Revenue (Tables)

12 Months Ended

Dec. 31, 2019

Risks and Uncertainties [Abstract]

Disaggregation of Revenue

The following table and description below shows the products from which the Company generated its revenue:

	Year Ended December 31,
Revenue by product (in thousands)	2019		2018			2017
MACI and Carticel implants and kits
Implants based on contracted rate sold through a specialty pharmacy (a)	$	56,185	$	42,926		$	37,796
Implants subject to third party reimbursement sold through a specialty pharmacy (b)	17,076		8,621			1,299
Implants sold direct based on contracted rates (c)	13,933		12,122			3,393
Implants sold direct subject to third party reimbursement (d)	1,529		2,257			—
Biopsy kits - direct bill	2,243		1,997			1,764
Change in estimates related to prior periods	654		(182		)	(350		)
Epicel
Direct bill (hospital)	26,230		23,116			18,858
Other revenue	—		—			1,164
Total revenue	$	117,850	$	90,857		$	63,924
(a) Represents implants sold through Orsini and AllCare in both 2019 and 2018 and Dohmen Life Science Services, LLC (DLSS) and Vital Care, Inc (Vital Care) in 2017 in which such specialty pharmacies have entered into a direct contract with the underlying insurance provider. The amount of reimbursement is based on contracted rates at the time of sale supported by the pharmacy's direct contracts. Also represents sales with DMS and UsBio, based on direct contracts the Company holds with the facilities. The Company sold implants through DLSS and Vital Care through June 2017 and began selling directly to Orsini based on a fixed transfer price under a distribution model until June 2018.
(b) Represents implants sold through Orsini, AllCare or DLSS in which such specialty pharmacy does not have a direct contract with the underlying payer. The amount of reimbursement is established based on a payer or state fee schedule and/or payer history.
(c) Represents implants sold directly from the Company to the facility based on a contract and known price agreed upon prior to the surgery date.
(d) Represents implants sold directly from the Company to the facility based on a contract and known price agreed upon prior to the surgery date. The payment terms are subject to third-party reimbursement from an underlying insurance provider.

Schedules of concentration of risk

The Company’s total revenue and accounts receivable balances were comprised of the following concentrations from its largest customer of MACI and Epicel based on customers whose revenue or accounts receivable concentration is greater than 10% of total revenue or total accounts receivable in any of the periods disclosed below and are as follows:

	Revenue Concentration						Accounts Receivable Concentration
	Year Ended December 31,						December 31,
	2019		2018		2017		2019		2018
MACI (a)	8	%	16	%	35	%	8	%	2	%
Epicel	7	%	7	%	10	%	2	%	4	%
(a) For MACI net revenue, the concentration of credit risk in 2018 and 2017 represents sales directly to Orsini. The comparable concentration in 2019 represents a different end customer under the sales model where the Company retains the credit and collection risk from the end customer.