and December 31, 2022, respectively. Foreign currency transaction gains and losses are included in other income (expense), net in the consolidated statements of operations and comprehensive loss and was $(0.8) million and $(0.4) million during the years ended December 31, 2023 and December 31, 2022, respectively. Stock-Based Compensation The Company accounts for stock-based compensation arrangements with employees and non-employees in accordance with ASC 718, Compensation—Stock Compensation, using a fair-value based method. The Company determines the fair value of all stock options and the 2020 Employee Share Purchase Plan (“ESPP”) awards on the date of grant using the Black-Scholes option pricing model. The Company’s determination of the fair value is impacted by its common stock price as well as assumptions regarding a number of complex and subjective variables. These variables include, but are not limited to, the expected term that options will remain outstanding, expected common stock price volatility over the term of the option awards, risk-free interest rates and expected dividends. Changes in the assumptions can materially affect the fair value and ultimately how much stock-based compensation expense is recognized. These inputs are subjective and generally require significant analysis and judgment to develop. The fair value of time-based awards is recognized over the period during which an option holder is required to provide services in exchange for the option award, known as the requisite service period, which is typically the vesting period using the straight-line method. The fair value of performance-based awards, if applicable, is recognized over the requisite service period using the graded vesting method. The Company accounts for forfeitures as they occur. The Company issued stock options in exchange for the receipt of goods or services from non-employees. Costs for such equity instruments are measured at the fair value of the equity instruments issued on the measurement date as the Company believes that the fair value of the equity instrument is more reliably measured than the fair value of the services received. Income Taxes The Company accounts for income taxes under the asset and liability method, whereby deferred tax assets and liabilities are determined based on the difference between the consolidated financial statements and tax bases of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to affect taxable income. A valuation allowance is established when necessary to reduce deferred tax assets when management estimates, based on available objective evidence, that it is more likely than not that the benefit will not be realized for the deferred tax assets. The Company also follows the provisions of ASC 740-10, Accounting for Uncertainty in Income Taxes. ASC 740-10 prescribes a comprehensive model for the recognition, measurement, presentation and disclosure in financial statements of any uncertain tax positions that have been taken or expected to be taken on a tax return. No liability related to uncertain tax positions is recorded on the consolidated financial statements. It is the Company’s policy to include penalties and interest expense related to income taxes as part of the provision for income taxes. Net Loss per Share Attributable to Common Stockholders Basic net loss per common share is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of common stock outstanding during the period, without consideration of potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss attributable to common stockholders by the weighted-average number of common stock and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, stock options and common stock subject to repurchase related to early exercise of stock options are considered to be potentially dilutive securities. Basic and diluted net loss attributable to common stockholders per share is presented in conformity with the two-class method required for participating securities. The Company considers the shares issued upon the early exercise of stock options subject to repurchase to be participating securities, because holders of such shares have non-forfeitable dividend rights in the event a dividend is paid on common stock. The holders of the shares issued upon early exercise of stock options subject to repurchase do not have a contractual obligation to share in the Company’s losses. As such, the net loss was attributed entirely to common stockholders. Because the Company has reported a net loss for all periods presented, diluted net loss per common share is the same as basic net loss per common share for those periods. Comprehensive Loss The Company is required to report all components of comprehensive loss, including net loss, in the financial statements in the period in which they are recognized. Comprehensive gain or loss is defined as a change in equity of a business enterprise during a period, resulting from transactions and other events and circumstances from non-owner sources. The Company’s currency translation adjustment and unrealized gains and losses from marketable securities are the components of other comprehensive income (loss) that are excluded from the reported net loss for all periods presented.

Income Taxes - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
Income Taxes - Narrative (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Tax Credit Carryforward [Line Items]
Valuation allowance	$ 79,362	$ 68,427
Increase (decrease) in deferred tax asset valuation allowance	10,900	11,900
Write off of net operating losses			$ 3,100
Write off of tax credits			1,200
Unrecognized tax benefits	8,662	$ 8,642	$ 8,489
Federal
Tax Credit Carryforward [Line Items]
Net operating loss carryforwards	245,800
Federal \| Tax Year 2018
Tax Credit Carryforward [Line Items]
Net operating loss carryforwards	173,900
Federal \| Research and Development
Tax Credit Carryforward [Line Items]
Tax credit carryforward	3,600
State
Tax Credit Carryforward [Line Items]
Net operating loss carryforwards	155,400
State \| Research and Development
Tax Credit Carryforward [Line Items]
Tax credit carryforward	$ 5,100

Leases, Lease Commitments and Contingencies

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases, Lease Commitments and Contingencies

The Company has a lease for its headquarters location in Redwood City, California. In October 2019, the Company renewed its lease for the headquarters location in Redwood City, California for an additional five years commencing in August 2020 and expiring in July 2025. The monthly base rent during the renewed term is $0.1 million and is subject to an annual increase of 3.5%. The Company is responsible for its share of real estate taxes, common area maintenance and management fees.

During 2013, the Company entered into a five-year lease for office facilities in Switzerland. The Company had an option to extend the lease through January 2022, which was not exercised by the Company. Per the lease terms, in the event the option to extend is not exercised, the lease remains in force and can be terminated with 12-months’ notice.

In April 2020, the Company executed a sublease for another office facility in Redwood City, California for a three-year term commencing on June 1, 2020 (the “Sublease Agreement”). The Sublease Agreement provides for early termination if the Company or Sublandlord elects to terminate the lease by providing the other party at least 180 days prior written notice. The early termination may only occur on or after the expiration of the 18th full calendar month of the sublease term. The monthly base rent during the term is less than $0.1 million and is subject to an annual increase of 3.5%. The Company is responsible for its share of real estate taxes, common area maintenance and management fees.

In September 2020, the Company amended the Sublease Agreement to include additional facility space in Redwood City, California for a four-year term (the “First Amendment to Sublease Agreement”). The First Amendment to Sublease Agreement was accounted as a separate sublease agreement. The First Amendment to Sublease Agreement contained a rent-free period through February 14, 2021, after which rent is approximately $0.1 million per month

and is subject to an annual increase of 3.5%. The Company is responsible for its share of real estate taxes, common area maintenance and management fees. The Company is eligible to receive a tenant improvement allowance of $0.7 million to fund facility enhancements. The First Amendment to Sublease Agreement can be extended for an additional twelve-month period, at the Company’s option. For accounting purposes, the lease term is 4 years as it is not reasonably certain that the Company will exercise the renewal option. The First Amendment to Sublease Agreement also changed the lease term entered into in April 2020, which was extended until May 31, 2024, but left the early termination clause unchanged. In September 2021, the Company became reasonably certain that the early termination clause would not be exercised as capital expenditures on the facility build-out created sufficient disincentive to terminate the lease early. The lease term was reevaluated and extended from November 30, 2021 to May 31, 2024. In April 2023, the Company entered into a Second Amendment to Sublease Agreement (the “Second Amendment to Sublease Agreement”) to remove the early termination clause and extend the lease term by four months to expire contemporaneously with the expiration date as defined in Sublease Agreement. The amendment was accounted for as a modification that resulted in additional right of use assets in exchange for lease liabilities of $0.2 million.

As of December 31, 2023, the Company has leases on 14 vehicles with an average lease term of 3.0 years.

Operating lease cost consists of the following (in thousands):


	Years Ended December 31,
	2023		2022
Operating lease cost	$	2,884	$	2,893
Short-term lease cost	38		35
Variable lease cost	652		599
Total lease cost	$	3,574	$	3,527

The following table summarizes a maturity analysis of the Company’s lease liabilities showing the aggregate lease payments as of December 31, 2023 (in thousands):


Fiscal Year Ending December 31,	Amount
2024	$	3,219
2025	1,098
2026	30
Total minimum lease payments	4,347
Less: Amount of lease payments representing interest	167
Present value of future minimum lease payments	$	4,180
Less: Current lease liabilities	3,074
Long-term lease liabilities	$	1,106

The following table summarizes additional information related to the Company’s operating leases (in thousands, except weighted average data):


	December 31,
	2023			2022
Right of use asset	$	3,406		$	5,806
Weighted average remaining lease term (years)	1.35			2.08
Weighted average discount rate	6.7		%	6.0		%

The following table summarizes other supplemental information related to the Company’s operating leases (in thousands):


	Years Ended December 31,
	2023		2022
Cash paid for amounts included in the measurement of lease liabilities included in cash flows used in operating activities	$	3,563	$	2,701
Right-of-use assets obtained in exchange for lease liabilities	$	284	$	229

Service Agreement

In April 2022, the Company entered into an agreement with a service provider, which requires total minimum purchases of $0.6 million, $0.4 million, and $0.4 million over a three-year period. From inception of the agreement through December 31, 2023, the Company recorded $0.9 million of expense for services related to this agreement in cost of goods sold.

Contingencies

From time to time, the Company may be a party to various litigation claims in the normal course of business. Legal fees and other costs associated with such actions are expensed as incurred. The Company assesses, in conjunction with legal counsel, the need to record a liability for litigation and contingencies. Accrual estimates are recorded when and if it is determinable that such a liability for litigation and contingencies are both probable and reasonably estimable.

In December 2022, the Company received a civil investigative demand (“CID”) from the U.S. Department of Justice, Civil Division in connection with an investigation under the Anti-Kickback Statute and False Claims Act (the “Investigation”). The CID requests information and documents regarding the Company’s relationships with certain health care providers, medical practices, and hospitals in connection with the sales and marketing of the Zephyr Valves and related products and services. The Company is fully cooperating with the Investigation. The Company is unable to express a view at this time regarding the ultimate outcome of the Investigation or estimate an amount or range of reasonably possible loss. Depending on the outcome of the Investigation, there could be a material impact on the Company’s business, results of operations and financial condition.

Leases, Lease Commitments and Contingencies

As of December 31, 2023, the Company has leases on 14 vehicles with an average lease term of 3.0 years.

Operating lease cost consists of the following (in thousands):


	Years Ended December 31,
	2023		2022
Operating lease cost	$	2,884	$	2,893
Short-term lease cost	38		35
Variable lease cost	652		599
Total lease cost	$	3,574	$	3,527

The following table summarizes a maturity analysis of the Company’s lease liabilities showing the aggregate lease payments as of December 31, 2023 (in thousands):


Fiscal Year Ending December 31,	Amount
2024	$	3,219
2025	1,098
2026	30
Total minimum lease payments	4,347
Less: Amount of lease payments representing interest	167
Present value of future minimum lease payments	$	4,180
Less: Current lease liabilities	3,074
Long-term lease liabilities	$	1,106

The following table summarizes additional information related to the Company’s operating leases (in thousands, except weighted average data):


	December 31,
	2023			2022
Right of use asset	$	3,406		$	5,806
Weighted average remaining lease term (years)	1.35			2.08
Weighted average discount rate	6.7		%	6.0		%

The following table summarizes other supplemental information related to the Company’s operating leases (in thousands):


	Years Ended December 31,
	2023		2022
Cash paid for amounts included in the measurement of lease liabilities included in cash flows used in operating activities	$	3,563	$	2,701
Right-of-use assets obtained in exchange for lease liabilities	$	284	$	229

Service Agreement

Contingencies

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule of Shares Reserved for Future Issuance

The Company has reserved shares of common stock for future issuances as follows:


	December 31,
	2023	2022
Common stock options issued and outstanding	3,142,981	2,495,528
Common stock restricted stock units issued and outstanding	2,244,903	998,473
Common stock available for future grants	2,541,438	3,765,706
Common stock available for ESPP	1,436,823	1,212,109
Total	9,366,145	8,471,816

Schedule of Summary of Stock Option Activity

Activity under the Stock Plans is set forth below:


	Outstanding Options
	Number of Shares	Weighted Average Exercise Price
Balance, December 31, 2021	2,145,131	$	13.44
Options granted	765,900	24.09
Options exercised	(297,463)	2.13
Options canceled	(118,040)	28.30
Balance, December 31, 2022	2,495,528	$	17.35
Options granted	835,400	11.48
Options exercised	(137,902)	2.27
Options canceled	(50,045)	20.62
Balance, December 31, 2023	3,142,981	$	16.40

Schedule of Options Vested and Expected to Vest


	December 31, 2023
	Number of Shares	Weighted Average Exercise Price		Weighted Average Contractual Life (in Years)
Options vested	1,751,674	$	15.34	6.70
Options vested and expected to vest	3,142,981	$	16.40	7.47

Schedule of Activity with Respect to Restricted Stock Units

Activity with respect to restricted stock units was as follows:


	Number of Shares Underlying Outstanding Restricted Stock	Weighted Average Grant Date Fair Value
Unvested, December 31, 2021	442,428	$	42.36
Granted	937,400	23.63
Vested	(251,133)	35.09
Canceled	(130,222)	33.85
Unvested, December 31, 2022	998,473	27.72
Granted	2,042,593	11.48
Vested	(672,180)	19.93
Canceled	(123,983)	19.29
Unvested, December 31, 2023	2,244,903	$	15.74

Schedule of Stock Options Valuation Assumptions

The estimated grant date fair values of employee stock options were calculated using the following assumptions:


	Years Ended December 31,
	2023	2022
Weighted average expected term (in years)	6.0	6.0 - 6.1
Volatility	73.4%	44.5% - 44.8%
Risk-free interest rate	4.2%	1.6% - 3.6%
Dividend yield	—	—

Schedule of Compensation Expense Valuation Assumptions

Compensation expense is calculated using the fair value of the employees' purchase rights under the Black-Scholes model.


