GMED Globus Medical Inc

Globus Medical, Inc. (NYSE: GMED), a leading musculoskeletal technology company, today announced its financial results for the fourth quarter and year ended December 31, 2023.

Fourth Quarter 2023:

• Worldwide net sales were $616.5 million, an increase of 124.6%, or 123.8% on a constant currency basis
• GAAP net income for the quarter was $15.0 million
• GAAP diluted earnings per share (“EPS”) was $0.11 and non-GAAP diluted EPS was $0.60
• Non-GAAP adjusted EBITDA was $170.0 million, or 27.6% of net sales

Full Year 2023:

• Worldwide net sales were $1,568.5 million, an increase of 53.3% on an actual and constant currency basis
• GAAP net income for the year was $122.9 million
• GAAP diluted EPS was $1.07 and non-GAAP diluted EPS was $2.32
• Non-GAAP adjusted EBITDA was $464.1 million, or 29.6% of net sales

“I am pleased to report on the remarkable progress we’ve made at Globus Medical. Our merger with NuVasive has been a transformative milestone, where we pursue a vision of providing the best innovative technology and most dedicated level of customer service for our surgeons and their patients,” said Dan Scavilla, president and CEO. “The integration is progressing according to plan, underscoring our commitment to a seamless transition and operational efficiency. Looking ahead to 2024, the pipeline of product launches, especially in enabling technologies, aligns with our philosophy of anticipating and meeting evolving customer needs. We recognize the importance of staying ahead of the curve, a principle that guides our approach to innovation and client service. I believe the potential for Globus has never been greater, as we continue to redefine spine surgery with procedural solutions built around enabling technology.”

“Worldwide sales set a record for both fourth quarter and full year 2023, as we completed the merger with NuVasive on September 1, 2023,” said Keith Pfeil, COO-CFO. “Excluding the impacts of the NuVasive merger, legacy Globus fourth quarter revenue was $304.1 million, an increase of 10.8 percent over the prior year fourth quarter, and full year revenue was $1.154 billion, or 12.8 percent higher than the prior year. We remain focused on merger integration activities as they continue to proceed according to plan and we look forward to achieving milestones as we work to get back to a steady state of running the business. We remain well positioned to deliver on our commitments for the coming year.”

Worldwide net sales for the fourth quarter were $616.5 million, an as-reported increase of 124.6% over the fourth quarter of 2023, and an increase of 123.8% on a constant currency basis. U.S. net sales for the fourth quarter of 2023 increased by 111.1% compared to the fourth quarter of 2022. International net sales increased by 200.9% over the fourth quarter of 2023 on an as-reported basis, and an increase of 200.8% on a constant currency basis. Net Sales increases were driven by the addition of NuVasive, as well as increased volume of spine product sales and enabling technology volume.

Worldwide net sales for the full year of 2023 were $1,568.5 million, an increase of 53.3% as compared to the full year of 2022 on an actual and constant currency basis. U.S. net sales for the full year of 2023 increased by 46.8 % compared to the full year of 2022. International net sales increased by 91.3% over the full year of 2023 on an as-reported basis, and an increase of 92.3% on a constant currency basis.

GAAP net income for the fourth quarter was $15.0 million, a decrease of 70.0% over the same period in the prior year, driven primarily by the addition of NuVasive results and acquisition related costs incurred in the quarter since the closing date. Diluted EPS for the fourth quarter was $0.11, compared to $0.49 for the fourth quarter of 2022. Non-GAAP net income for the fourth quarter was $83.5 million, an increase of 38.9% over the same period in the prior year, driven primarily by contributions from the NuVasive merger. Non-GAAP diluted EPS for the fourth quarter of 2023 was $0.60, compared to $0.59 in the fourth quarter of 2022, an increase of 2.1% driven by higher Non-GAAP net income, partially offset by a higher diluted share count as a result of the stock-for-stock merger with NuVasive.

Net cash provided by operating activities was $258.9 million, and non-GAAP free cash flow was $178.9 million for the full year of 2023.

2024 Annual Guidance

The Company reaffirms its full year 2024 revenue guidance range of $2.450 billion to $2.475 billion and fully diluted non-GAAP earnings per share range between $2.68 to $2.70.

Conference Call Information

Globus Medical will hold a teleconference to discuss its 2023 fourth quarter and full year results with the investment community at 4:30 p.m. Eastern Time today.

