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, 2024.

Fourth Quarter 2024:

• Worldwide net sales were $657.3 million, an increase of 6.6% on an as-reported basis and an increase of 6.9% on a constant currency basis
• GAAP net income for the quarter was $26.5 million
• GAAP diluted earnings per share (“EPS”) was $0.19 and non-GAAP diluted EPS was $0.84
• Non-GAAP adjusted EBITDA was $196.9 million, or 30.0% of net sales

Full Year 2024:

• Worldwide net sales were $2,519.4 million, an increase of 60.6% on an as-reported basis and an increase of 61.1% on a constant currency basis
• GAAP net income for the year was $103.0 million
• GAAP diluted EPS was $0.75 and non-GAAP diluted EPS was $3.04
• Non-GAAP adjusted EBITDA was $735.0 million, or 29.2% of net sales

“I’m proud of our team at Globus Medical, delivering incredible results for 2024. We made significant progress integrating the business and creating a strong foundation for future growth while remaining focused on improving patient outcomes. Our spine sales force is the most dedicated and talented team in the market. Our innovation engine delivered a record amount of new product launches in 2024 and remains unmatched in our industry.” said Dan Scavilla, President and CEO. “The potential for Globus has never been greater, as we continue to redefine spine surgery and address unmet clinical needs with procedural solutions built around enabling technology.”

“Our financial results demonstrate the potential of our combined organization and the growing value creation from the merger”, commented Keith Pfeil, COO-CFO. “Despite the complexities of integration, we delivered record fourth quarter and full year sales, while maintaining our disciplined approach to operational excellence and cost management. Our team executed against the strategic objectives to drive integration success, which has unlocked tremendous value, as demonstrated in our financial results, which include record operating cash flow for the fourth quarter and full year. Looking ahead, we remain well positioned to unlock operational efficiencies, while delivering innovation and market leadership.”

Worldwide net sales for the fourth quarter were $657.3 million, an as-reported increase of 6.6% over the fourth quarter of 2023, and an increase of 6.9% on a constant currency basis. U.S. net sales for the fourth quarter of 2024 increased by 6.3% compared to the fourth quarter of 2023. International net sales increased by 7.7% over the fourth quarter of 2023 on an as-reported basis, and an increase of 8.9% on a constant currency basis. Net Sales increases were driven by the addition of NuVasive, as well as increased spine products and enabling technology volume.

Worldwide net sales for the full year of 2024 were $2,519.4 million, an increase of 60.6% as compared to the full year of 2023 on an as-reported basis, and an increase of 61.1% on a constant currency basis. U.S. net sales for the full year of 2024 increased by 56.3% compared to the full year of 2023. International net sales increased by 79.9% over the full year of 2024 on an as-reported basis, and an increase of 82.7% on a constant currency basis.

GAAP net income for the fourth quarter was $26.5 million, an increase of 76.3% over the same period in the prior year, driven primarily by higher net sales as a result of the Merger. Diluted EPS for the fourth quarter was $0.19, compared to $0.11 for the fourth quarter of 2023. Non-GAAP net income for the fourth quarter was $117.4 million, an increase of 40.6% over the same period in the prior year, driven primarily by higher net sales as a result of the Merger. Non-GAAP diluted EPS for the fourth quarter of 2024 was $0.84, compared to $0.60 in the fourth quarter of 2023, an increase of 35.7% driven by higher net sales.

Net cash provided by operating activities was $520.6 million, and non-GAAP free cash flow was $405.2 million for the full year of 2024.

2025 Annual Guidance

On a stand-alone basis, Globus Medical reaffirms its full year 2025 revenue guidance range of $2.66 billion to $2.69 billion and fully diluted non-GAAP earnings per share range between $3.40 to $3.50. Following the consummation of the Nevro, Inc. acquisition, which we expect to close in the late second quarter of 2025, Globus Medical anticipates 2025 net sales of $2.80 billion to $2.90 billion and fully diluted non-GAAP earnings per share range between $3.10 to $3.40.