	Years Ended December 31,
	2023	2022
Weighted average expected term (in years)	0.5	0.5
Volatility	43.4% - 55.6%	37.8% - 42.8%
Risk-free interest rate	5.0% - 5.5%	0.7% - 3.1%
Dividend yield	—	—

Schedule of Total Stock-Based Compensation

Stock-based compensation expense is reflected in the statements of operations and comprehensive loss as follows (in thousands):


	Years Ended December 31,
	2023		2022
Cost of goods sold	$	1,320	$	686
Research and development	2,821		2,190
Selling, general and administrative	17,960		13,569
Total	$	22,101	$	16,445

The above stock-based compensation expense related to the following equity-based awards (in thousands):


	Years Ended December 31,
	2023		2022
Stock options and restricted stock units	$	21,675	$	15,807
ESPP	426		638
Total	$	22,101	$	16,445

- Definition

Tabular disclosure of an entity's stock, including par or stated value per share, number and dollar amount of share subscriptions, shares authorized, shares issued, shares outstanding, number and dollar amount of shares held in an employee trust, dividend per share, total dividends, share conversion features, par value plus additional paid in capital, the value of treasury stock and other information necessary to a fair presentation, and EPS information. Stock by class includes common, convertible, and preferred stocks which are not redeemable or redeemable solely at the option of the issuer. Includes preferred stock with redemption features that are solely within the control of the issuer and mandatorily redeemable stock if redemption is required to occur only upon liquidation or termination of the reporting entity. If more than one issue is outstanding, state the title of each issue and the corresponding dollar amount; dollar amount of any shares subscribed but unissued and the deduction of subscriptions receivable there from; number of shares authorized, issued, and outstanding.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(27))
-SubTopic 10
-Topic 210
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480566/210-10-S99-1

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 210
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(28))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480566/210-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
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+ Details

Segment Information - Revenue by Geographic Area (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenue	$ 68,675	$ 53,662
United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenue	45,917	32,487
Europe, Middle-East and Africa (“EMEA”)
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenue	19,336	18,154
Asia Pacific
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenue	3,023	2,866
Other International
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenue	$ 399	$ 155

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

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+ Details

Fair Value Measurements - Narrative (Details) - USD ($)	12 Months Ended
Fair Value Measurements - Narrative (Details) - USD ($)	Dec. 31, 2023	Dec. 31, 2022
Derivative [Line Items]
Allowance for credit loss	$ 0	$ 0
Impairment losses	0	0
Accrued interest on marketable securities	$ 400,000	$ 100,000
Debt Securities, Available-for-Sale, Accrued Interest, after Allowance for Credit Loss, Statement of Financial Position [Extensible Enumeration]	Prepaid expenses and other current assets	Prepaid expenses and other current assets
Accrued interest	$ 0	$ 0
Fair Value, Recurring
Derivative [Line Items]
Liabilities measured at fair value on a recurring and non-recurring	0	0
Fair Value, Nonrecurring
Derivative [Line Items]
Liabilities measured at fair value on a recurring and non-recurring	$ 0	$ 0

Net Loss per Share Attributable to Common Stockholders

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Net Loss per Share Attributable to Common Stockholders

The following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders which excludes shares which are legally outstanding, but subject to repurchase by the Company (in thousands, except share and per share amounts):


	Years Ended December 31,
	2023		2022
Numerator
Net loss attributable to common stockholders	$	(60,843)	$	(58,923)
Denominator
Weighted-average common stock outstanding	37,998,509		37,248,292
Less: weighted-average common shares subject to repurchase	(23,942)		(151,751)
Weighted-average common shares used to compute basic and diluted net loss per share	37,974,567		37,096,541
Net loss per share attributable to common stockholders, basic and diluted	$	(1.60)	$	(1.59)

The following potentially dilutive securities outstanding have been excluded from the computation of diluted weighted average shares outstanding because such securities have an antidilutive impact due to the Company’s net loss, in common stock equivalent shares:


	Years Ended December 31,
	2023	2022
Options to purchase common stock	3,142,981	2,495,528
Unvested restricted stock units	2,244,903	998,473
Unvested early exercised common stock options	109	77,782
Shares committed under ESPP	55,714	28,141
Total Shares	5,443,707	3,599,924

Leases, Lease Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Schedule of Operating Lease Cost and Additional Information

Operating lease cost consists of the following (in thousands):


	Years Ended December 31,
	2023		2022
Operating lease cost	$	2,884	$	2,893
Short-term lease cost	38		35
Variable lease cost	652		599
Total lease cost	$	3,574	$	3,527

The following table summarizes additional information related to the Company’s operating leases (in thousands, except weighted average data):


	December 31,
	2023			2022
Right of use asset	$	3,406		$	5,806
Weighted average remaining lease term (years)	1.35			2.08
Weighted average discount rate	6.7		%	6.0		%

The following table summarizes other supplemental information related to the Company’s operating leases (in thousands):


	Years Ended December 31,
	2023		2022
Cash paid for amounts included in the measurement of lease liabilities included in cash flows used in operating activities	$	3,563	$	2,701
Right-of-use assets obtained in exchange for lease liabilities	$	284	$	229

Schedule of Maturity Analysis of Lease Liabilities

The following table summarizes a maturity analysis of the Company’s lease liabilities showing the aggregate lease payments as of December 31, 2023 (in thousands):


Fiscal Year Ending December 31,	Amount
2024	$	3,219
2025	1,098
2026	30
Total minimum lease payments	4,347
Less: Amount of lease payments representing interest	167
Present value of future minimum lease payments	$	4,180
Less: Current lease liabilities	3,074
Long-term lease liabilities	$	1,106

