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Cover Page - USD ($) $ in Millions	12 Months Ended
Cover Page - USD ($) $ in Millions	Dec. 31, 2019	Mar. 02, 2020	Jun. 28, 2019
Cover page.
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	FY
Title of 12(b) Security	Common stock, par value $0.0001 per share
Trading Symbol	AXNX
Security Exchange Name	NASDAQ
Entity Registrant Name	Axonics Modulation Technologies, Inc.
Entity Central Index Key	0001603756
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Emerging Growth Company	true
Entity Small Business	true
Entity Shell Company	false
Entity Ex Transition period	true
Entity Public Float			$ 632.8
Entity Common Stock, Shares Outstanding		34,292,177

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Current assets
Cash and cash equivalents	$ 171,082	$ 98,306
Short-term investments	12,592	59,218
Accounts receivable, net of allowance for doubtful accounts of $75 and $0 at December 31, 2019 and 2018, respectively	7,879	427
Inventory, net	15,659	3,673
Prepaid expenses and other current assets	4,468	3,716
Total current assets	211,680	165,340
Property and equipment, net	3,047	2,784
Intangible asset, net	311	426
Other assets	4,784	3,356
Total assets	219,822	171,906
Current liabilities
Accounts payable	5,882	3,436
Accrued liabilities	2,174	1,019
Accrued compensation and benefits	3,375	664
Operating lease liability, current portion	602	768
Total current liabilities	12,033	5,887
Operating lease liability, net of current portion	4,450	3,281
Debt, net of unamortized debt issuance costs	20,336	19,463
Total liabilities	36,819	28,631
Stockholders’ Equity
Preferred stock, par value $0.0001 per share; 10,000,000 shares authorized, no shares issued and outstanding at December 31, 2019 and 2018	0	0
Common stock, par value $0.0001, 50,000,000 shares authorized at December 31, 2019 and 2018; 34,110,995 and 27,806,934 shares issued and outstanding at December 31, 2019 and 2018, respectively	3	3
Additional paid-in capital	363,012	243,337
Accumulated deficit	(179,584)	(99,649)
Accumulated other comprehensive loss	(428)	(416)
Total stockholders’ equity	183,003	143,275
Total liabilities and stockholders’ equity	$ 219,822	$ 171,906

Consolidated Balance Sheets - (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 75	$ 0
Common stock, par value (USD per share)	$ 0.0001	$ 0.0001
Common stock authorized (shares)	50,000,000	50,000,000
Common stock issued (shares)	34,110,995	27,806,934
Common stock outstanding (shares)	34,110,995	27,806,934
Preferred stock, par value (USD per share)	$ 0.0001	$ 0.0001
Preferred stock authorized (shares)	10,000,000	10,000,000
Preferred stock issued (shares)	0	0
Preferred stock outstanding (shares)	0	0

Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Statement of Comprehensive Income [Abstract]
Net revenue	$ 13,820	$ 707
Cost of goods sold	6,490	356
Gross profit	7,330	351
Operating Expenses
Research and development	20,181	19,402
General and administrative	19,076	9,362
Sales and marketing	48,672	3,724
Total operating expenses	87,929	32,488
Loss from operations	(80,599)	(32,137)
Other Income (Expense)
Interest income	2,974	998
Interest and other expense	(2,309)	(1,343)
Other income (expense), net	665	(345)
Loss before income tax expense	(79,934)	(32,482)
Income tax expense	1	1
Net loss	(79,935)	(32,483)
Foreign currency translation adjustment	(12)	(14)
Comprehensive loss	$ (79,947)	$ (32,497)
Net loss per share, basic and diluted (USD per share)	$ (2.80)	$ (4.64)
Weighted-average shares used to compute basic and diluted net loss per share (shares)	28,567,302	6,997,777