Conference Call Information

Globus Medical will hold a teleconference to discuss its 2024 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, merger and acquisition related costs, restructuring related costs, 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. As of December 31, 2024, we no longer include acquisition of in-process research and development as an adjustment to non-GAAP Adjusted EBITDA. 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. Merger and acquisition related costs 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. Restructuring related costs include severance, retention bonus, accelerated stock-based compensation expense, and costs associated with consolidating facilities. 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, 2024 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, merger and acquisition related costs, restructuring related costs, 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. As of December 31, 2024, we no longer include acquisition of in-process research and development as an adjustment to non-GAAP net income. 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, 2024, 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, our ability to complete the acquisition of and successfully integrate the Nevro, Inc. 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)	2024				2023				2022				2024				2023				2022
Net sales	$	657,293			$	616,534			$	274,498			$	2,519,355			$	1,568,476			$	1,022,843
Cost of Sales and Operating expenses:
Cost of Sales (exclusive of amortization of intangibles)		263,437				265,486				70,591				1,035,479				548,174				263,725
Research and development		33,408				52,253				19,507				163,754				124,010				73,015
Selling, general and administrative		253,481				244,718				118,075				981,048				643,410				432,117
Provision for litigation, net		(314	)			250				—				314				434				2,341
Amortization of intangibles		29,912				28,122				4,506				119,373				51,032				17,735
Acquisition-related costs		17,088				15,581				7,791				29,623				68,274				5,959
Restructuring cost		6				—				—				23,773				—				—
Operating income/(loss)		60,275				10,124				54,028				165,991				133,142				227,951
Other income/(expense), net
Interest income/(expense), net		815				(2,581	)			5,315				(4,189	)			20,130				14,233
Foreign currency transaction gain/(loss)		(37,491	)			19,908				2,688				(43,285	)			14,259				(1,020	)
Other income/(expense)		1,069				(2,456	)			85				2,205				(2,138	)			1,855
Total other income/(expense), net		(35,607	)			14,872				8,088				(45,269	)			32,251				15,068
Income/(loss) before income taxes		24,668				24,995				62,116				120,722				165,393				243,019
Income tax provision		(1,837	)			9,960				12,051				17,738				42,520				52,850
Net income/(loss)	$	26,505			$	15,035			$	50,065			$	102,984			$	122,873			$	190,169
Other comprehensive income/(loss), net of tax:
Unrealized gain/(loss) on marketable securities		(238	)			8,893				4,199				1,545				13,231				(14,040	)
Foreign currency translation gain/(loss)		340				(18	)			3,397				1,786				1,207				(3,818	)
Total other comprehensive income/(loss), net of tax		102				8,875				7,596				3,331				14,438				(17,858	)
Comprehensive income/(loss)	$	26,607			$	23,910			$	57,661			$	106,315			$	137,311			$	172,311
Earnings per share:
Basic	$	0.19			$	0.11			$	0.50			$	0.76			$	1.09			$	1.89
Diluted	$	0.19			$	0.11			$	0.49			$	0.75			$	1.07			$	1.85
Weighted average shares outstanding:
Basic		136,729				137,883				99,967				135,726				113,087				100,469
Diluted		139,711				139,021				102,209				137,863				114,630				102,643

GLOBUS MEDICAL, INC. AND SUBSIDIARIESCONSOLIDATED BALANCE SHEETS(unaudited)
	December 31,				December 31,
(In thousands, except share and per share values)	2024				2023
ASSETS
Current assets:
Cash and cash equivalents	$	784,438			$	467,292
Short-term marketable securities		105,619				50,497
Accounts receivable, net of allowances of $15,505 and $8,934, respectively		557,697				503,235
Inventories		659,233				848,135
Prepaid expenses and other current assets		49,640				44,580
Income taxes receivable		20,633				1,635
Total current assets		2,177,260				1,915,374
Property and equipment, net of accumulated depreciation of $545,786 and $425,695, respectively		561,909				586,932
Operating lease right of use assets		49,647				59,931
Long-term marketable securities		66,134				75,428
Intangible assets, net		795,117				924,603
Goodwill		1,432,387				1,434,540
Other assets		75,096				78,590
Deferred income taxes		94,200				10,685
Total assets	$	5,251,750			$	5,086,083
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable	$	75,118			$	56,671
Accrued expenses		260,591				240,460
Operating lease liabilities		10,249				11,967
Income taxes payable		10,725				3,845
Senior convertible notes		443,351				—
Business acquisition liabilities		33,739				61,035
Deferred revenue		22,140				18,369
Total current liabilities		855,913				392,347
Business acquisition liabilities, net of current portion		89,496				78,323
Operating lease liabilities		83,588				91,037
Senior convertible notes		—				417,400
Deferred income taxes and other tax liabilities		23,889				84,421
Other liabilities		21,531				24,596
Total liabilities		1,074,417				1,088,124
Equity:
Class A common stock; $0.001 par value. Authorized 500,000,000 shares; issued and outstanding 114,990,219 and 113,905,565 shares at December 31, 2024 and December 31, 2023, respectively		115				114
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, 2024 and December 31, 2023, respectively		22				22
Additional paid-in capital		3,031,244				2,870,749
Accumulated other comprehensive income/(loss)		(6,861	)			(10,192	)
Retained earnings		1,152,813				1,137,266
Total equity		4,177,333				3,997,959
Total liabilities and equity	$	5,251,750			$	5,086,083