Stockholders' Equity - Shares Reserved for Future Issuance (Details) - shares	Dec. 31, 2023	Dec. 31, 2022	Sep. 30, 2020
Class of Stock [Line Items]
Shares reserved for future issuance (in shares)	9,366,145	8,471,816
Common stock options issued and outstanding
Class of Stock [Line Items]
Shares reserved for future issuance (in shares)	3,142,981	2,495,528
Common stock restricted stock units issued and outstanding
Class of Stock [Line Items]
Shares reserved for future issuance (in shares)	2,244,903	998,473
Common stock available for future grants
Class of Stock [Line Items]
Shares reserved for future issuance (in shares)	2,541,438	3,765,706
Common stock available for ESPP
Class of Stock [Line Items]
Shares reserved for future issuance (in shares)	1,436,823	1,212,109	720,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Summary of Significant Accounting Policies (Policies)	12 Months Ended
Summary of Significant Accounting Policies (Policies)	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The Company’s consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“U.S. GAAP”). Any reference in these notes to applicable guidance is meant to refer to the authoritative United States generally accepted accounting principles as found in the Accounting Standards Codification (“ASC”) and Accounting Standards Updates (“ASU”) of the Financial Accounting Standards Board (“FASB”).
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting periods. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, actual results may ultimately materially differ from these estimates and assumptions. Significant estimates and assumptions include reserves and write-downs related to inventories, classification of short-term and long-term inventories, the recoverability of long term assets, stock-based compensation, intangible assets, goodwill, deferred tax assets and related valuation allowances, and impact of contingencies.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying amounts of the Company’s financial instruments consisting of cash and cash equivalents, accounts receivable, accounts payable and accrued liabilities approximate fair value due to their relatively short maturities. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates their fair value. The fair value of marketable debt securities is estimated using Level 1 and Level 2 inputs
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with an original maturity of three months or less at the time of purchase to be cash equivalents, which include money market funds, commercial paper and corporate bonds.
Restricted Cash	Restricted Cash Restricted cash is comprised of cash that is restricted as to withdrawal or use under the terms of certain contractual agreements.
Marketable Securities	Marketable Securities The Company determines the appropriate classification of its investments in marketable securities at the time of purchase and reevaluates such designation at each balance sheet date. The Company has classified and accounted for its marketable securities as available-for-sale. After consideration of the Company’s risk versus reward objectives and liquidity requirements, the Company may sell these securities prior to their stated maturities. As the Company views these securities as available to support current operations, the Company classifies highly liquid securities with original maturities greater than three months at the time of purchase, and remaining maturities of less than one year, as short-term marketable securities and those with remaining maturities greater than twelve months as long-term marketable securities on the consolidated balance sheets. These securities are carried at fair value as determined based upon quoted market prices or pricing models for similar securities. Unrealized gains and losses on available for sale marketable securities, which consist of debt securities, if any, are excluded from earnings and are reported as a component of other comprehensive income (loss). The amortized cost of debt securities is adjusted for amortization of premiums and accretion of discounts to maturity, which is included in interest income on the consolidated statements of operations and comprehensive loss. Realized gains and losses, if any, on available-for-sale securities are included in other income (expense), net. The cost of securities sold is based on the specific identification method. Interest and dividends on securities classified as available-for-sale are included in interest income. For marketable securities in an unrealized loss position, the Company periodically assesses its portfolio for impairment. The assessment first considers the intent or requirement to sell the marketable security. If either of these criteria are met, the amortized cost basis is written down to fair value through earnings. Upon the adoption of ASU 2016-13, Financial Instruments – Credit Losses, on January 1, 2023, if the criteria above are not met, the Company evaluates whether the decline resulted from credit losses or other factors by considering the extent to which fair value is less than amortized cost, any changes to the rating of the marketable security by a rating agency, and any adverse conditions specifically related to the marketable security, among other factors. If this assessment indicates that a credit loss exists, the present value of cash flows expected to be collected from the marketable security is compared to the amortized cost basis of the marketable security. If the present value of cash flows expected to be collected is less than the amortized cost basis, a credit loss exists and an allowance for credit losses is recorded, limited by the amount that the fair value is less than the amortized cost basis. Any impairment that has not been recorded through an allowance for credit losses is recognized in other comprehensive loss.
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents and accounts receivable. The Company maintains its cash and cash equivalents balances with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation (“FDIC”) insured limits.
Accounts Receivable and Allowances	Accounts Receivable and Allowances Accounts receivable are recorded at the amounts billed less estimated allowances for credit losses for any potential uncollectible amounts. The Company continually monitors customer payments and maintains an allowance for estimated losses resulting from a customer’s inability to make required payments. The Company considers factors such as historical experience, credit quality, age of the accounts receivable balances, geographic related risks and economic conditions that may affect a customer’s ability to pay. Accounts receivable are written-off and charged against an allowance for credit losses when the Company has exhausted collection efforts without success.
Inventories	Inventories Inventories are valued at the lower of cost to purchase or manufacture the inventory or net realizable value. Cost is determined using the first-in, first-out method (“FIFO”) for all inventories. Net realizable value is determined as the estimated selling prices in the ordinary course of business, less reasonably predictable costs of completion, disposal and transportation. The Company records write-downs of inventories which are obsolete or in excess of anticipated demand or market value based on consideration of product lifecycle stage, technology trends, product development plans and assumptions about future demand and market conditions. Inventory write-downs reduce the carrying value of inventory to its net realizable value. The Company reviews its inventories for classification purposes. The value of inventories not expected to be realized in cash, sold or consumed during the next 12 months are classified as long-term inventory.
Internal-Use Software	Internal-Use Software The Company capitalizes certain costs in connection with obtaining or developing software for internal use. Amortization of such costs begins when the project is substantially complete and ready for its intended use. Capitalized software development costs are classified as property and equipment, net on the consolidated balance sheets and are amortized using the straight-line method over the estimated useful life of the applicable software.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are stated at cost less accumulated depreciation and amortization. Depreciation and amortization are computed using the straight-line method over the estimated useful lives of the assets, generally between three to five years. Leasehold improvements are amortized using the straight-line method over the shorter of the lease term or useful economic life of the asset. When assets are retired or otherwise disposed of, the cost and accumulated depreciation are removed from the balance sheet, and any resulting gain or loss is reflected in operations in the period realized.
Impairment of Long-lived Assets	Impairment of Long-lived Assets The Company evaluates its long-lived assets for indicators of possible impairment by comparison of the carrying amounts to future net undiscounted cash flows expected to be generated by such assets when events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Should an impairment exist, the impairment loss would be measured based on the excess carrying value of the asset over the asset’s fair value or discounted estimates of future cash flows. The Company has not identified any such impairment losses to date.
Goodwill	Goodwill Goodwill represents the excess of the purchase price over the fair value of net tangible and identified intangible assets acquired in a business combination. Goodwill is not amortized but is evaluated at least annually for impairment or when a change in facts and circumstances indicate that the fair value of the goodwill may be below its carrying value. The Company tests goodwill for impairment at the reporting unit level (“reporting unit”). The Company has determined that it has one operating segment and one reporting unit. The operating results are reviewed only on a consolidated basis to make decisions about resources to be allocated and assess performance. Prior to performing the impairment test, the Company assesses qualitative factors to determine whether the existence of events or circumstances would indicate that it is more likely than not that the fair value of the reporting unit was less than the carrying amount. If after assessing the totality of events or circumstances, the Company were to determine that it is more likely than not that the fair value of the reporting unit is less than the carrying amount, then the Company would perform a quantitative impairment test. The quantitative impairment test involves comparing the fair value of the reporting unit to the carrying value. If the fair value of the reporting unit exceeds the carrying value of the net assets, goodwill is not impaired, and no further testing is required. If the fair value of the reporting unit is less than the carrying value, the Company measures the amount of impairment loss, if any, as the excess of the carrying value over the fair value of the reporting unit. Estimations and assumptions regarding the future performance and results of the Company’s operations, including estimates related to future sales growth, gross margin and operating expenses, and the fair value of the Company’s common stock are used in the impairment assessment. Circumstances that could reasonably be expected to negatively affect the key assumptions related to the impairment assessment include but are not limited to, (1) a significant adverse change in legal factors affecting our existing and future products or in business climate, (2) unanticipated competition, (3) an adverse action or assessment by a regulator, or (4) an adverse change in market conditions that are indicative of a decline in the fair value of the assets.
Intangible Assets	Intangible Assets Intangible assets consist of developed technology and trademarks. Intangible assets were recorded at their fair values at the date of acquisition and are amortized using the straight-line method over a 15-year useful life (Note 5).
Leases	Leases The Company leases facilities and vehicles and meets the requirements to account for these leases as operating leases. The Company recognizes rent expense on a straight-line basis over the non-cancelable lease term. Where leases contain escalation clauses, rent abatements or concessions, such as rent holidays and landlord or tenant incentives or allowances, the Company applies them in the determination of straight-line rent expense over the lease term. The Company determined if an arrangement is a lease, or contains a lease, at inception. The asset component of the Company’s operating leases is recorded as right-of-use assets, and the liability component is recorded as current lease liabilities and long-term lease liabilities in the Company’s consolidated balance sheets. As of December 31, 2023 and 2022, the Company did not record any finance leases. ROU assets and lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate, which is the estimated rate the Company would be required to pay for a fully collateralized borrowing equal to the total lease payments over the term of the lease, to determine the present value of future minimum lease payments. The ROU asset also includes any lease payments made to the lessor at or before the commencement date, minus lease incentives received, and initial direct costs incurred. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. For lease agreements entered into or reassessed after the adoption of ASC 842, the Company combines lease and non-lease components. Variable lease payments are expenses as incurred. The Company does not recognize lease liabilities and ROU assets for short-term leases with terms of twelve months or less. Assumptions made by the Company at the commencement date are re-evaluated upon occurrence of certain events, including a lease modification. A lease modification results in a separate contract when the modification grants the lessee an additional right of use not included in the original lease and when lease payments increase commensurate with the standalone price for the additional right of use. When a lease modification results in a separate contract, it is accounted for in the same manner as a new lease.
Revenue Recognition	Revenue Recognition The Company’s revenue is generated primarily from the sale of its products to hospitals and distributors in the United States and international markets. Under ASC 606, revenue is recognized when the customer obtains controls of promised goods or services, in an amount that reflects consideration which the entity expects to receive in exchange for those goods or services. The Company determines revenue recognition by applying the following five steps as prescribed by ASC 606: (i)identify the contract(s) with a customer; (ii)identify the performance obligations in the contract; (iii)determine the transaction price; (iv)allocate the transaction price to the performance obligations in the contract; and (v)recognize revenue when (or as) the entity satisfies performance obligations. A contract with a customer exists when (i) the Company enters into a legally enforceable contract with a customer that defines each party’s rights regarding the products or services to be transferred and identifies the payment terms related to these products or services, (ii) the contract has commercial substance and, (iii) the Company determines that collection of substantially all consideration for products or services that are transferred is probable based on the customer’s intent and ability to pay the promised consideration. The Company identifies performance obligations in contracts with customers, which may include its products and implied promises to provide free products and analysis services for patient scans. The transaction price is determined based on the amount expected to be entitled to in exchange for transferring the promised services or product to the customer. The Company is entitled to the total consideration for the products ordered by customers, net of early pay discounts, volume rebate adjustments and other transaction price adjustments. The Company’s payment terms to customers generally range from 30 to 60 days. Payment terms fall within the one-year guidance for the practical expedient which allows the Company to forgo adjustment of the promised amount of consideration for the effects of a significant financing component. The Company excludes taxes assessed by governmental authorities on revenue-producing transactions from the measurement of the transaction price. Assuming all other revenue recognition criteria are met, revenue is recognized when control of the Company’s products transfers to the customer. For sales where the Company’s sales representative hand delivers product directly to the hospital or medical center, control transfers to the customer upon this delivery. For sales where products are shipped, control is transferred either upon shipment or delivery of the products to the customer, depending on the shipping terms and conditions. For consignment sales, control is transferred when the products are used by the customer in procedures. The Company defers revenue relating to any remaining performance obligations by the Company to the customer after delivery, such as free products and free analysis services of patient scans to determine suitability of the patients for the treatment using the Company’s Zephyr Valves. As permitted under the practical expedient, the Company does not disclose the value of unsatisfied performance obligations for contracts with an original expected length of one year or less. The Company accepts product returns at its discretion or if the product is defective as manufactured. Historically, the actual product returns have been immaterial to the Company’s financial statements. The Company elected to treat shipping and handling costs as a fulfillment cost and include them in the cost of goods sold as incurred. In those cases where the Company bills shipping and handling costs to customers, it will classify the amounts billed within revenue. The Company disaggregates its revenue by major geographic region, which is disclosed in Note 12, “Segment Information”. Costs associated with product sales include commissions. The Company applies the practical expedient and recognizes commissions as expense when incurred because the expense is incurred at a point in time and the amortization period is less than one year. Commissions are recorded as selling expense.
Cost of Goods Sold	Cost of Goods Sold The Company manufactures certain products at its facility and purchases other products from third party manufacturers. Cost of goods sold consists primarily of costs related to materials, components and subassemblies, third-party costs, manufacturing overhead costs, direct labor, reserves for excess, obsolete and non-sellable inventories and distribution-related expenses. A significant portion of the Company’s cost of goods sold currently consists of manufacturing overhead costs. These overhead costs include the cost of quality assurance, material procurement, inventory control, facilities, equipment and operations supervision and management. Cost of goods sold also includes depreciation expense for production equipment and certain direct costs such as shipping costs.
Research and Development	Research and Development Research and development expenses consist of compensation costs, stock-based compensation, engineering and research expenses, clinical trials and related expenses, regulatory expenses, manufacturing expenses incurred to build products for testing, allocated facilities costs, consulting fees and other expenses incurred to sustain the Company’s overall research and development programs. All research and development costs are expensed as incurred. Clinical trial costs are a significant component of the Company’s research and development expenses. The Company has a history of contracting with third parties that perform various clinical trial activities on the Company’s behalf in the ongoing development of its product candidates. The financial terms of these contracts are subject to negotiations and may vary from contract to contract and may result in uneven payment flow. The Company accrues and expenses costs for its clinical trial activities performed by third parties, including clinical research organizations and other service providers, based upon estimates of the work completed over the life of the individual study in accordance with associated agreements. The Company determines these estimates through discussion with internal personnel and outside service providers as to progress or stage of completion of trials or services pursuant to contracts with clinical research organizations and other service providers and the agreed-upon fee to be paid for such services.
Advertising Costs	Advertising Costs The Company expenses the costs of advertising as incurred.
Foreign Currency Translation and Transaction Gains and Losses	Foreign Currency Translation and Transaction Gains and Losses The functional currencies of the Company’s wholly owned subsidiaries in Switzerland, Germany, Australia, the United Kingdom, France and Hong Kong are the Swiss franc. The functional currency of the Company’s subsidiaries in Italy and Japan is the Euro and Yen, respectively. Accordingly, asset and liability accounts of Switzerland, France, Germany, Australia, the United Kingdom, Italy, Hong Kong and Japan operations are translated into U.S. dollars using the current exchange rate in effect at the balance sheet date and equity accounts are translated into U.S. dollars using historical rates. The revenues and expenses are translated using the average exchange rates in effect during the period, and gains and losses from foreign currency translation adjustments are included as a component of accumulated other comprehensive income in the consolidated balance sheet.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for stock-based compensation arrangements with employees and non-employees in accordance with ASC 718, Compensation—Stock Compensation, using a fair-value based method. The Company determines the fair value of all stock options and the 2020 Employee Share Purchase Plan (“ESPP”) awards on the date of grant using the Black-Scholes option pricing model. The Company’s determination of the fair value is impacted by its common stock price as well as assumptions regarding a number of complex and subjective variables. These variables include, but are not limited to, the expected term that options will remain outstanding, expected common stock price volatility over the term of the option awards, risk-free interest rates and expected dividends. Changes in the assumptions can materially affect the fair value and ultimately how much stock-based compensation expense is recognized. These inputs are subjective and generally require significant analysis and judgment to develop. The fair value of time-based awards is recognized over the period during which an option holder is required to provide services in exchange for the option award, known as the requisite service period, which is typically the vesting period using the straight-line method. The fair value of performance-based awards, if applicable, is recognized over the requisite service period using the graded vesting method. The Company accounts for forfeitures as they occur. The Company issued stock options in exchange for the receipt of goods or services from non-employees. Costs for such equity instruments are measured at the fair value of the equity instruments issued on the measurement date as the Company believes that the fair value of the equity instrument is more reliably measured than the fair value of the services received.
Income Taxes	Income Taxes The Company accounts for income taxes under the asset and liability method, whereby deferred tax assets and liabilities are determined based on the difference between the consolidated financial statements and tax bases of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to affect taxable income. A valuation allowance is established when necessary to reduce deferred tax assets when management estimates, based on available objective evidence, that it is more likely than not that the benefit will not be realized for the deferred tax assets. The Company also follows the provisions of ASC 740-10, Accounting for Uncertainty in Income Taxes. ASC 740-10 prescribes a comprehensive model for the recognition, measurement, presentation and disclosure in financial statements of any uncertain tax positions that have been taken or expected to be taken on a tax return. No liability related to uncertain tax positions is recorded on the consolidated financial statements. It is the Company’s policy to include penalties and interest expense related to income taxes as part of the provision for income taxes.
Net Loss per Share Attributable to Common Stockholders	Net Loss per Share Attributable to Common Stockholders Basic net loss per common share is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of common stock outstanding during the period, without consideration of potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss attributable to common stockholders by the weighted-average number of common stock and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, stock options and common stock subject to repurchase related to early exercise of stock options are considered to be potentially dilutive securities. Basic and diluted net loss attributable to common stockholders per share is presented in conformity with the two-class method required for participating securities. The Company considers the shares issued upon the early exercise of stock options subject to repurchase to be participating securities, because holders of such shares have non-forfeitable dividend rights in the event a dividend is paid on common stock. The holders of the shares issued upon early exercise of stock options subject to repurchase do not have a contractual obligation to share in the Company’s losses. As such, the net loss was attributed entirely to common stockholders. Because the Company has reported a net loss for all periods presented, diluted net loss per common share is the same as basic net loss per common share for those periods.
Comprehensive Loss	Comprehensive Loss The Company is required to report all components of comprehensive loss, including net loss, in the financial statements in the period in which they are recognized. Comprehensive gain or loss is defined as a change in equity of a business enterprise during a period, resulting from transactions and other events and circumstances from non-owner sources. The Company’s currency translation adjustment and unrealized gains and losses from marketable securities are the components of other comprehensive income (loss) that are excluded from the reported net loss for all periods presented.
Recently Adopted Accounting Pronouncements and Recent Accounting Pronouncements Not Yet Adopted	Recently Adopted Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses. This new guidance will require financial instruments to be measured at amortized cost, and trade accounts receivable to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information and reasonable and supportable forecasts, including estimates of prepayments. In November 2019, the FASB issued ASU 2019-10, according to which, the new standard is effective for public business entities that meet the definition of an SEC filer, excluding entities eligible to be smaller reporting companies (“SRC”) as defined by the SEC, for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. For all other entities, including the Company, the new standard is effective for fiscal years beginning after December 15, 2022, and interim periods within that fiscal year. The Company adopted ASU 2016-13 as of January 1, 2023 and the adoption did not have a material impact on the Company’s consolidated financial statements and related disclosures. Recent Accounting Pronouncements Not Yet Adopted In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. The amendments in this ASU require disclosures, on an annual and interim basis, of significant segment expenses that are regularly provided to the chief operating decision maker (CODM), as well as the aggregate amount of other segment items included in the reported measure of segment profit or loss. This ASU requires that a public entity disclose the title and position of the CODM and an explanation of how the CODM uses the reported measure(s) of segment profit or loss. Public entities will be required to provide all annual disclosures currently required by Topic 280 in interim periods, and entities with a single reportable segment are required to provide all the disclosures required by the amendments in the update and existing segment disclosures in Topic 280. This ASU is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact that this update will have on its disclosures in the consolidated financial statements. In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, which improves the transparency of income tax disclosures by requiring consistent categories and greater disaggregation of information in the effective tax rate reconciliation and income taxes paid disaggregated by jurisdiction. It also includes certain other amendments to improve the effectiveness of income tax disclosures. The standard is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the disclosure requirements related to the new standard. All other newly issued accounting pronouncements not yet effective have been deemed either immaterial or not applicable.
Assets and Liabilities Measured at Fair Value	Assets and liabilities recorded at fair value in the consolidated financial statements are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Hierarchical levels which are directly related to the amount of subjectivity associated with the inputs to the valuation of these assets or liabilities are as follows: Level 1—Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date. Level 2—Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities. Level 3—Unobservable inputs for the asset or liability only used when there is little, if any, market activity for the asset or liability at the measurement date. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis—Financial assets and liabilities held by the Company measured at fair value on a recurring basis include money market funds and marketable securities. Assets and Liabilities Measured and Recorded at Fair Value on a Nonrecurring Basis—The Company determines the fair value of long-lived assets held and used, such as intangible assets, by reference to independent appraisals, quoted market prices (e.g. an offer to purchase) and other factors. An impairment charge is recorded when the carrying value of the asset exceeds its fair value. As noted above, there have been no impairment charges recorded to date. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates the fair value. The fair value of the term loan is estimated using Level 2 inputs. Assets and liabilities measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires management to make judgments and consider factors specific to the asset or liability.