Consolidated Statements of Mezzanine Equity - 12 months ended Dec. 31, 2018 - USD ($) $ in Thousands	Total	Preferred Stock Series A Convertible Preferred Stock	Preferred Stock Series B-1 Convertible Preferred Stock	Preferred Stock Series B-2 Convertible Preferred Stock	Preferred Stock Series C Convertible Preferred Stock	Noncontrolling Interests
Balance at beginning of period (shares) at Dec. 31, 2017		719,500	1,925,302	2,213,794	1,898,213
Balance at beginning of period at Dec. 31, 2017	$ 93,293	$ 14,021	$ 13,757	$ 17,572	$ 16,877	$ 31,066
Increase (Decrease) in Temporary Equity [Roll Forward]
Issuance of preferred stock for cash, net of issuance costs (shares)					2,233,333
Issuance of preferred stock for cash, net of issuance costs	19,899				$ 19,899
Conversion of preferred stock to common stock (shares)		(719,500)	(1,925,302)	(2,213,794)	(4,131,546)
Conversion of preferred stock to common stock	(113,192)	$ (14,021)	$ (13,757)	$ (17,572)	$ (36,776)	(31,066)
Balance at end of period (shares) at Dec. 31, 2018		0	0	0	0
Balance at end of period at Dec. 31, 2018	$ 0	$ 0	$ 0	$ 0	$ 0	$ 0

Consolidated Statements of Mezzanine Equity - (Parenthetical) - Series C Convertible Preferred Stock $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($) $ / shares
Preferred stock issuance, price per share (USD per share) \| $ / shares	$ 9.00
Issuance costs \| $	$ 199

Consolidated Statements of Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Stock Subscriptions Receivable	Accumulated Deficit	Accumulated Other Comprehensive Loss	Initial Public Offering	Initial Public Offering Common Stock	Initial Public Offering Additional Paid-in Capital	Follow-on Offering	Follow-on Offering Common Stock	Follow-on Offering Additional Paid-in Capital
Balance at beginning of period (shares) at Dec. 31, 2017		2,776,583
Balance at beginning of period at Dec. 31, 2017	$ (66,421)	$ 0	$ 2,900	$ (1,753)	$ (67,166)	$ (402)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for employee stock option exercises for promissory notes (shares)		48,720
Issuance of common stock for employee stock option exercises for promissory notes	0		71	(71)
Issuance of common stock for employee stock option exercises for cash (shares)		7,120
Issuance of common stock for employee stock option exercises for cash	9		9
Warrants for common stock	986		986
Repurchase of common stock (shares)		(38,786)
Repurchase of common stock	(473)		(473)
Forgiveness of stock subscriptions receivable	1,824			1,824
Conversion of preferred stock to common stock (shares)		15,813,297
Conversion of preferred stock to common stock	113,192	$ 2	113,190
Stock-based compensation / Restricted Shares Award (RSA) and stock option issuances and forfeitures for terminations, net	606		606
Initial public offering / Follow-on offering - issuance, less closing costs (shares)								9,200,000
Initial public offering / Follow-on offering - issuance, less closing costs							$ 126,049	$ 1	$ 126,048
Foreign currency translation adjustment	(14)					(14)
Net loss	$ (32,483)				(32,483)
Balance at end of period (shares) at Dec. 31, 2018	27,806,934	27,806,934
Balance at end of period at Dec. 31, 2018	$ 143,275	$ 3	243,337	0	(99,649)	(416)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for employee stock option exercises for cash (shares)		281,744
Issuance of common stock for employee stock option exercises for cash	506		506
Restricted Shares Award (“RSA”) and stock option issuances and forfeitures for terminations, net (shares)		613,717
Stock-based compensation / Restricted Shares Award (RSA) and stock option issuances and forfeitures for terminations, net	7,655		7,655
Restricted Stock Units (“RSU”) issuances and forfeitures for terminations, net	1,065		1,065
Initial public offering / Follow-on offering - issuance, less closing costs (shares)											5,345,000
Initial public offering / Follow-on offering - issuance, less closing costs										$ 110,449		$ 110,449
Issuance of common stock for warrant exercise (shares)		63,600
Foreign currency translation adjustment	(12)					(12)
Net loss	$ (79,935)				(79,935)
Balance at end of period (shares) at Dec. 31, 2019	34,110,995	34,110,995
Balance at end of period at Dec. 31, 2019	$ 183,003	$ 3	$ 363,012	$ 0	$ (179,584)	$ (428)