Participants may access the conference call live via webcast on the Investors page of Globus Medical’s website at https://www.investors.globusmedical.com/news-events/events-webcasts.

To participate via telephone, please register in advance at this link. Upon registration, all telephone participants will receive a confirmation email detailing how to join the conference call, including the dial-in number along with a unique passcode and registrant ID that can be used to access the call. The audio archive will be available after the call on the Investor page of the Globus Medical website.

About Globus Medical, Inc.

Based in Audubon, Pennsylvania, Globus Medical, Inc. was founded in 2003 by an experienced team of professionals with a shared vision to create products that enable surgeons to promote healing in patients with musculoskeletal disorders. Additional information can be accessed at www.globusmedical.com.

Non-GAAP Financial Measures

To supplement our financial statements prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”), management uses certain non-GAAP financial measures. For example, non-GAAP Adjusted EBITDA, which represents net income before interest income, net and other non-operating expenses, provision for income taxes, depreciation and amortization, stock-based compensation expense, provision for litigation, acquisition related costs/licensing and acquisition of in-process research and development, merger and acquisition related costs/licensing, certain foreign currency acquisition-related impacts, and gains and losses from strategic investments, is useful as an additional measure of operating performance, and particularly as a measure of comparative operating performance from period to period, as it is reflective of changes in pricing decisions, cost controls and other factors that affect operating performance, and it removes the effect of our capital structure, asset base, income taxes and interest income and expense. Our management also uses non-GAAP Adjusted EBITDA for planning purposes, including the preparation of our annual operating budget and financial projections. Provision for litigation represents costs incurred for litigation settlements or unfavorable verdicts when the loss is known or considered probable and the amount can be reasonably estimated, or in the case of a favorable settlement, when income is realized. Acquisition related costs/licensing represents the change in fair value of business-acquisition-related contingent consideration; costs related to integrating recently acquired businesses, including but not limited to costs to exit or convert contractual obligations, severance, retention bonus, duplicative costs and information system conversion; and specific costs related to the consummation of the acquisition process such as banker fees, legal fees, and other acquisition related professional fees, as well as one-time licensing fees. Acquisition of in-process research and development represents the expensing of acquired assets with no alternative future use and related fees. We also adjusted for certain foreign currency impacts related to the acquisition costs and gains/losses on strategic investments within other assets as we believe these impacts are not a measure of our operating performance.

In addition, for the period ended December 31, 2023 and for other comparative periods, we are presenting non-GAAP net income and non-GAAP Diluted Earnings Per Share, which represent net income and diluted earnings per share excluding the provision for litigation, amortization of intangibles, acquisition related costs/licensing, acquisition of in-process research and development, merger and acquisition related costs/licensing, certain foreign currency impacts, gains and losses from strategic investments, the impact of dilution attributable to the Convertible Notes, and the tax effects of all of the foregoing adjustments. We also present Non-GAAP gross profit, which excludes the impacts of any inventory acquisition-related costs within cost of goods sold. The tax effect adjustment represents the tax effect of the pre-tax non-GAAP adjustments excluded from non-GAAP net income. The tax impact of the non-GAAP adjustments is calculated based on the consolidated effective tax rate on a GAAP basis, applied to the non-GAAP adjustments, unless the underlying item has a materially different tax treatment, in which case the estimated tax rate applicable to the adjustment is used. We believe these non-GAAP measures are also useful indicators of our operating performance, and particularly as additional measures of comparative operating performance from period to period as they remove the effects of the foregoing items, which we believe are not reflective of underlying business trends. Additionally, for the period ended December 31, 2023 and for other comparative periods, we also define the non-GAAP measure of free cash flow as the net cash provided by operating activities, adjusted for the impact of restricted cash, less the cash impact of purchases of property and equipment. We believe that this financial measure provides meaningful information for evaluating our overall financial performance for comparative periods as it facilitates an assessment of funds available to satisfy current and future obligations and fund acquisitions. Furthermore, the non-GAAP measure of constant currency net sales growth is calculated by translating current year net sales at the same average exchange rates in effect during the applicable prior year period. We believe constant currency net sales growth provides insight to the comparative increase or decrease in period net sales, in dollar and percentage terms, excluding the effects of fluctuations in foreign currency exchange rates.