Segment Information - Narrative (Details) - segment	12 Months Ended
Segment Information - Narrative (Details) - segment	Dec. 31, 2023	Dec. 31, 2022
Concentration Risk [Line Items]
Number of reportable segments	1
Number of operating segments	1
Revenue from Contract with Customer Benchmark \| Geographic Concentration Risk \| Germany
Concentration Risk [Line Items]
Concentration risk, percentage	8.00%	11.00%

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

Income before the provision for income taxes consists of the following (in thousands):


	Years Ended December 31,
	2023		2022
Domestic	$	(60,503)	$	(59,361)
Foreign	231		791
Total loss before provision for taxes	$	(60,272)	$	(58,570)

The components of income tax expense are as follows (in thousands):


	Years Ended December 31,
	2023		2022
Current:
Federal	$	—	$	—
State	62		66
Foreign	483		232
Total current expense	$	545	$	298

Deferred:
Federal	$	7	$	32
State	10		14
Foreign	9		9
Total deferred expense	26		55
Total income tax expense	$	571	$	353

The reconciliation between the federal statutory rate and the Company’s effective tax rate is summarized below:


	Years Ended December 31,
	2023		2022
Federal statutory rate	21.0	%	21.0	%
State taxes, net of federal benefit	(0.1)	%	(0.1)	%
Foreign earnings at different rates	(0.5)	%	(0.1)	%
Tax credits	(0.9)	%	1.8	%
Permanent differences	(4.6)	%	(4.6)	%
Prior year true-up	0.6	%	(0.8)	%
Change in valuation allowance	(16.4)	%	(17.8)	%
Effective tax rate	(0.9)	%	(0.6)	%

Deferred income taxes arise from temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax reporting purposes, as well as operating losses and tax credit carryforwards. Significant components of the Company’s deferred tax assets and liabilities for federal and state income taxes are as follows (in thousands):


	December 31,
	2023		2022
Deferred tax assets:
Net operating loss carryforwards	$	57,420	$	50,316
Tax credit carryforwards	6,493		7,169
Accruals and reserves	2,287		1,900
Depreciation	243		183
Intangible assets	4,049		4,394
Right of use liability	920		1,443
Capitalized research costs	5,749		2,838
Other	3,371		1,739
Gross deferred tax assets	80,532		69,982
Less: valuation allowance	(79,362)		(68,427)
Deferred tax assets	$	1,170	$	1,555
Deferred tax liabilities:
Right of use asset	$	(739)	$	(1,147)
Goodwill	(545)		(502)
Net deferred tax liabilities	$	(114)	$	(94)

The Company has established a full valuation allowance against its U.S. net deferred tax assets due to the uncertainty surrounding the realization of such assets. Realization of deferred tax assets is dependent upon future earnings, if any, the timing and amount of which are uncertain. Accordingly, the U.S. net deferred tax assets have been fully offset by a valuation allowance of $79.4 million as of December 31, 2023. The valuation allowance increased by $10.9 million and $11.9 million for the years ended December 31, 2023 and December 31, 2022, respectively.

As of December 31, 2023, the Company had a total net operating loss carryforwards for federal income tax purposes of approximately $245.8 million. If not utilized, these net federal operating loss carryforwards will begin to expire in 2024. The Company also had a state net operating loss carryforward of approximately $155.4 million which will begin to expire in 2024.

For tax years in January 1, 2018 onwards, any federal net operating losses generated will be allowable for carry forward indefinitely, as opposed to the original expiration of 20 years. As of December 31, 2023, the Company had $173.9 million of federal net operating losses that can be carryforward indefinitely.

The Company also had federal and state research and development (“R&D”) tax credit carryforwards of approximately $3.6 million and $5.1 million, respectively. The federal tax R&D credit carryforwards will expire beginning in the year 2030 while the state tax credit carryforwards have no expiration date.

Utilization of the net operating loss carryforwards and R&D tax credit carryforwards may be subject to annual limitations due to the ownership change limitations provided by the Internal Revenue Code, as defined in Section 382, and other similar state provisions. The annual limitation may result in the expiration of net operating losses and credits before utilization. During the year ended December 31, 2018, the Company completed a section 382 study for which the Company wrote off deferred tax assets for net operating losses and credits of $3.1 million and $1.2

million, respectively. Since the Company had a full valuation allowance on these assets, there was no material impact to the tax provision. The Company completed another section 382 study for the year ended December 31, 2020 for which the Company had a change in ownership. No additional net operating losses or credits will expire unused due to the 2020 annual limitation. The Company completed another section 382 study for the year ended December 31, 2022 for which the Company had no change in ownership. Additionally, based on the Company’s analysis, no further material net operating losses or credits have expired unused due to the section 382 limitations as of December 31, 2023.

Annually, the Company determines whether it is “more likely than not” that a tax position will be sustained upon examination by the appropriate taxing authorities in considering whether any tax benefit can be recorded in the consolidated financial statements. As of December 31, 2023, the Company had unrecognized tax benefits of approximately $8.7 million, none of which will affect the effective tax rate if recognized. It is unlikely that the amount of liability for unrecognized tax benefits will significantly change over the next 12 months.

The following table summarizes the activity related to the Company’s gross unrecognized tax benefits (in thousands):


Balance at December 31, 2021	$	8,489
Additions for tax positions related to prior year	106
Decreases for tax positions related to prior year	(153)
Additions for tax positions related to current year	200
Balance at December 31, 2022	$	8,642
Additions for tax positions related to prior year	144
Decreases for tax positions related to prior year	(162)
Additions for tax positions related to current year	38
Balance at December 31, 2023	$	8,662

It is the Company's policy to include penalties and interest expense related to income taxes as a component of other income (expense), net and interest expense, respectively, as necessary.

The Company’s major tax jurisdictions are the United States and California, and Switzerland and Neuchâtel. All of the Company’s tax years will remain open for examination by the federal and state tax authorities for three and four years, respectively, from the date of utilization of the net operating losses or R&D Credits. The Company does not have any tax audits or other issues pending.

As currently enacted, the Tax Cuts and Jobs Act (the "Tax Act") requires taxpayers to capitalize research and development expenses with amortization periods over five and fifteen years, which is expected to decrease the amount of the Company's generated net operating losses during the year.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Balance Sheet Components - Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Prepaid expenses	$ 1,910	$ 2,044
Prepaid insurance	906	1,407
VAT and other receivable	915	602
Other current assets	504	290
Total prepaid expenses and other current assets	$ 4,235	$ 4,343

Consolidated Statements of Stockholders’ Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income	Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2021		36,931,762
Beginning balance at Dec. 31, 2021	$ 193,239	$ 37	$ 482,885	$ 1,712	$ (291,395)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock upon vesting of restricted stock unit (in shares)		251,133
Issuance of common stock upon exercise of stock options (in shares)	297,463	297,463
Issuance of common stock upon exercise of stock options	$ 635	$ 1	634
Issuance of shares pursuant to Employee Stock Purchase Plan (in shares)		89,666
Issuance of shares pursuant to Employee Stock Purchase Plan	1,942		1,942
Repurchase of early exercised common stock options (in shares)		(14,459)
Change in shares subject to repurchase	227		227
Stock-based compensation expense	17,024		17,024
Currency translation adjustment	150			150
Change in unrealized gains (loss) on marketable securities	(287)			(287)
Net loss	$ (58,923)				(58,923)
Ending balance (in shares) at Dec. 31, 2022	37,555,565	37,555,565
Ending balance at Dec. 31, 2022	$ 154,007	$ 38	502,712	1,575	(350,318)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock upon vesting of restricted stock unit (in shares)		672,180
Issuance of common stock upon vesting of restricted stock units	$ 0	$ 1	(1)
Issuance of common stock upon exercise of stock options (in shares)	137,902	137,902
Issuance of common stock upon exercise of stock options	$ 314	$ 0	314
Issuance of shares pursuant to Employee Stock Purchase Plan (in shares)		150,842
Issuance of shares pursuant to Employee Stock Purchase Plan	1,184		1,184
Repurchase of early exercised common stock options (in shares)		(106)
Change in shares subject to repurchase	144		144
Stock-based compensation expense	22,444		22,444
Currency translation adjustment	671			671
Change in unrealized gains (loss) on marketable securities	394			394
Net loss	$ (60,843)				(60,843)
Ending balance (in shares) at Dec. 31, 2023	38,516,383	38,516,383
Ending balance at Dec. 31, 2023	$ 118,315	$ 39	$ 526,797	$ 2,640	$ (411,161)

Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Statement [Abstract]
Revenue	$ 68,675	$ 53,662
Cost of goods sold	17,923	13,797
Gross profit	50,752	39,865
Operating expenses
Research and development	18,080	15,397
Selling, general and administrative	94,607	83,105
Total operating expenses	112,687	98,502
Loss from operations	(61,935)	(58,637)
Interest income	5,568	1,529
Interest expense	(3,232)	(1,066)
Other income (expense), net	(673)	(396)
Net loss before tax	(60,272)	(58,570)
Income tax expense	571	353
Net loss	(60,843)	(58,923)
Other comprehensive income (loss)
Currency translation adjustment	671	150
Change in unrealized gain (losses) on marketable securities	394	(287)
Total other comprehensive income (loss)	1,065	(137)
Comprehensive loss	$ (59,778)	$ (59,060)
Net loss per share attributable to common stockholders, basic (in dollars per share)	$ (1.60)	$ (1.59)
Net loss per share attributable to common stockholders, diluted (in dollars per share)	$ (1.60)	$ (1.59)
Weighted-average shares used in computing net loss per share attributable to common stockholders, basic (in shares)	37,974,567	37,096,541
Weighted-average shares used in computing net loss per share attributable to common stockholders, diluted (in shares)	37,974,567	37,096,541