Consolidated Statements of Stockholders' Equity (Deficit) (Parenthetical) - Common Stock - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Initial Public Offering
Stock issuance price (USD per share)		$ 15.00
Stock issuance - closing costs	$ 0	$ 11,951
Follow-on Offering
Stock issuance price (USD per share)	$ 22
Stock issuance - closing costs	$ 7,141	$ 0

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Cash Flows from Operating Activities
Net loss	$ (79,935)	$ (32,483)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization	1,191	946
Stock-based compensation	8,720	606
Amortization of debt issuance costs	873	338
Provision for doubtful accounts	75	0
Forgiveness of stock subscriptions receivable	0	1,824
Change in fair value of warrants	0	254
Changes in operating assets and liabilities
Accounts receivable	(7,527)	(427)
Inventory	(11,986)	(2,255)
Prepaid expenses and other current assets	(752)	(3,009)
Other assets	(299)	65
Accounts payable	2,446	1,820
Accrued liabilities	1,155	846
Accrued compensation and benefits	2,711	214
Lease liability	(126)	(109)
Net cash used in operating activities	(83,454)	(31,370)
Cash Flows from Investing Activities
Purchases of property and equipment	(1,339)	(1,228)
Purchases of short-term investments	(36,404)	(78,122)
Proceeds from sales and maturities of short-term investments	83,030	19,300
Net cash provided by (used in) investing activities	45,287	(60,050)
Cash Flows from Financing Activities
Payment of debt issuance costs	0	(142)
Proceeds from debt	0	20,000
Proceeds from exercise of stock options	506	9
Proceeds from issuance of preferred stock and noncontrolling interest	0	20,098
Repurchase of common stock	0	(473)
Net cash provided by financing activities	110,955	165,342
Effect of exchange rate changes on cash and cash equivalents	(12)	(14)
Net increase in cash and cash equivalents	72,776	73,908
Cash and cash equivalents, beginning of year	98,306	24,398
Cash and cash equivalents, end of year	171,082	98,306
Supplemental Disclosure of Cash Flow Information
Cash paid for interest	1,436	751
Cash paid for taxes	1	1
Noncash Investing and Financing Activities
Common stock issuance on stock option exercises for promissory notes	0	71
Warrants issued as debt issuance costs	0	733
Accrued loan fees as debt issuance costs	0	1,500
Forgiveness of stock subscriptions receivable	0	1,824
Preferred Stock
Cash Flows from Financing Activities
Payment of issuance costs	0	(199)
Follow-on Offering
Cash Flows from Financing Activities
Proceeds from issuance of common stock upon initial public offering / follow-on offering	117,590	0
Follow-on Offering \| Common Stock
Cash Flows from Financing Activities
Payment of issuance costs	(7,141)	0
Initial Public Offering
Cash Flows from Financing Activities
Proceeds from issuance of common stock upon initial public offering / follow-on offering	0	138,000
Initial Public Offering \| Common Stock
Cash Flows from Financing Activities
Payment of issuance costs	$ 0	$ (11,951)

Nature of Operations and Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2019

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Nature of Operations and Summary of Significant Accounting Policies