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

Supplemental Financial Information
Net Sales by Product Category:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2024				2023				2022				2024				2023				2022
Musculoskeletal Solutions	$	610,341			$	583,820			$	244,999			$	2,365,352			$	1,448,260			$	926,703
Enabling Technologies		46,952				32,714				29,499				154,003				120,216				96,140
Total net sales	$	657,293			$	616,534			$	274,498			$	2,519,355			$	1,568,476			$	1,022,843

Liquidity and Capital Resources:
	December 31,				December 31,
(In thousands)	2024				2023
Cash and cash equivalents	$	784,438			$	467,292
Short-term marketable securities		105,619				50,497
Long-term marketable securities		66,134				75,428
Total cash, cash equivalents and marketable securities	$	956,191			$	593,217

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

As of September 30, 2024, we no longer include Acquisition of in-process research and development as an adjustment to the non-GAAP financial measures. As previously disclosed, the Company incurred $12.6 million in the twelve months ended December 31, 2024 for the Acquisition of in-process research and development, which, when it was previously included, resulted in an impact for the year ended December 31, 2024 of 0.5% on Adjusted EBITDA as a percentage of net sales and $0.09 on Non-GAAP diluted earnings per share.

Non-GAAP Adjusted EBITDA Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands, except percentages)	2024				2023				2022				2024				2023				2022
Net income/(loss)	$	26,505			$	15,035			$	50,065			$	102,984			$	122,873			$	190,169
Interest (income)/expense, net		(815	)			2,581				(5,315	)			4,189				(20,130	)			(14,233	)
Provision for income taxes		(1,838	)			9,960				12,051				17,738				42,520				52,850
Depreciation and amortization		68,228				71,162				16,911				254,024				144,733				68,252
EBITDA		92,080				98,737				73,712				378,935				289,996				297,038
Stock-based compensation expense		11,756				11,577				8,507				48,286				38,995				32,810
Provision for litigation, net		(314	)			250				—				314				434				2,341
Merger and acquisition-related costs(1)		64,561				76,431				7,791				249,721				148,498				6,854
Acquisition of in-process research and development		—				—				150				—				—				150
Net (gain) loss from strategic investments		1,098				(460	)			—				831				(192	)			—
Non-cash acquisition-related foreign currency impacts		27,566				(16,572	)			—				25,212				(13,674	)			—
Restructuring costs		132				—				—				31,674				—				—
Adjusted EBITDA	$	196,879			$	169,963			$	90,160			$	734,973			$	464,057			$	339,193
Net income/(loss) as a percentage of net sales		4.0	%			2.4	%			18.2	%			4.1	%			7.8	%			18.6	%
Adjusted EBITDA as a percentage of net sales		30.0	%			27.6	%			32.8	%			29.2	%			29.6	%			33.2	%
(1) Merger and acquisition-related costs represent certain costs associated with acquisitions. These costs, presented on a before-tax effect basis, include the following:

	Three Months Ended								Year Ended
	December 31,								December 31,
	2024				2023				2024				2023
(In thousands)
Amortization of inventory fair value step up	$	47,323			$	52,591			$	215,420			$	71,656
Change in fair value of business acquisition liabilities		16,966				12,684				25,575				17,259
Employee-related costs		—				8,545				5,031				42,857
Other acquisition-related costs(a)		272				2,612				3,695				16,725
Merger and acquisition-related costs	$	64,561			$	76,432			$	249,721			$	148,498
(a) Primarily comprised of legal fees, investment banking and consulting fees.

Non-GAAP Net Income Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2024				2023				2022				2024				2023				2022
Net income/(loss)	$	26,505			$	15,034			$	50,065			$	102,984			$	122,873			$	190,169
Provision for litigation, net		(314	)			250				—				314				434				2,341
Amortization of intangibles		29,912				28,123				4,506				119,373				51,032				17,735
Merger and acquisition -related costs(1)		64,561				76,431				7,791				249,721				148,498				6,854
Acquisition of in-process research and development		—				—				150				—				—				150
Non-cash acquisition-related foreign currency impacts		27,566				(16,572	)			—				25,212				(13,674	)			—
Restructuring Costs		132				—								31,674				—
Net gain/(loss) on strategic investments		1,098				(460	)			—				831				(192	)			—
Tax effect of adjusting items		(32,042	)			(19,310	)			(2,415	)			(110,496	)			(42,570	)			(5,695	)
Non-GAAP net income/(loss)	$	117,418			$	83,496			$	60,097			$	419,613			$	266,401			$	211,554
(1) see footnote 1 to the Non-GAAP Adjusted EBITDA Reconciliation Table above for the detail of these costs.