Leases, Lease Commitments and Contingencies - Narrative (Details) $ in Millions	1 Months Ended				12 Months Ended
	Apr. 30, 2023 USD ($)	Sep. 30, 2020 USD ($)	Aug. 31, 2020 USD ($)	Apr. 30, 2020 USD ($)	Dec. 31, 2013	Dec. 31, 2023 lease
Lessee, Lease, Description [Line Items]
Lease renewal term			5 years
Monthly base rent			$ 0.1
Annual increase rate			3.50%
Option to terminate, notice period					12 months
Sublease term		4 years		3 years
Sublease, option to terminate, notice period				180 days
Sublease, period for option to terminate				18 months
Sublease monthly rent (less than)		$ 0.1		$ 0.1
Monthly base rent, annual increase rate		3.50%		3.50%
Sublease, tenant improvement allowance, receivable upon lease renewal		$ 0.7
Sublease renewal term		12 months
Extended term	4 months
Right-of-use asset obtained in exchange for finance lease liability	$ 0.2
Number of vehicle leases \| lease						14
Office Facilities
Lessee, Lease, Description [Line Items]
Lease term					5 years
Vehicles
Lessee, Lease, Description [Line Items]
Lease term						3 years

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets
Cash and cash equivalents	$ 83,547	$ 101,736
Restricted cash	237	231
Short-term marketable securities	33,555	39,402
Accounts receivable, net	12,105	8,677
Inventory	16,743	14,564
Prepaid expenses and other current assets	4,235	4,343
Total current assets	150,422	168,953
Long-term marketable securities	14,390	5,924
Long-term inventory	2,580	5,283
Property and equipment, net	4,028	4,694
Goodwill	2,333	2,333
Intangible assets, net	31	154
Right of use assets	3,406	5,806
Other long-term assets	591	529
Total assets	177,781	193,676
Current liabilities
Accounts payable	1,497	1,758
Accrued liabilities	16,234	13,276
Income taxes payable	93	19
Deferred revenue	104	120
Short-term debt	2,155	90
Current lease liabilities	3,074	3,229
Total current liabilities	23,157	18,492
Deferred tax liability	114	94
Long-term lease liabilities	1,106	3,849
Long-term debt	35,089	17,234
Total liabilities	59,466	39,669
Commitments and contingencies (Note 8)
Stockholders’ Equity
Preferred stock, $0.001 par value, 10,000,000 shares authorized; no shares issued and outstanding as of December 31, 2023 and December 31, 2022	0	0
Common stock, $0.001 par value, 200,000,000 shares authorized; 38,516,383 shares and 37,555,565 shares issued and outstanding as of December 31, 2023 and December 31, 2022, respectively	39	38
Additional paid-in capital	526,797	502,712
Accumulated other comprehensive income	2,640	1,575
Accumulated deficit	(411,161)	(350,318)
Total stockholders’ equity	118,315	154,007
Total liabilities and stockholders’ equity	$ 177,781	$ 193,676

Long Term Debt

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Long Term Debt

CIBC Loan

On February 20, 2020, the Company executed a Loan and Security Agreement with Canadian Imperial Bank of Commerce (“CIBC”), which the Company subsequently amended on April 17, 2020 and December 28, 2020 (as amended, the “CIBC Agreement”). The CIBC Agreement originally provided the Company with the ability to borrow up to $32.0 million in debt financing (“CIBC Loan”) consisting of $17.0 million advanced at the closing of the agreement (“Tranche A”), with the option to draw up to an additional $8.0 million (“Tranche B”) and an additional financing tranche (“Tranche C”) of up to $7.0 million on or prior to February 20, 2022. Neither Tranche B nor Tranche C was drawn before the option expired.

The CIBC Loan originally had a five-year term maturing on February 20, 2025, which included 24 months of interest only payments followed by 36 months of equal payments of principal and interest. In April 2020, the Company entered into a First Amendment to CIBC Agreement that changed the maturity date to March 15, 2022, which would be automatically extended to February 20, 2025 if the maturity of all outstanding convertible notes was extended to a date no earlier than May 21, 2025 or all convertible notes converted into convertible preferred stock of the Company. An amendment fee of $0.2 million was paid. The amendment was accounted for as a debt modification and no gain or loss was recognized. In December 2020, to address certain post-close covenants for which the Company was not in compliance, the Company entered into a Second Amendment to the CIBC Agreement that extended the compliance of such covenants to June 30, 2021.

In March 2021, the Company entered into an Amended and Restated Loan and Security Agreement with CIBC (as amended, the “Amended and Restated CIBC Agreement”) which, among other things, extended the loan maturity date of the CIBC Loan from March 15, 2022 to February 20, 2025, and modified certain financial covenants. Per the amended terms, 36 equal payments of principal plus accrued interest would be due beginning March 31, 2022. In connection with the Amended and Restated CIBC Agreement, the Company paid fees to CIBC of less than $0.1 million which were recorded as a discount on the CIBC Loan and are being accreted over the life of the term loan using the effective interest method. The amendment was accounted for as a debt modification and no gain or loss was recognized.

In June 2021, the Company entered into a First Amendment to the Amended and Restated CIBC Agreement that extended the compliance of certain post-close covenants to March 31, 2022.

In October 2021, the Company entered into a Second Amendment to the Amended and Restated CIBC Agreement, which extended the interest only period of the loan from 24 months to 36 months. Under the amended terms, principal repayment will begin in February 2023. There was no change to the loan interest rate or maturity date.

In October 2022, the Company entered into a Third Amendment to the Amended and Restated CIBC Agreement (the “Third Amendment”) with CIBC, which amended certain provisions of the CIBC Loan. The amendment provided the option to draw up to an additional $20.0 million (“Amended Tranche B”) on or prior to October 31, 2023, which can be drawn in increments of at least $5.0 million. Upon request by the Company, CIBC may, in its sole discretion, make additional term loans of up to $10.0 million (“Amended Tranche C”) at any time. The Third Amendment extended the maturity date of the CIBC Loan from February 20, 2025 to October 31, 2027 and provided for a new interest only period of 24 months from the signing date of the Third Amendment, with the possibility of an additional extension of such interest only period of up to 12 months, subject to satisfaction of certain conditions set forth in the Third Amendment. The Company paid a commitment fee of less than $0.1 million in connection with the Third Amendment. The amendment was accounted for as a debt modification and no gain or loss was recognized.

In February 2023, the Company drew $20.0 million of the Amended Tranche B of the CIBC Loan. The Amended Tranche B bears interest at a floating rate equal to 1.0% above the Wall Street Journal Prime Rate and has the same repayment terms as the Tranche A.

Upon draw of the Amended Tranche B, the financial covenants in the Amended and Restated CIBC Agreement require that, when the cash and cash equivalents of the Company as defined in the Amended and Restated CIBC Agreement is less than $100.0 million, the Company have revenue for the trailing three-month period ending on the last day of each fiscal quarter of not less than 80.0% of the revenue for the trailing three-month period, as set forth in the annual projections delivered to the CIBC. Further, the Company is required to maintain unrestricted cash in an aggregate amount equal to the greater of $20.0 million and the Adjusted EBITDA loss as defined in the Amended and Restated CIBC Agreement for the six-month period ending on any date of determination. As of December 31, 2023, the Company was in compliance with all covenants contained in Amended and Restated CIBC Agreement.

The CIBC Loan bears interest at a floating rate equal to 1.0% above the Wall Street Journal Prime Rate at any time. The CIBC Loan is collateralized by substantially all of the Company’s assets, including cash and cash equivalents, accounts receivable, intellectual property and equipment. The Company may prepay the borrowings under the Amended and Restated CIBC Agreement, subject to certain conditions, including a prepayment fee equal to 2.0% of the principal amount repaid during the first year after the effective date of the Third Amendment or 1.0% of the principal amount prepaid during the second year after the effective date of the Third Amendment. As of December 31, 2023 and December 31, 2022, the CIBC Loan had an annual effective interest rate of 10.1% and 9.1% per year.

The CIBC Loan consists of the following (in thousands):


	December 31,
	2023		2022
Term loan	$	37,000	$	17,000
Less: debt issuance costs	(152)		(127)
Term loan	$	36,848	$	16,873
Reported as:
Short-term debt	$	2,056	$	—
Long-term debt	34,792		16,873
Total term loan	$	36,848	$	16,873

The Company paid $0.5 million fees to the lender and third parties, which is reflected as a discount on the CIBC Loan and is being accreted over the life of the term loan using the effective interest method.

During the years ended December 31, 2023 and December 31, 2022, the Company recorded interest expense related to debt discount and debt issuance costs of CIBC Loan of less than $0.1 million and $0.1 million, respectively.

Interest expense on the CIBC Loan amounted to $3.2 million and $1.1 million during the years ended December 31, 2023 and December 31, 2022, respectively.

Credit Agreement

In May 2020, Pulmonx International Sàrl, a wholly owned subsidiary of the Company, received 0.5 million Swiss Francs ($0.5 million U.S. dollar equivalent) from a COVID-19 Credit Agreement under a Swiss Federal Government program designed to mitigate the economic impact of the spread of the coronavirus. The COVID-19 Credit Agreement initially bore no interest through March 31, 2023. Beginning April 1, 2023, the COVID-19 Credit Agreement bears interest at a rate of 1.5% per year, payable at the end of each calendar quarter. The loan principal is being repaid in twelve equal installments, paid semi-annually, which began in March of 2022. Interest expense was immaterial during the year ended December 31, 2023. Pulmonx International Sàrl repaid $0.1 million and $0.1 million to the lender during the years ended December 31, 2023 and December 31, 2022, respectively.

Contractual Maturities of Financing Obligations

As of December 31, 2023, the aggregate future payments under the CIBC Loan and Credit Agreement (including interest payments) are as follows (in thousands):


Fiscal Year Ending December 31,	Amount
2024	$	5,666
2025	15,217
2026	14,043
2027	10,823
Total	$	45,749
Less: unamortized debt discount	(152)
Less: interest	(8,353)
Term loan and credit agreement	$	37,244

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

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+ Details

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net loss	$ (60,843)	$ (58,923)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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Reference 31: http://www.xbrl.org/2003/role/disclosureRef
-Topic 260
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 60B
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482689/260-10-45-60B

Reference 32: http://www.xbrl.org/2003/role/exampleRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-31

Reference 33: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 34: http://www.xbrl.org/2003/role/disclosureRef
-Topic 205
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483499/205-20-50-7

Reference 35: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 230
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Publisher FASB
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Reference 36: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 1A
-Subparagraph (a)
-Publisher FASB
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Reference 37: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
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-Paragraph 1B
-Subparagraph (a)
-Publisher FASB
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-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(20))
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Reference 39: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 942
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(22))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483589/942-220-S99-1

+ Details

Stockholders' Equity - Narrative (Details)	1 Months Ended		12 Months Ended
Stockholders' Equity - Narrative (Details)	Jan. 31, 2024 shares	Sep. 30, 2020 USD ($) shares	Dec. 31, 2023 USD ($) vote $ / shares shares	Dec. 31, 2022 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock, shares authorized (in shares) \| shares			200,000,000	200,000,000
Dividends declared			$ 0
Number of votes for each share of common stock held \| vote			1
Shares reserved for future issuance (in shares) \| shares			9,366,145	8,471,816
Options exercised, aggregate intrinsic value			$ 1,300,000	$ 4,600,000
Options exercisable, aggregate intrinsic value			11,100,000	6,900,000
Options outstanding, aggregate intrinsic value			11,100,000	6,900,000
Options vested and expenses to vest, intrinsic value			8,600,000	4,100,000
Aggregate exercise price of shares subject to repurchase			$ 100,000	$ 100,000
Fair value of stock options granted (in dollars per share) \| $ / shares			$ 7.77	$ 10.74
Fair value of shares vested			$ 21,700,000	$ 15,500,000
Cost Of Goods And Services Sold
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation capitalized into inventory			1,300,000	700,000
Inventory, Net
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation capitalized into inventory			$ 1,600,000	$ 1,200,000
Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Repurchase of early exercised common stock options (in shares) \| shares			106	14,459
Common stock, shares repurchased, less than			$ 100,000	$ 100,000
Options to purchase common stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Purchase price of common stock, percentage of fair market value, greater than			100.00%
Award vesting period			4 years
Award expiration period, not more than			10 years
Shares subject to repurchase (in shares) \| shares			109	77,782
Weighted-average period for recognition of compensation costs			2 years 6 months
Options to purchase common stock \| Share-based Payment Arrangement, Tranche Four
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rate			25.00%
Options to purchase common stock \| Share-based Payment Arrangement, Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rate			25.00%
Options to purchase common stock \| Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rate			25.00%
Options to purchase common stock \| Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting rate			25.00%
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options outstanding, aggregate intrinsic value			$ 28,600,000	$ 8,400,000
Fair value of shares vested			$ 7,500,000	$ 3,900,000
Shares committed under ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares reserved for future issuance (in shares) \| shares		720,000	1,436,823	1,212,109
Payroll deduction rate, percentage of base compensation		15.00%
Maximum number of shares available per employee (in shares) \| shares		2,500
Maximum amount of shares per employee		$ 25,000
Purchase price as percent of lower fair value		85.00%
Shares issued in period (in shares) \| shares			150,842	89,666
Weighted-average period for recognition of compensation costs			1 month 6 days
Non-option unrecognized compensation costs			$ 100,000
Shares committed under ESPP \| Subsequent Event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Increase in shares from automatic increase provision (in shares) \| shares	385,164
Stock Options And Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation costs			$ 43,700,000
Over 10% Shareholder \| Options to purchase common stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Purchase price of common stock, percentage of fair market value, greater than			110.00%
Stock Plans
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares reserved for future issuance (in shares) \| shares			14,249,394
2000 Stock Plan \| Directors, Employees And Consultants
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares reserved for future issuance (in shares) \| shares			0	0
Equity Incentive plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares reserved for future issuance (in shares) \| shares			1,540,655