Nature of Operations

Axonics Modulation Technologies, Inc. (the “Company”), formerly American Restorative Medicine, Inc., was incorporated in the state of Delaware on March 2, 2012. The Company had no operations until October 1, 2013, when the license agreement between Alfred E. Mann Foundation for Scientific Research (“AMF”) and the Company (the “License Agreement”) was entered into. The Company is a medical technology company that has developed and is commercializing an innovative and minimally invasive implantable neurostimulation system. The Company has designed and developed the rechargeable sacral neuromodulation (“SNM”) system (“r-SNM System”), which delivers mild electrical pulses to the targeted sacral nerve in order to restore normal communication to and from the brain to reduce the symptoms of overactive bladder (“OAB”), urinary retention (“UR”) and fecal incontinence (“FI”). The r-SNM System is protected by intellectual property based on Company-generated innovations and patents and other intellectual property licensed from AMF. The Company has marketing approvals in Europe, Canada, and Australia for all relevant clinical indications. On September 6, 2019, the premarket approval (“PMA”) application for the r-SNM System for the treatment of FI was approved by the U.S. Food and Drug Administration (“FDA”) and on November 13, 2019, the PMA application for the r-SNM System for the treatment of OAB and UR was approved by the FDA. Accordingly, the Company began U.S. commercialization of its r-SNM System in the fourth quarter of 2019. Prior to the fourth quarter of 2019, the Company has derived revenue only from its international operations in select markets including England, the Netherlands and Canada, and its activities have consisted primarily of developing the r-SNM System, conducting its RELAX-OAB post-market clinical follow-up study in Europe, its ARTISAN-SNM pivotal clinical study in the United States and hiring and training its U.S. commercial team in preparation for the launch of the r-SNM System in the United States.

Initial Public Offering

On November 2, 2018, the Company completed its initial public offering (“IPO”) by issuing 9,200,000 shares of common stock, at an offering price of $15.00 per share, inclusive of 1,200,000 shares of the Company’s common stock issued upon the exercise by the underwriters of their option to purchase additional shares. The net proceeds were approximately $126.0 million, after deducting underwriting discounts, commissions and offering expenses payable by the Company. In connection with the IPO, the Company’s outstanding shares of convertible preferred stock were automatically converted into an aggregate of 15,813,297 shares of common stock, and the Company’s outstanding warrants to purchase shares of Series C convertible preferred stock were automatically converted into warrants to purchase up to an aggregate of 80,000 shares of common stock (see Note 6).

Follow-On Offering

On November 22, 2019, the Company completed a follow-on offering by issuing 5,345,000 shares of common stock, at an offering price of $22.00 per share, inclusive of 750,000 shares of the Company’s common stock issued upon the exercise by the underwriters of their option to purchase additional shares. The net proceeds to the Company were approximately $110.4 million, after deducting underwriting discounts, commissions and offering expenses payable by the Company.

Principles of Consolidation

The consolidated financial statements include the accounts of the Company, its wholly-owned subsidiaries, Axonics Europe, S.A.S., Axonics Modulation Technologies U.K. Limited and Axonics Modulation Technologies Australia Pty Ltd. Intercompany accounts and transactions have been eliminated in consolidation.

Basis of Presentation

The accompanying consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”). Certain prior year reported amounts have been reclassified to conform with the 2019 presentation.

Stock Split and Charter Amendment

In October 2018, the board of directors and certain stockholders of the Company approved an amendment to the Company’s Certificate of Incorporation to (i) increase the authorized shares of common stock from 17,500,000 to 20,500,000, (ii) effect a 1.2-for-1 forward stock split of the Company’s common stock and (iii) define a “Qualified IPO” to include a per share price equal to at least $12.00 (as adjusted for stock splits, combinations, stock dividends, recapitalizations and the like). All shares of common stock, stock options, and per share information presented in the consolidated financial statements have been adjusted to reflect the stock split on a retroactive basis for all periods presented. Any fractional shares that resulted from the stock split were rounded up to the nearest whole share. There was no change in the par value of the Company’s common stock. The ratios by which shares of preferred stock are convertible into shares of common stock have been adjusted to reflect the effects of the forward stock split.

In November 2018, the board of directors and certain stockholders of the Company approved an amendment to the Company’s Certificate of Incorporation to increase the authorized shares of common stock from 20,500,000 to 50,000,000 and authorize 10,000,000 shares of preferred stock.

Use of Estimates

The preparation of consolidated financial statements in conformity with GAAP requires the Company’s management to make estimates and judgments that affect the reported amounts of assets, liabilities, and expenses, and related disclosure of contingent assets and liabilities. The Company bases its estimates on historical experience and on various other assumptions that it believes to be reasonable under the circumstances. The results of this evaluation then form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions, and such differences may be material to the consolidated financial statements.