Non-GAAP adjusted EBITDA, non-GAAP net income, non-GAAP diluted earnings per share, non-GAAP gross profit, free cash flow and constant currency net sales growth are not calculated in conformity with U.S. GAAP. Non-GAAP financial measures have limitations as analytical tools and should not be considered in isolation or as a substitute for financial measures prepared in accordance with U.S. GAAP. These measures do not include certain expenses that may be necessary to evaluate our liquidity or operating results. Our definitions of non-GAAP adjusted EBITDA, non-GAAP net income, non-GAAP diluted earnings per share, non-GAAP gross profit, free cash flow and constant currency net sales growth may differ from that of other companies and therefore may not be comparable.

Safe Harbor Statements

All statements included in this press release other than statements of historical fact are forward-looking statements and may be identified by their use of words such as “believe,” “may,” “might,” “could,” “will,” “aim,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “plan” and other similar terms. These forward-looking statements are based on our current assumptions, expectations and estimates of future events and trends. Forward-looking statements are only predictions and are subject to many risks, uncertainties and other factors that may affect our businesses and operations and could cause actual results to differ materially from those predicted. These risks and uncertainties include, but are not limited to, the risks and costs associated with the integration of the NuVasive business and Globus Medical, Inc.’s ability to successfully integrate and achieve anticipated synergies with the NuVasive business, health epidemics, pandemics and similar outbreaks, factors affecting our quarterly results, our ability to manage our growth, our ability to sustain our profitability, demand for our products, our ability to compete successfully (including without limitation our ability to convince surgeons to use our products and our ability to attract and retain sales and other personnel), our ability to rapidly develop and introduce new products, our ability to develop and execute on successful business strategies, our ability to comply with laws and regulations that are or may become applicable to our businesses, our ability to safeguard our intellectual property, our success in defending legal proceedings brought against us, trends in the medical device industry, general economic conditions, and other risks. For a discussion of these and other risks, uncertainties and other factors that could affect our results, you should refer to the disclosure contained in our most recent annual report on Form 10-K filed with the U.S. Securities and Exchange Commission, including the sections labeled “Risk Factors” and “Cautionary Note Concerning Forward-Looking Statements,” and in our Forms 10-Q, Forms 8-K and other filings with the U.S. Securities and Exchange Commission. These documents are available at www.sec.gov. Moreover, we operate in an evolving environment. New risk factors and uncertainties emerge from time to time and it is not possible for us to predict all risk factors and uncertainties, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements. Given these risks and uncertainties, readers are cautioned not to place undue reliance on any forward-looking statements. Forward-looking statements contained in this press release speak only as of the date of this press release. We undertake no obligation to update any forward-looking statements as a result of new information, events or circumstances or other factors arising or coming to our attention after the date hereof.

GLOBUS MEDICAL, INC. AND SUBSIDIARIESCONSOLIDATED STATEMENTS OF INCOME(unaudited)
	Three Months Ended											Year Ended
	December 31,											December 31,
(In thousands, except per share amounts)	2023				2022			2021				2023				2022				2021
Net sales	$	616,534			$	274,498		$	250,021			$	1,568,476			$	1,022,843			$	958,102
Cost of sales		265,486				70,591			61,796				548,174				263,725				239,223
Gross profit		351,048				203,907			188,225				1,020,302				759,118				718,879
Operating expenses:
Research and development		52,253				19,507			51,022				124,010				73,015				97,346
Selling, general and administrative		244,718				118,075			106,560				643,410				432,117				408,149
Provision for litigation, net		250				—			5,410				434				2,341				5,921
Amortization of intangibles		28,122				4,506			4,556				51,032				17,735				18,526
Acquisition-related costs		15,581				7,791			2,477				68,274				5,959				16,984
Total operating expenses		340,924				149,879			170,025				887,160				531,167				546,926
Operating income/(loss)		10,124				54,028			18,200				133,142				227,951				171,953
Other income/(expense), net
Interest income/(expense), net		(2,581	)			5,315			1,939				20,130				14,233				9,297
Foreign currency transaction gain/(loss)		19,908				2,688			(454	)			14,259				(1,020	)			(1,423	)
Other income/(expense)		(2,456	)			85			143				(2,138	)			1,855				580
Total other income/(expense), net		14,871				8,088			1,628				32,251				15,068				8,454
Income/(loss) before income taxes		24,995				62,116			19,828				165,393				243,019				180,407
Income tax provision		9,960				12,051			4,722				42,520				52,850				31,216
Net income/(loss)	$	15,035			$	50,065		$	15,106			$	122,873			$	190,169			$	149,191
Other comprehensive income/(loss), net of tax:
Unrealized gain/(loss) on marketable securities		8,893				4,199			(2,623	)			13,231				(14,040	)			(6,054	)
Foreign currency translation gain/(loss)		(18	)			3,397			(1,095	)			1,207				(3,818	)			(4,673	)
Total other comprehensive income/(loss), net of tax		8,875				7,596			(3,718	)			14,438				(17,858	)			(10,727	)
Comprehensive income/(loss)	$	23,910			$	57,661		$	11,388			$	137,311			$	172,311			$	138,464
Earnings per share:
Basic	$	0.11			$	0.50		$	0.15			$	1.09			$	1.89			$	1.48
Diluted	$	0.11			$	0.49		$	0.14			$	1.07			$	1.85			$	1.44
Weighted average shares outstanding:
Basic		137,883				99,967			101,495				113,087				100,469				100,734
Diluted		139,021				102,209			104,192				114,630				102,643				103,623