Cover - USD ($) $ in Millions	12 Months Ended
Cover - USD ($) $ in Millions	Dec. 31, 2023	Feb. 19, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-39562
Entity Registrant Name	PULMONX CORPORATION
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	77-0424412
Entity Address, Address Line One	700 Chesapeake Drive
Entity Address, City or Town	Redwood City
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94063
Country Region	1
City Area Code	650
Local Phone Number	364-0400
Title of 12(b) Security	Common Stock, $0.001 par value per share
Trading Symbol	LUNG
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	false
Document Financial Statement Error Correction	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		38,537,356
Entity Public Float			$ 478.5
Documents Incorporated by Reference	Portions of the registrant’s definitive proxy statement relating to its 2024 annual meeting of stockholders (the “2024 Proxy Statement”) are incorporated by reference into Part III of this Annual Report on Form 10-K where indicated. The 2024 Proxy Statement will be filed with the U.S. Securities and Exchange Commission within 120 days after the end of the fiscal year to which this Annual Report on Form 10-K relates.
Entity Central Index Key	0001127537
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Amendment Flag	false

Income Taxes - Reconciliation of Statutory to Effective Tax Rate (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Federal statutory rate	21.00%	21.00%
State taxes, net of federal benefit	(0.10%)	(0.10%)
Foreign earnings at different rates	(0.50%)	(0.10%)
Tax credits	(0.90%)	1.80%
Permanent differences	(4.60%)	(4.60%)
Prior year true-up	0.60%	(0.80%)
Change in valuation allowance	(16.40%)	(17.80%)
Effective tax rate	(0.90%)	(0.60%)

Stockholders' Equity - Stock Option Activity (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Number of Shares
Balance, beginning of period (in shares)	2,495,528	2,145,131
Options granted (in shares)	835,400	765,900
Options exercised (in shares)	(137,902)	(297,463)
Options canceled (in shares)	(50,045)	(118,040)
Balance, end of period (in shares)	3,142,981	2,495,528
Weighted Average Exercise Price
Balance, beginning of period (in dollars per share)	$ 17.35	$ 13.44
Options granted (in dollars per share)	11.48	24.09
Options exercised (in dollars per share)	2.27	2.13
Options canceled (in dollars per share)	20.62	28.30
Balance, end of period (in dollars per share)	$ 16.40	$ 17.35

Balance Sheet Components - Property and Equipment, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	$ 8,883	$ 8,250
Less: accumulated depreciation	(4,855)	(3,556)
Property and equipment, net	4,028	4,694
Machinery and equipment
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	2,271	2,112
Computer equipment and software
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	1,872	1,773
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	264	263
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	2,277	2,277
Construction in progress
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	$ 2,199	$ 1,825

Employee Benefit Plan (Details) - USD ($)	12 Months Ended	315 Months Ended
Employee Benefit Plan (Details) - USD ($)	Dec. 31, 2023	Dec. 31, 2023
Retirement Benefits [Abstract]
Maximum employee contribution percentage	100.00%
Contributions made by the company since inception		$ 0

Net Loss per Share Attributable to Common Stockholders (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Schedule of Basic and Diluted Net Loss per Share


	Years Ended December 31,
	2023		2022
Numerator
Net loss attributable to common stockholders	$	(60,843)	$	(58,923)
Denominator
Weighted-average common stock outstanding	37,998,509		37,248,292
Less: weighted-average common shares subject to repurchase	(23,942)		(151,751)
Weighted-average common shares used to compute basic and diluted net loss per share	37,974,567		37,096,541
Net loss per share attributable to common stockholders, basic and diluted	$	(1.60)	$	(1.59)

Schedule of Potentially Dilutive Securities Outstanding


	Years Ended December 31,
	2023	2022
Options to purchase common stock	3,142,981	2,495,528
Unvested restricted stock units	2,244,903	998,473
Unvested early exercised common stock options	109	77,782
Shares committed under ESPP	55,714	28,141
Total Shares	5,443,707	3,599,924

Balance Sheet Components - Cash and Cash Equivalents (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash	$ 58,418	$ 97,089
Cash equivalents:
Money market funds	25,129	4,647
Total cash and cash equivalents	$ 83,547	$ 101,736

- Definition

Amount of currency on hand as well as demand deposits with banks or financial institutions. Includes other kinds of accounts that have the general characteristics of demand deposits. Excludes cash and cash equivalents within disposal group and discontinued operation.

+ References + Details

Balance Sheet Components - Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 1,849	$ 1,849
Accumulated Amortization	(1,818)	(1,695)
Net Carrying Value	31	154
Developed technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	1,658	1,658
Accumulated Amortization	(1,630)	(1,520)
Net Carrying Value	28	138
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	191	191
Accumulated Amortization	(188)	(175)
Net Carrying Value	$ 3	$ 16

Fair Value Measurements - Fair Value of Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Assets:
Marketable securities:	$ 47,945	$ 45,326
U.S. Government agency bonds
Assets:
Marketable securities:	35,264	30,615
Recurring Basis
Assets:
Cash equivalents:	25,129	4,647
Marketable securities:	47,945	45,326
Total financial assets	73,074	49,973
Recurring Basis \| U.S. Government agency bonds
Assets:
Marketable securities:	35,264	30,615
Recurring Basis \| Commercial paper
Assets:
Marketable securities:	12,681	14,711
Recurring Basis \| Money market funds
Assets:
Cash equivalents:	25,129	4,647
Recurring Basis \| Level 1
Assets:
Cash equivalents:	25,129	4,647
Marketable securities:	5,798	14,743
Total financial assets	30,927	19,390
Recurring Basis \| Level 1 \| U.S. Government agency bonds
Assets:
Marketable securities:	5,798	14,743
Recurring Basis \| Level 1 \| Commercial paper
Assets:
Marketable securities:	0	0
Recurring Basis \| Level 1 \| Money market funds
Assets:
Cash equivalents:	25,129	4,647
Recurring Basis \| Level 2
Assets:
Cash equivalents:	0	0
Marketable securities:	42,147	30,583
Total financial assets	42,147	30,583
Recurring Basis \| Level 2 \| U.S. Government agency bonds
Assets:
Marketable securities:	29,466	15,872
Recurring Basis \| Level 2 \| Commercial paper
Assets:
Marketable securities:	12,681	14,711
Recurring Basis \| Level 2 \| Money market funds
Assets:
Cash equivalents:	0	0
Recurring Basis \| Level 3
Assets:
Cash equivalents:	0	0
Marketable securities:	0	0
Total financial assets	0	0
Recurring Basis \| Level 3 \| U.S. Government agency bonds
Assets:
Marketable securities:	0	0
Recurring Basis \| Level 3 \| Commercial paper
Assets:
Marketable securities:	0	0
Recurring Basis \| Level 3 \| Money market funds
Assets:
Cash equivalents:	$ 0	$ 0

Balance Sheet Components - Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accrued employee bonuses and commissions	$ 7,875	$ 4,973
Accrued vacation	2,400	2,113
Other accrued personnel related expenses	2,859	2,513
Accrued professional fees	1,705	2,366
Sales taxes, franchise tax and VAT	763	627
Liability for early exercise of stock options	37	145
Accrued inventory purchases	170	167
Other	425	372
Total accrued liabilities	$ 16,234	$ 13,276

Leases, Lease Commitments and Contingencies - Service Agreement (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended		21 Months Ended
	Apr. 30, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2023
Purchase Commitment, Excluding Long-Term Commitment [Line Items]
Cost of goods sold		$ 17,923	$ 13,797
Service Agreement
Purchase Commitment, Excluding Long-Term Commitment [Line Items]
Purchase obligation, to be paid, year one	$ 600
Purchase obligation, to be paid, year two	400
Purchase obligation, to be paid, year three	$ 400
Period	3 years
Cost of goods sold				$ 900

Stockholders' Equity

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Stockholders' Equity

Stockholders’ Equity

Common Stock

As of December 31, 2023 and December 31, 2022, the Company’s certificate of incorporation authorized the Company to issue up to 200,000,000 shares of common stock. Common stockholders are entitled to dividends as and when declared by the Board of Directors, subject to the rights of holders of all classes of stock outstanding having priority rights as to dividends. There have been no dividends declared to date. The holder of each share of common stock is entitled to one vote.

Shares Reserved for Future Issuance

The Company has reserved shares of common stock for future issuances as follows:


	December 31,
	2023	2022
Common stock options issued and outstanding	3,142,981	2,495,528
Common stock restricted stock units issued and outstanding	2,244,903	998,473
Common stock available for future grants	2,541,438	3,765,706
Common stock available for ESPP	1,436,823	1,212,109
Total	9,366,145	8,471,816

Stock Option Plan

As of December 31, 2023, the Company reserved 14,249,394 shares of its common stock under its 2000 Stock Plan (the “2000 Stock Plan”), the 2010 Stock Plan (the “2010 Stock Plan”), the 2020 Stock Plan (the “2020 Stock Plan”), and the 2020 Equity Incentive Plan (the “2020 Equity Incentive Plan” and, together with the 2000 Stock Plan, the 2010 Stock Plan and the 2020 Stock Plan, the “Stock Plans”). Options granted under the Stock Plans may be either incentive stock options or nonqualified stock options. Incentive stock options (“ISO”) may be granted only to the Company employees (including officers and directors). Nonqualified stock options (“NSO”) may be granted to the Company employees and consultants. As of December 31, 2023 and December 31, 2022, no shares of common stock remain available for issuance to officers, directors, employees and consultants pursuant to the 2000 Stock Plan. In January 2024, the number of shares of common stock available for issuance under the 2020 Equity Incentive Plan was increased by 1,540,655 shares as a result of the automatic increase provision in the 2020 Equity Incentive Plan.

Options to purchase the Company’s common stock may be granted at a price not less than 100% of the fair market value in the case of ISO or NSO, except for an employee or non-employee with options who owns more than 10% of the voting power of all classes of stock of the Company in which case the exercise price shall be no less than 110% of the fair market value per share on the grant date. Options vest ranging from immediately upon grant to a rate of 25% per annum over four years from the grant date. Options expire but not more than ten years after the date of grant.

Activity under the Stock Plans is set forth below:


	Outstanding Options
	Number of Shares	Weighted Average Exercise Price
Balance, December 31, 2021	2,145,131	$	13.44
Options granted	765,900	24.09
Options exercised	(297,463)	2.13
Options canceled	(118,040)	28.30
Balance, December 31, 2022	2,495,528	$	17.35
Options granted	835,400	11.48
Options exercised	(137,902)	2.27
Options canceled	(50,045)	20.62
Balance, December 31, 2023	3,142,981	$	16.40

The aggregate intrinsic value of options exercised during the years ended December 31, 2023 and December 31, 2022 was $1.3 million and $4.6 million, respectively.

The aggregate intrinsic value of options outstanding as of December 31, 2023 and December 31, 2022 was $11.1 million and $6.9 million, respectively. The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying stock options and the fair value of the Company’s common stock for stock options that were in-the-money as of December 31, 2023 and December 31, 2022.


	December 31, 2023
	Number of Shares	Weighted Average Exercise Price		Weighted Average Contractual Life (in Years)
Options vested	1,751,674	$	15.34	6.70
Options vested and expected to vest	3,142,981	$	16.40	7.47

The aggregate intrinsic value of options exercisable as of December 31, 2023 and December 31, 2022 was $8.6 million and $4.1 million, respectively.