Revenue Recognition

Revenue recognized during the years ended December 31, 2019 and 2018 relates entirely to the sale of our r-SNM System. In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2014-09 “Revenue from Contracts with Customers” (“ASU 2014-09”) as Accounting Standards Codification (“ASC”) Topic 606. The objective of Topic 606 is to establish a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and superseded most of the existing revenue recognition guidance, including industry-specific guidance. The core principle is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Topic 606 applies to all contracts with customers except those that are within the scope of other topics in the FASB ASC.

The Company has revenue arrangements that consist of a single performance obligation. The Company recognizes revenue at the point in time when it transfers control of promised goods to its customers. Revenue is measured as the amount of consideration it expects to receive in exchange for transferring goods. The amount of revenue that is recognized is based on the transaction price, which represents the invoiced amount and includes estimates of variable consideration such as discounts, where applicable. The Company does not offer rights of return or price protection. The amount of variable consideration included in the transaction price may be constrained and is included only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized under the contract will not occur in a future period. Payment terms, typically less than three months, are offered to the Company’s customers and do not include a significant financing component. The Company extends credit to its customers based upon an evaluation of the customer’s financial condition and credit history and generally requires no collateral. The Company does not have any contract balances related to product sales. The Company also does not have significant contract acquisition costs related to product sales.

In accordance with Company policy, no allowance for product returns has been provided. Damaged or defective products are replaced at no charge under the Company’s standard warranty. For the years ended December 31, 2019 and 2018, the replacement costs were immaterial.

The following table provides additional information pertaining to net revenue disaggregated by geographic market for the years ended December 31, 2019 and 2018:



	Years Ended December 31,
	2019		2018
United States	$	8,376	$	—
International markets	5,444		707
Total net revenue	$	13,820	$	707

Allowance for Doubtful Accounts

The Company makes estimates of the collectability of accounts receivable. In doing so, the Company analyzes historical bad debt trends, customer credit worthiness, current economic trends and changes in customer payment patterns when evaluating the adequacy of the allowance for doubtful accounts.

Cash and Cash Equivalents

Cash equivalents consist of short-term, highly liquid investments purchased with an original maturity of three months or less. Financial instruments that potentially subject the Company to a concentration of credit risk consist of cash and cash equivalents. At times, the cash and cash equivalent balances may exceed federally insured limits. The Company does not believe that this results in any significant credit risk.

Fair Value of Financial Instruments

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. A three-level fair value hierarchy prioritizes the inputs used to measure fair value. The hierarchy requires entities to maximize the use of observable inputs and minimize the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows:


•	Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities.


•	Level 2: Inputs are quoted prices for similar assets and liabilities in active markets or quoted prices for identical or similar instruments in markets that are not active and model-derived valuations in which all significant inputs and significant value drivers are observable in active markets.

•

Level 3: Inputs are unobservable inputs based on the Company’s assumptions and valuation techniques used to measure assets and liabilities at fair value. The inputs require significant management judgment or estimation. The Company’s assessment of the significance of an input to the fair value measurement requires judgment, which may affect the valuation of fair value assets and liabilities and their placement within the fair value hierarchy levels. The carrying amounts reported in the consolidated financial statements approximate the fair value for cash and cash equivalents, accounts receivable, accounts payables, and accrued expenses, due to their short-term nature. The carrying amount of the Company’s term loan, which is described below, approximates fair value, considering the interest rates are based on the prime interest rate.

Investment Securities

The Company classifies its investment securities as available-for-sale. Those investments in debt securities with maturities less than 12 months at the date of purchase are considered short-term investments. Those investments in debt securities with maturities greater than 12 months at the date of purchase are considered long-term investments. The Company’s investment securities classified as available-for-sale are recorded at fair value based on the fair value hierarchy (Level 1 and Level 2 inputs in the fair value hierarchy), and consists primarily of commercial paper, corporate notes and U.S. government and agency securities. Unrealized gains or losses, deemed temporary in nature, are reported as other comprehensive income within the consolidated statement of comprehensive income (loss). There were no unrealized gains or losses during the years ended December 31, 2019 and 2018.