GLOBUS MEDICAL, INC. AND SUBSIDIARIESCONSOLIDATED BALANCE SHEETS(unaudited)
		December 31,				December 31,
(In thousands, except share and per share values)		2023				2022
ASSETS
Current assets:
Cash and cash equivalents		$	467,292			$	150,466
Short-term marketable securities			50,497				295,592
Accounts receivable, net of allowances of $8,934 and $4,724, respectively			503,235				213,247
Inventories			848,135				298,981
Prepaid expenses and other current assets			44,580				20,997
Income taxes receivable			1,635				4,061
Total current assets			1,915,374				983,344
Property and equipment, net of accumulated depreciation of $425,695 and $343,036, respectively			586,932				243,729
Operating lease right of use assets			59,931				5,988
Long-term marketable securities			75,428				495,852
Intangible assets, net			924,603				63,574
Goodwill			1,434,540				197,471
Other assets			78,590				37,323
Deferred income taxes			10,685				48,845
Total assets		$	5,086,083			$	2,076,126
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable		$	56,671			$	36,101
Accrued expenses			240,460				92,169
Operating lease liabilities			11,967				2,536
Income taxes payable			3,845				990
Business acquisition liabilities			61,035				13,308
Deferred revenue			18,369				14,100
Total current liabilities			392,347				159,204
Business acquisition liabilities, net of current portion			78,323				54,950
Operating lease liabilities			91,037				3,475
Senior convertible notes			417,400				—
Deferred income taxes and other tax liabilities			84,421				1,779
Other liabilities			24,596				10,345
Total liabilities			1,088,124				229,753
Equity:
Class A common stock; $0.001 par value. Authorized 500,000,000 shares; issued and outstanding 113,905,565 and 77,762,282 shares at December 31, 2023 and December 31, 2022, respectively			114				78
Class B common stock; $0.001 par value. Authorized 275,000,000 shares; issued and outstanding 22,430,097 and 22,430,097 shares at December 31, 2023 and December 31, 2022, respectively			22				22
Additional paid-in capital			2,870,749				630,952
Accumulated other comprehensive income/(loss)			(10,192	)			(24,630	)
Retained earnings			1,137,266				1,239,951
Total equity			3,997,959				1,846,373
Total liabilities and equity		$	5,086,083			$	2,076,126