Early Exercise of Stock Options

Under the terms of the individual option grants, options granted from the 2000 Stock Plan, the 2010 Stock Plan and the 2020 Stock Plan are fully exercisable on the grant date, subject to the Company’s repurchase right at the original exercise price. Accordingly, options granted under these plans may be exercised prior to vesting. The shares are subject to the Company’s lapsing repurchase right upon termination of employment or over the options’ vesting period of generally four years at the original purchase price. The proceeds initially are recorded in other liabilities from the early exercise of stock options and are reclassified to additional paid-in capital as the Company’s repurchase right lapses. During the years ended December 31, 2023 and December 31, 2022, the Company repurchased 106 and 14,459 shares of common stock for less than $0.1 million and less than $0.1 million, respectively. As of December 31, 2023 and December 31, 2022, 109 and 77,782 shares were subject to repurchase, with an aggregate exercise price of less than $0.1 million and $0.1 million, respectively, and were recorded in accrued liabilities on the consolidated balance sheets.

Restricted Stock Units

Activity with respect to restricted stock units was as follows:


	Number of Shares Underlying Outstanding Restricted Stock	Weighted Average Grant Date Fair Value
Unvested, December 31, 2021	442,428	$	42.36
Granted	937,400	23.63
Vested	(251,133)	35.09
Canceled	(130,222)	33.85
Unvested, December 31, 2022	998,473	27.72
Granted	2,042,593	11.48
Vested	(672,180)	19.93
Canceled	(123,983)	19.29
Unvested, December 31, 2023	2,244,903	$	15.74

The fair value as of the respective vesting dates of restricted stock units that vested during the years ended December 31, 2023 and December 31, 2022 was $7.5 million and $3.9 million, respectively. The aggregate intrinsic

value of restricted stock units outstanding as of December 31, 2023 and December 31, 2022 was $28.6 million and $8.4 million, respectively.

Stock-Based Compensation for Employees and Non-Employees

The weighted average grant-date fair value of the stock options granted during the years ended December 31, 2023 and December 31, 2022 was $7.77 and $10.74 per share, respectively.

The Company uses the Black-Scholes Merton option-pricing model to determine the fair value of stock options. The determination of the fair value of stock-based payment awards on the date of grant is affected by the stock price as well as assumptions regarding a number of complex and subjective variables. These variables include expected stock price volatility over the term of the awards, risk-free interest rates and expected dividends. The estimated grant date fair values of employee stock options were calculated using the following assumptions:


	Years Ended December 31,
	2023	2022
Weighted average expected term (in years)	6.0	6.0 - 6.1
Volatility	73.4%	44.5% - 44.8%
Risk-free interest rate	4.2%	1.6% - 3.6%
Dividend yield	—	—

Expected Term

The expected term is calculated using the simplified method, which is available where there is insufficient historical data about exercise patterns and post-vesting employment termination behavior. The simplified method is based on the vesting period and the contractual term for each grant, or for each vesting-tranche for awards with graded vesting. The mid-point between the vesting date and the maximum contractual expiration date is used as the expected term under this method. For awards with multiple vesting-tranches, the periods from grant until the mid-point for each of the tranches are averaged to provide an overall expected term.

Volatility

The expected stock price volatility assumptions for the Company’s stock options for the years ended December 31, 2023 and December 31, 2022 were determined using the Company’s historical volatility and the historical volatilities of industry peers, referred to as “guideline” companies, as the Company had limited trading history for the Company’s common stock. In evaluating similarity, the Company considered factors such as industry, stage of life cycle and size.

The expected stock price volatility assumptions for the purchase rights under the employee share purchase plan for the years ended December 31, 2023 and December 31, 2022 were determined using the historical volatility of the Company’s common stock.

Risk-Free Rate

The risk-free interest rate assumption is based on the U.S. Treasury instruments whose term was consistent with the expected term of the Company’s stock options.

Dividend Yield

The expected dividend assumption is based on the Company’s history and expectation of dividend payouts.

Fair Value of Common Stock

The fair value of the Company’s common stock is determined based on its closing market price on the date of grant.

2020 Employee Share Purchase Plan

In September 2020, the Company adopted the ESPP, which became effective on the business day prior to the effectiveness of the registration statement relating to the IPO. A total of 720,000 shares of common stock were initially reserved for issuance under the ESPP. The ESPP permits eligible employees to acquire shares of the Company’s common stock through periodic payroll deductions of up to 15% of base compensation. No employee may purchase more than 2,500 shares during an offering period. In addition, no employee may purchase more than $25,000 worth of stock, determined by the fair market value of the shares at the time such option is granted, in one calendar year. At the end of each purchase period, employees are able to purchase shares at 85% of the lower of the fair market value of the Company’s common stock on the first trading day of the offering period or on the last trading day of the offering period. The Company entered into a new offering period beginning August 16, 2023 and ending February 15, 2024.

The Company issued 150,842 and 89,666 shares under the ESPP for the years ended December 31, 2023 and December 31, 2022, respectively. As of December 31, 2023, there were 1,436,823 shares authorized for future purchase under the ESPP. In January 2024, the number of shares of common stock available for issuance under the ESPP was increased by 385,164 shares as a result of the automatic increase provision in the ESPP.

Compensation expense is calculated using the fair value of the employees' purchase rights under the Black-Scholes model.


	Years Ended December 31,
	2023	2022
Weighted average expected term (in years)	0.5	0.5
Volatility	43.4% - 55.6%	37.8% - 42.8%
Risk-free interest rate	5.0% - 5.5%	0.7% - 3.1%
Dividend yield	—	—

Total Stock-Based Compensation

Stock-based compensation expense is reflected in the statements of operations and comprehensive loss as follows (in thousands):


	Years Ended December 31,
	2023		2022
Cost of goods sold	$	1,320	$	686
Research and development	2,821		2,190
Selling, general and administrative	17,960		13,569
Total	$	22,101	$	16,445

The above stock-based compensation expense related to the following equity-based awards (in thousands):


	Years Ended December 31,
	2023		2022
Stock options and restricted stock units	$	21,675	$	15,807
ESPP	426		638
Total	$	22,101	$	16,445

Stock-based compensation of $1.6 million and $1.2 million was capitalized into inventory for the years ended December 31, 2023 and 2022, respectively. Stock-based compensation capitalized in prior periods of $1.3 million and $0.7 million was recognized as cost of sales in the years ended December 31, 2023 and 2022, respectively.

As of December 31, 2023, there was $43.7 million of unrecognized compensation costs related to non-vested common stock options and restricted stock units, expected to be recognized over a weighted-average period of 2.5 years. The total grant date fair value of shares vested during the years ended December 31, 2023 and December 31, 2022 was $21.7 million and $15.5 million, respectively.

As of December 31, 2023, the Company had unrecognized employee stock-based compensation relating to ESPP awards of approximately $0.1 million, which is expected to be recognized over a weighted-average period of 0.1 years.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147480237/815-40-50-6

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480008/505-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

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-Topic 505
-Name Accounting Standards Codification
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-URI https://asc.fasb.org//505/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Segment Information (Tables)

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

Schedule of Revenue by Geographic Area

Revenue by geographic area is based on the billing address of the customer. The following table sets forth our revenue by geographic area (in thousands):


	Years Ended December 31,
	2023		2022
United States	$	45,917	$	32,487
Europe, Middle-East and Africa (“EMEA”)	19,336		18,154
Asia Pacific	3,023		2,866
Other International	399		155
Total	$	68,675	$	53,662

Schedule of Long-lived Assets by Geographic Area

Long-lived assets by geographic area are based on physical location of those assets. The following table sets forth our long-lived assets by geographic area (in thousands):


	December 31,
	2023		2022
United States	$	3,962	$	4,634
Europe, Middle-East and Africa	54		58
Asia Pacific	12		2
Total	$	4,028	$	4,694

Leases, Lease Commitments and Contingencies - Maturity Analysis of Lease Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
2024	$ 3,219
2025	1,098
2026	30
Total minimum lease payments	4,347
Less: Amount of lease payments representing interest	167
Present value of future minimum lease payments	4,180
Less: Current lease liabilities	3,074	$ 3,229
Long-term lease liabilities	$ 1,106	$ 3,849

Revenue Recognition	12 Months Ended
Revenue Recognition	Dec. 31, 2023
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition The Company’s contract liabilities consist of deferred revenue for remaining performance obligations by the Company to the customer after delivery, which was $0.1 million as of December 31, 2023, which is expected to be recognized as revenue in fiscal year 2024. The deferred revenue as of December 31, 2022 was $0.1 million, which was recognized as revenue during the year ended December 31, 2023. The deferred revenue as of December 31, 2021 was $0.2 million, which was recognized as revenue during the year ended December 31, 2022. The Company disaggregates its revenue by major geographic region, which has been disclosed in Note 12, “Segment Information”.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Section 50
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
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-URI https://asc.fasb.org//606/tableOfContent

+ Details

Stockholders' Equity - Total Stock-Based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 22,101	$ 16,445
Stock options and restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	21,675	15,807
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	426	638
Cost of goods sold
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	1,320	686
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	2,821	2,190
Selling, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 17,960	$ 13,569

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Section 35
-Paragraph 1D
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Balance Sheet Components (Tables)

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Cash and Cash Equivalents

The Company’s cash and cash equivalents consist of the following (in thousands):


	December 31,
	2023		2022
Cash	$	58,418	$	97,089
Cash equivalents:
Money market funds	25,129		4,647
Total cash and cash equivalents	$	83,547	$	101,736

Schedule of Inventory

Inventory consists of the following (in thousands):


	December 31,
	2023		2022
Raw materials	$	2,924	$	3,820
Work in process	427		386
Finished goods	15,972		15,641
Total inventory	$	19,323	$	19,847
Reported as:
Inventory	$	16,743	$	14,564
Long-term inventory	2,580		5,283
Total inventory	$	19,323	$	19,847

Schedule of Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consist of the following (in thousands):


	December 31,
	2023		2022
Prepaid expenses	$	1,910	$	2,044
Prepaid insurance	906		1,407
VAT and other receivable	915		602
Other current assets	504		290
Total prepaid expenses and other current assets	$	4,235	$	4,343

Schedule of Property and Equipment, Net

Property and equipment, net consist of the following (in thousands):


	December 31,
	2023		2022
Machinery and equipment	$	2,271	$	2,112
Computer equipment and software	1,872		1,773
Furniture and fixtures	264		263
Leasehold improvements	2,277		2,277
Construction in progress	2,199		1,825
Total	8,883		8,250
Less: accumulated depreciation	(4,855)		(3,556)
Property and equipment, net	$	4,028	$	4,694

Schedule Intangible Assets

Intangible assets consist of the following (in thousands):


	December 31, 2023
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value
Developed technology	$	1,658	$	(1,630)	$	28
Trademarks	191		(188)		3
Total intangible assets	$	1,849	$	(1,818)	$	31


	December 31, 2022
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value
Developed technology	$	1,658	$	(1,520)	$	138
Trademarks	191		(175)		16
Total intangible assets	$	1,849	$	(1,695)	$	154

Schedule of Future Amortization Expense

Future amortization expense is as follows as of December 31, 2023 (in thousands):


Fiscal Year Ending December 31,	Amortization
2024	$	31
Total amortization expense	$	31

Schedule of Accrued Liabilities

Accrued liabilities consist of the following (in thousands):


	December 31,
	2023		2022
Accrued employee bonuses and commissions	$	7,875	$	4,973
Accrued vacation	2,400		2,113
Other accrued personnel related expenses	2,859		2,513
Accrued professional fees	1,705		2,366
Sales taxes, franchise tax and VAT	763		627
Liability for early exercise of stock options	37		145
Accrued inventory purchases	170		167
Other	425		372
Total accrued liabilities	$	16,234	$	13,276

Leases, Lease Commitments and Contingencies - Other Supplemental Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities included in cash flows used in operating activities	$ 3,563	$ 2,701
Right-of-use assets obtained in exchange for lease liabilities	$ 284	$ 229

Fair Value Measurements - Schedule of Marketable Securities with Unrealized Losses (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Fair Value
Less than 12 months	$ 12,884	$ 31,586
12 months or greater	1,745	10,847
Total	14,629	42,433
Unrealized Losses
Less than 12 months	(24)	(170)
12 months or greater	(3)	(143)
Total	(27)	(313)
U.S. Government agency bonds
Fair Value
Less than 12 months	11,888	19,768
12 months or greater	1,745	10,847
Total	13,633	30,615
Unrealized Losses
Less than 12 months	(23)	(139)
12 months or greater	(3)	(143)
Total	(26)	(282)
Commercial paper
Fair Value
Less than 12 months	996	11,818
12 months or greater	0	0
Total	996	11,818
Unrealized Losses
Less than 12 months	(1)	(31)
12 months or greater	0	0
Total	$ (1)	$ (31)