Non-GAAP Gross Profit Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2024				2023				2022				2024				2023				2022
Net Sales	$	657,293			$	616,534			$	274,498			$	2,519,355			$	1,568,476			$	1,022,843
Cost of Sales (exclusive of amortization of intangibles)		263,437				265,486			—	70,591				1,035,479				548,174				263,725
Amortization of Intangibles		17,585				9,526				4,506				84,079				15,408				17,735
Gross Profit		376,271				341,522				188,225				1,399,797				1,004,893				718,879
Amortization of inventory fair value step up		47,323				52,591				—				215,420				71,656				—
Amortization of Intangibles		17,585				9,526				4,506				84,079				15,408				17,735
Adjusted Gross Profit	$	441,179			$	403,639			$	192,731			$	1,699,296			$	1,091,957			$	736,614
Gross Profit % of Net Sales		57.2	%			55.4	%			68.6	%			55.6	%			64.1	%			70.3	%
Adjusted Gross Profit % of Net Sales		67.1	%			65.5	%			70.2	%			67.4	%			69.6	%			72.0	%

Non-GAAP Diluted Earnings Per Share Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2024				2023				2022				2024				2023				2022
Diluted earnings per share, as reported	$	0.19			$	0.11			$	0.49			$	0.75			$	1.07			$	1.85
Dilution attributable to Convertible Notes		—				—				—				—				—				—
Provision for litigation, net		(0.00	)			—				—				—				—				0.02
Amortization of intangibles		0.21				0.20				0.04				0.87				0.45				0.17
Merger and acquisition -related costs(1)		0.46				0.55				0.08				1.81				1.30				0.07
Acquisition of in-process research and development		—				—				—				—				—				—
Net (gain) loss from strategic investments		0.01				—				—				0.01				(0.00	)			—
Non-cash acquisition-related foreign currency impacts		0.20				(0.12	)			—				0.18				(0.12	)			—
Tax reform impact		—				—				—				—				—				—
Restructuring costs		0.00				—				—				0.23				—				—
Tax effect of adjusting items		(0.23	)			(0.14	)			(0.02	)			(0.80	)			(0.37	)			(0.06	)
Non-GAAP diluted earnings per share	$	0.84			$	0.60			$	0.59			$	3.04			$	2.32			$	2.06
(1) see footnote 1 to the Non-GAAP Adjusted EBITDA Reconciliation Table above for the detail of these costs.
* amounts may not add due to rounding.

Non-GAAP Free Cash Flow Reconciliation Table:
	Three Months Ended												Year Ended
	December 31,												December 31,
(In thousands)	2024				2023				2022				2024				2023				2022
Net cash provided by operating activities	$	210,338			$	104,674			$	63,975			$	520,638			$	243,499			$	178,468
Purchases of property and equipment		(17,111	)			(22,881	)			(18,340	)			(115,429	)			(78,274	)			(74,047	)
Free cash flow	$	193,227			$	81,793			$	45,635			$	405,209			$	165,225			$	104,421

Non-GAAP Net Sales on a Constant Currency Basis Comparative Table:
	Three Months Ended								Reported				CurrencyImpact on				ConstantCurrency
	December 31,								Net Sales				Current				Net Sales
(In thousands, except percentages)	2024				2023				Growth				Period Net Sales				Growth
United States	$	521,892			$	490,841				6.3	%		$	—				6.3	%
International		135,401				125,693				7.7	%			(1,490	)			8.9	%
Total net sales	$	657,293			$	616,534				6.6	%		$	(1,490	)			6.9	%

	Year Ended								Reported				CurrencyImpact on				ConstantCurrency
	December 31,								Net Sales				Current				Net Sales
(In thousands, except percentages)	2024				2023				Growth				Period Net Sales				Growth
United States	$	2,000,067			$	1,279,765				56.3	%		$	—				56.3	%
International		519,288				288,711				79.9	%			(8,090	)			82.7	%
Total net sales	$	2,519,355			$	1,568,476				60.6	%		$	(8,090	)			61.1	%

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