GLOBUS MEDICAL, INC. AND SUBSIDIARIESCONSOLIDATED STATEMENTS OF CASH FLOWS(unaudited)
		Year Ended
		December 31,
(In thousands)		2023				2022				2021
Cash flows from operating activities:
Net income		$	122,873			$	190,169			$	149,191
Adjustments to reconcile net income to net cash provided by operating activities:
Acquired in-process research and development			—				150				34,312
Depreciation and amortization			144,733				68,252				69,867
Amortization of premiums on marketable securities			793				5,389				2,781
Provision for excess and obsolete inventory			10,959				6,400				6,143
Amortization of inventory fair value step up			71,656				—				—
Amortization of 2025 Note fair value step up			8,176				—				—
Stock-based compensation expense			52,742				32,810				30,586
Allowance for doubtful accounts			3,658				(1	)			1,200
Change in fair value of business acquisition liabilities			17,434				5,132				16,807
Change in deferred income taxes			(57,789	)			(22,223	)			(17,615	)
(Gain)/loss on disposal of assets, net			1,541				299				464
Payment of business acquisition related liabilities			(3,005	)			(2,647	)			(210	)
Net (gain)/loss from foreign currency adjustment			(13,674	)			—				—
(Increase) decrease in:
Accounts receivable			(49,914	)			(50,843	)			(25,895	)
Inventories			(70,328	)			(61,745	)			(11,971	)
Prepaid expenses and other assets			1,148				(10,292	)			(6,178	)
Increase (decrease) in:
Accounts payable			(14,223	)			14,418				3,684
Accrued expenses and other liabilities			17,127				6,087				17,896
Income taxes payable/receivable			(408	)			(2,887	)			5,212
Net cash provided by/(used in) operating activities			243,499				178,468				276,274
Cash flows from investing activities:
Purchases of marketable securities			(100,643	)			(419,534	)			(622,359	)
Maturities of marketable securities			240,190				312,221				227,908
Sales of marketable securities			537,723				102,433				109,898
Purchases of property and equipment			(78,274	)			(74,047	)			(56,898	)
Acquisition of businesses, net of cash acquired and purchases of intangible and other assets			(296,028	)			(31,435	)			(34,488	)
Net cash provided by/(used in) investing activities			302,968				(110,362	)			(375,939	)
Cash flows from financing activities:
Payment of business acquisition-related liabilities			(8,039	)			(7,185	)			(9,349	)
Net proceeds from exercise of stock options			12,397				41,716				63,496
Payments related to tax withholdings for share-based compensation			(10,617	)			—				—
Repurchase of common stock			(225,562	)			(144,493	)			—
Net cash provided by/(used in) financing activities			(231,821	)			(109,962	)			54,147
Effect of foreign exchange rates on cash			2,180				(747	)			(810	)
Net increase/(decrease) in cash and cash equivalents			316,826				(42,603	)			(46,328	)
Cash and cash equivalents at beginning of period			150,466				193,069				239,397
Cash and cash equivalents at end of period		$	467,292			$	150,466			$	193,069
Supplemental disclosures of cash flow information:
Income taxes paid, net		$	100,593			$	77,823			$	45,027
Non-cash investing and financing activities:
Equity issued in conjunction with the NuVasive merger		$	2,153,883			$	—				—
Accrued purchases of property and equipment		$	7,100			$	7,423			$	4,551

Supplemental Financial InformationNet Sales by Product Category:
		Three Months Ended									Year Ended
		December 31,									December 31,
(In thousands)		2023			2022			2021			2023			2022			2021
Musculoskeletal Solutions		$	583,820		$	244,999		$	224,624		$	1,448,260		$	926,703		$	876,780
Enabling Technologies			32,714			29,499			25,397			120,216			96,140			81,322
Total net sales		$	616,534		$	274,498		$	250,021		$	1,568,476		$	1,022,843		$	958,102

Liquidity and Capital Resources:
		December 31,			December 31,
(In thousands)		2023			2022
Cash and cash equivalents		$	467,292		$	150,466
Short-term marketable securities			50,497			295,592
Long-term marketable securities			75,428			495,852
Total cash, cash equivalents and marketable securities		$	593,217		$	941,910

The following tables reconcile GAAP to Non-GAAP financial measures.

Non-GAAP Adjusted EBITDA Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands, except percentages)	2023				2022				2021				2023				2022				2021
Net income/(loss)	$	15,034			$	50,065			$	15,106			$	122,873			$	190,169			$	149,191
Interest (income)/expense, net		2,581				(5,315	)			(1,939	)			(20,130	)			(14,233	)			(9,297	)
Provision for income taxes		9,960				12,051				4,722				42,520				52,850				31,216
Depreciation and amortization		71,162				16,911				16,829				144,733				68,252				69,867
EBITDA		98,737				73,712				34,718				289,996				297,038				240,977
Stock-based compensation expense		11,577				8,507				7,805				38,995				32,810				30,586
Provision for litigation, net		250				—				5,410				434				2,341				5,921
Acquisition-related costs/licensing		76,431				7,791				2,934				148,498				6,854				19,622
Acquisition of in-process research and development		—				150				34,312				—				150				34,312
Net (gain) loss from strategic investments		(460	)			—				—				(192	)			—				—
Non-cash acquisition-related foreign currency impacts		(16,572	)			—				—				(13,674	)			—				—
Adjusted EBITDA	$	169,963			$	90,160			$	85,179			$	464,057			$	339,193			$	331,418
Net income/(loss) as a percentage of net sales		2.4	%			18.2	%			6.0	%			7.8	%			18.6	%			15.6	%
Adjusted EBITDA as a percentage of net sales		27.6	%			32.8	%			34.1	%			29.6	%			33.2	%			34.6	%