Balance Sheet Components - Narrative (Details) - USD ($)	3 Months Ended		12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Depreciation expense			$ 1,400,000	$ 1,400,000
Goodwill	$ 2,333,000	$ 2,333,000	2,333,000	2,333,000
Amortization expense related to intangibles			100,000	100,000
Emphasys Medical, Inc
Business Acquisition [Line Items]
Goodwill	2,300,000	2,300,000	2,300,000	2,300,000
Goodwill, accumulated impairment loss	0		0
Goodwill acquired			0	$ 0
Goodwill disposed of			$ 0
Goodwill, impairment loss	$ 0	$ 0

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Fair Value Measurements - Contractual Maturities of the Company’s Marketable Securities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Amortized cost, due within one year	$ 33,551
Amortized cost, due in one year to five years	14,310
Amortized Cost	47,861	$ 45,637
Fair value, due within one year	33,555
Fair value, due in one year to five years	14,390
Fair Value	$ 47,945	$ 45,326

Net Loss per Share Attributable to Common Stockholders - Excluded Potentially Dilutive Securities Outstanding (Details) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted weighted average shares outstanding (in shares)	5,443,707	3,599,924
Options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted weighted average shares outstanding (in shares)	3,142,981	2,495,528
Unvested restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted weighted average shares outstanding (in shares)	2,244,903	998,473
Unvested early exercised common stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted weighted average shares outstanding (in shares)	109	77,782
Shares committed under ESPP
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from computation of diluted weighted average shares outstanding (in shares)	55,714	28,141

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Balance at beginning of period	$ 8,642	$ 8,489
Additions for tax positions related to prior year	144	106
Additions for tax positions related to current year	38	200
Decreases for tax positions related to prior year	(162)	(153)
Balance at end of period	$ 8,662	$ 8,642

Balance Sheet Components

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Balance Sheet Components

Cash and Cash Equivalents

The Company’s cash and cash equivalents consist of the following (in thousands):


	December 31,
	2023		2022
Cash	$	58,418	$	97,089
Cash equivalents:
Money market funds	25,129		4,647
Total cash and cash equivalents	$	83,547	$	101,736

Inventory

Inventory consists of the following (in thousands):


	December 31,
	2023		2022
Raw materials	$	2,924	$	3,820
Work in process	427		386
Finished goods	15,972		15,641
Total inventory	$	19,323	$	19,847
Reported as:
Inventory	$	16,743	$	14,564
Long-term inventory	2,580		5,283
Total inventory	$	19,323	$	19,847

Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consist of the following (in thousands):


	December 31,
	2023		2022
Prepaid expenses	$	1,910	$	2,044
Prepaid insurance	906		1,407
VAT and other receivable	915		602
Other current assets	504		290
Total prepaid expenses and other current assets	$	4,235	$	4,343

Capitalized Implementation Costs of a Hosting Arrangement

The Company has several software systems that are cloud-based hosting arrangements with service contracts. The Company accounts for costs incurred in connection with the implementation of these various software systems under ASU 2018-15, Intangibles—Goodwill and Other—Internal Use Software (Subtopic 350–40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That is a Service Contract. The Company expenses all costs (internal and external) that are incurred in the planning and post-implementation operation stages. As of December 31, 2023 and December 31, 2022, the Company has capitalized approximately $0.1 million and $0.5 million in implementation costs, net of amortization, respectively. The capitalized costs are amortized on a straight-line basis over the non-cancelable contract terms, which are generally three years. As of December 31, 2023, the capitalized costs of $0.1 million were included in prepaid expenses and other current assets. Amortization expense, which was included in selling, general and administrative expenses, was $0.4 million and $0.2 million for the years ended December 31, 2023 and December 31, 2022, respectively.

Property and Equipment, Net

Property and equipment, net consist of the following (in thousands):


	December 31,
	2023		2022
Machinery and equipment	$	2,271	$	2,112
Computer equipment and software	1,872		1,773
Furniture and fixtures	264		263
Leasehold improvements	2,277		2,277
Construction in progress	2,199		1,825
Total	8,883		8,250
Less: accumulated depreciation	(4,855)		(3,556)
Property and equipment, net	$	4,028	$	4,694

Depreciation expense for both the years ended December 31, 2023 and December 31, 2022 was $1.4 million.

Goodwill

Goodwill was $2.3 million as of December 31, 2023 and December 31, 2022. No goodwill impairment losses have been recognized since the acquisition. There were no acquisitions or dispositions of goodwill for the years ended December 31, 2023 or December 31, 2022. The Company performed an annual test for goodwill impairment in the

fourth quarter of the fiscal years ended December 31, 2023 and December 31, 2022 and determined that goodwill was not impaired.

Intangible Assets

Intangible assets consist of the following (in thousands):


	December 31, 2023
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value
Developed technology	$	1,658	$	(1,630)	$	28
Trademarks	191		(188)		3
Total intangible assets	$	1,849	$	(1,818)	$	31


	December 31, 2022
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value
Developed technology	$	1,658	$	(1,520)	$	138
Trademarks	191		(175)		16
Total intangible assets	$	1,849	$	(1,695)	$	154

Amortization expense relating to the intangibles totaled $0.1 million during each of the years ended on December 31, 2023 and December 31, 2022.

Future amortization expense is as follows as of December 31, 2023 (in thousands):


Fiscal Year Ending December 31,	Amortization
2024	$	31
Total amortization expense	$	31

Accrued Liabilities

Accrued liabilities consist of the following (in thousands):


	December 31,
	2023		2022
Accrued employee bonuses and commissions	$	7,875	$	4,973
Accrued vacation	2,400		2,113
Other accrued personnel related expenses	2,859		2,513
Accrued professional fees	1,705		2,366
Sales taxes, franchise tax and VAT	763		627
Liability for early exercise of stock options	37		145
Accrued inventory purchases	170		167
Other	425		372
Total accrued liabilities	$	16,234	$	13,276

Employee Benefit Plan	12 Months Ended
Employee Benefit Plan	Dec. 31, 2023
Retirement Benefits [Abstract]
Employee Benefit Plan	Employee Benefit Plan Effective October 1997, the Company implemented a retirement savings plan (the “Savings Plan”) which is intended to qualify as a deferred savings plan under Section 401(k) of the Internal Revenue Code. Participants are allowed to contribute up to 100% of the total compensation, not to exceed the amount allowed by the applicable statutory prescribed limit. There have been no contributions made to the Savings Plan by the Company since inception.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 70
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
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-URI https://asc.fasb.org//1943274/2147480794/715-70-50-1

Reference 2: http://www.xbrl.org/2003/role/exampleRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480266/715-60-50-3

+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Stockholders' Equity - Valuation Assumptions (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend yield	$ 0	$ 0
Options to purchase common stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Volatility, minimum	73.40%	44.50%
Volatility, maximum		44.80%
Options to purchase common stock \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average expected term (in years)	6 years	6 years
Risk-free interest rate	4.20%	1.60%
Options to purchase common stock \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average expected term (in years)		6 years 1 month 6 days
Risk-free interest rate		3.60%
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average expected term (in years)	6 months	6 months
Volatility, minimum	43.40%	37.80%
Volatility, maximum	55.60%	42.80%
Risk free interest rate, minimum	5.00%	0.70%
Risk free interest rate, maximum	5.50%	3.10%
Dividend yield	$ 0	$ 0

Segment Information - Long-Lived Assets by Geographical Area (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 4,028	$ 4,694
United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	3,962	4,634
Europe, Middle-East and Africa (“EMEA”)
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	54	58
Asia Pacific
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 12	$ 2

Balance Sheet Components - Capitalized Implementation Costs of a Hosting Arrangement (Details) - Software and Software Development Costs - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Capitalized costs	$ 0.1	$ 0.5
Amortization period		3 years
Amortization expense	0.4	$ 0.2
Other Noncurrent Assets
Property, Plant and Equipment [Line Items]
Capitalized costs	$ 0.1

Recent Accounting Pronouncements	12 Months Ended
Recent Accounting Pronouncements	Dec. 31, 2023
Accounting Policies [Abstract]
Recent Accounting Pronouncements	Recent Accounting Pronouncements Recently Adopted Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses. This new guidance will require financial instruments to be measured at amortized cost, and trade accounts receivable to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information and reasonable and supportable forecasts, including estimates of prepayments. In November 2019, the FASB issued ASU 2019-10, according to which, the new standard is effective for public business entities that meet the definition of an SEC filer, excluding entities eligible to be smaller reporting companies (“SRC”) as defined by the SEC, for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. For all other entities, including the Company, the new standard is effective for fiscal years beginning after December 15, 2022, and interim periods within that fiscal year. The Company adopted ASU 2016-13 as of January 1, 2023 and the adoption did not have a material impact on the Company’s consolidated financial statements and related disclosures. Recent Accounting Pronouncements Not Yet Adopted In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. The amendments in this ASU require disclosures, on an annual and interim basis, of significant segment expenses that are regularly provided to the chief operating decision maker (CODM), as well as the aggregate amount of other segment items included in the reported measure of segment profit or loss. This ASU requires that a public entity disclose the title and position of the CODM and an explanation of how the CODM uses the reported measure(s) of segment profit or loss. Public entities will be required to provide all annual disclosures currently required by Topic 280 in interim periods, and entities with a single reportable segment are required to provide all the disclosures required by the amendments in the update and existing segment disclosures in Topic 280. This ASU is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact that this update will have on its disclosures in the consolidated financial statements. In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, which improves the transparency of income tax disclosures by requiring consistent categories and greater disaggregation of information in the effective tax rate reconciliation and income taxes paid disaggregated by jurisdiction. It also includes certain other amendments to improve the effectiveness of income tax disclosures. The standard is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the disclosure requirements related to the new standard. All other newly issued accounting pronouncements not yet effective have been deemed either immaterial or not applicable.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Long Term Debt - Contractual Maturities of Financing Obligations (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Long-term Debt, Fiscal Year Maturity [Abstract]
2024	$ 5,666
2025	15,217
2026	14,043
2027	10,823
Total	45,749
Less: unamortized debt discount	(152)
Less: interest	(8,353)
Term loan and credit agreement	$ 37,244

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Summary of Significant Accounting Policies (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) segment	Dec. 31, 2022 USD ($)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Cash on deposit with foreign banks	$ 4,700	$ 4,500
Accounts receivable, allowance for credit loss	$ 0	100
Number of operating segments \| segment	1
Number of reporting units \| segment	1
Intangible assets useful life	15 years
Advertising costs	$ 4,800	6,100
Other comprehensive loss, foreign currency translation adjustments	671	150
Foreign currency transaction gains and (losses)	$ (800)	$ (400)
Minimum
Accumulated Other Comprehensive Income (Loss) [Line Items]
Property and equipment, useful life	3 years
Payment term	30 days
Maximum
Accumulated Other Comprehensive Income (Loss) [Line Items]
Property and equipment, useful life	5 years
Payment term	60 days

Income Taxes - Income Before Continuing Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Domestic	$ (60,503)	$ (59,361)
Foreign	231	791
Net loss before tax	$ (60,272)	$ (58,570)

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

+ References

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+ Details

Segment Information

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

Segment Information

The chief operating decision maker for the Company is the Chief Executive Officer. The Company’s Chief Executive Officer reviews financial information presented on a consolidated basis, accompanied by information about revenue by geographic region, for purposes of allocating resources and evaluating financial performance. The Company has one business activity and there are no segment managers who are held accountable for operations, operating results or plans for levels or components below the consolidated unit level. Accordingly, the Company has

determined that it has a single reportable and operating segment structure. The Company’s Chief Executive Officer evaluates performance based primarily on revenue in the geographic locations in which the Company operates.

Revenue by geographic area is based on the billing address of the customer. The following table sets forth our revenue by geographic area (in thousands):


	Years Ended December 31,
	2023		2022
United States	$	45,917	$	32,487
Europe, Middle-East and Africa (“EMEA”)	19,336		18,154
Asia Pacific	3,023		2,866
Other International	399		155
Total	$	68,675	$	53,662

Revenue from Germany represented 8% and 11% of total revenue for the years ended December 31, 2023 and 2022, respectively.

Long-lived assets by geographic area are based on physical location of those assets. The following table sets forth our long-lived assets by geographic area (in thousands):


	December 31,
	2023		2022
United States	$	3,962	$	4,634
Europe, Middle-East and Africa	54		58
Asia Pacific	12		2
Total	$	4,028	$	4,694

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

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+ Details

Formation and Business of the Company (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accumulated deficit	$ 411,161	$ 350,318
Cash used in operating activities	37,610	$ 45,083
Cash, cash equivalents and marketable securities	$ 131,500

- Definition

Amount of accumulated undistributed earnings (deficit).

+ References + Details