Non-GAAP Net Income Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2023				2022				2021				2023				2022				2021
Net income/(loss)	$	15,034			$	50,065			$	15,106			$	122,873			$	190,169			$	149,191
Provision for litigation, net		250				—				5,410				434				2,341				5,921
Amortization of intangibles		28,123				4,506				4,556				51,032				17,735				18,526
Acquisition-related costs/licensing		76,431				7,791				2,934				148,498				6,854				19,622
Acquisition of in-process research and development		—				150				34,312				—				150				34,312
Non-cash acquisition-related foreign currency impacts		(16,572	)			—				—				(13,674	)			—				—
Net gain/(loss) on strategic investments		(460	)			—				—				(192	)			—				—
Tax effect of adjusting items		(19,310	)			(2,415	)			(11,245	)			(42,570	)			(5,695	)			(16,151	)
Non-GAAP net income/(loss)	$	83,496			$	60,097			$	51,073			$	266,401			$	211,554			$	211,421

Non-GAAP Gross Profit Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2023				2022				2021				2023				2022				2021
Cost of sales	$	265,486			$	70,591			$	61,796			$	548,174			$	263,725			$	239,223
Acquisition related costs/licensing		(52,591	)			—				—				(71,656	)			—				—
Adjusted cost of sales	$	212,895			$	70,591			$	61,796			$	476,518			$	263,725			$	239,223
Adjusted gross profit	$	403,638			$	203,907			$	188,225			$	1,091,958			$	759,118			$	718,879
Adjusted gross profit as a percentage		65.5	%			74.3	%			75.3	%			69.6	%			74.2	%			75.0	%

Non-GAAP Diluted Earnings Per Share Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2023				2022				2021				2023				2022				2021
Diluted earnings per share, as reported	$	0.11			$	0.49			$	0.14			$	1.07			$	1.85			$	1.44
Provision for litigation, net		0.00				—				0.06				—				0.02				0.06
Amortization of intangibles		0.20				0.04				0.04				0.45				0.17				0.18
Acquisition-related costs/licensing		0.55				0.08				0.03				1.30				0.07				0.19
Acquisition of in-process research and development		—				—				0.33				—				—				0.33
Net (gain) loss from strategic investments		(0.00	)			—				—				(0.00	)			—				—
Non-cash acquisition-related foreign currency impacts		(0.12	)			—				—				(0.12	)			—				—
Tax effect of adjusting items		(0.14	)			(0.02	)			(0.11	)			(0.37	)			(0.06	)			(0.16	)
Non-GAAP diluted earnings per share	$	0.60			$	0.59			$	0.49			$	2.32			$	2.06			$	2.04

*amounts might not add due to rounding

Non-GAAP Free Cash Flow Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2023				2022				2021				2023				2022				2021
Net cash provided by operating activities	$	104,674			$	63,975			$	76,253			$	243,499			$	178,468			$	276,274
Purchases of property and equipment		(22,881	)			(18,340	)			(17,045	)			(78,274	)			(74,047	)			(56,898	)
Free cash flow	$	81,793			$	45,635			$	59,208			$	165,225			$	104,421			$	219,376

Non-GAAP Net Sales on a Constant Currency Basis Comparative Table:
		Three Months EndedDecember 31,						ReportedNet SalesGrowth		CurrencyImpact on CurrentPeriod Net Sales			ConstantCurrencyNet SalesGrowth
(In thousands, except percentages)		2023			2022
United States		$	490,841		$	233,232		110.5%		$	—		110.5%
International			125,693			41,266		204.6%			2,331		198.9%
Total net sales		$	616,534		$	274,498		124.6%		$	2,331		123.8%

		Year EndedDecember 31,						ReportedNet SalesGrowth		CurrencyImpact on CurrentPeriod Net Sales			ConstantCurrencyNet SalesGrowth
(In thousands, except percentages)		2023			2022
United States		$	1,279,765		$	871,939		46.8%		$	—		46.8%
International			288,711			150,904		91.3%			860		90.8%
Total net sales		$	1,568,476		$	1,022,843		53.3%		$	860		53.3%

Contact:Brian KearnsSenior Vice President, Business Development and Investor RelationsPhone: (610) 930-1800Email: investors@globusmedical.comwww.globusmedical.com