A decline in the fair value of any security below cost that is deemed other than temporary results in a charge to net income (loss) and the corresponding establishment of a new cost basis for the security. Premiums (discounts) are amortized (accreted) over the life of the related security as an adjustment to yield using the straight-line interest method. Dividend and interest income are recognized when earned. Realized gains or losses are included in net income (loss) and are derived using the specific identification method for determining the cost of securities sold.

The following table presents the fair value hierarchy for those assets measured at fair value on a recurring basis as of December 31, 2019 and 2018 (in thousands):



	Fair Value Measurements at December 31, 2019
Assets:	Level 1		Level 2		Level 3		Total
Commercial paper	$	—	$	7,195	$	—	$	7,195
Corporate notes	2,018		—		—		2,018
U.S. government and agency securities	3,379		—		—		3,379
	$	5,397	$	7,195	$	—	$	12,592



	Fair Value Measurements at December 31, 2018
Assets:	Level 1		Level 2		Level 3		Total
Commercial paper	$	—	$	32,163	$	—	$	32,163
Corporate notes	12,606		3,156		—		15,762
U.S. government and agency securities	11,293		—		—		11,293
	$	23,899	$	35,319	$	—	$	59,218

Foreign Currency Translation

The functional currencies of the Company’s subsidiaries are currencies other than the U.S. dollar. The Company translates assets and liabilities of the foreign subsidiaries into U.S. dollars at the exchange rate in effect on the balance sheet date. Costs and expenses of the subsidiaries are translated into U.S. dollars at the average exchange rate during the period. Gains or losses from these translation adjustments are reported as a separate component of stockholders’ equity in accumulated other comprehensive loss until there is a sale or complete or substantially complete liquidation of the Company’s investment in the foreign subsidiary at which time the gains or losses will be realized and included in net income (loss). As of December 31, 2019 and 2018, all foreign currency translation gains (losses) have been unrealized and included in accumulated other comprehensive loss. Accumulated other comprehensive loss consists entirely of losses from translation of foreign subsidiaries at December 31, 2019 and 2018. Foreign currency transaction gains and losses are included in results of operations and have not been significant for the periods presented.

Inventory, Net

Inventories are stated at the lower of cost or net realizable value, with cost computed on a first-in, first-out basis. The Company reduces the carrying value of inventories for items that are potentially excess, obsolete, or slow-moving based on changes in customer demand, technology developments, or other economic factors.

The Company capitalizes inventory produced for commercial sale. The Company capitalizes manufacturing costs as inventory following both the receipt of regulatory approval from regulatory bodies and the Company’s intent to commercialize. Costs associated with developmental products prior to satisfying the Company’s inventory capitalization criteria are charged to research and development expense as incurred.

Products that have been approved by certain regulatory authorities are also used in clinical programs to assess the safety and efficacy of the products for usage that have not been approved by the FDA or other regulatory authorities. The form of product utilized for both commercial and clinical programs is identical and, as a result, the inventory has an “alternative future use” as defined in authoritative guidance. Component materials and purchased products associated with clinical development programs are included in inventory and charged to research and development expense when the product enters the research and development process and no longer can be used for commercial purposes and, therefore, does not have an “alternative future use.”

For products that are under development and have not yet been approved by regulatory authorities, purchased component materials are charged to research and development expense when the inventory ownership transfers to the Company.

The Company analyzes inventory levels to identify inventory that may expire prior to sale, inventory that has a cost basis in excess of its net realizable value, or inventory in excess of expected sales requirements. Although the manufacturing of the r-SNM System is subject to strict quality control, certain batches or units of product may no longer meet quality specifications or may expire, which would require adjustments to the Company’s inventory values. The Company also applies judgment related to the results of quality tests that are performed throughout the production process, as well as the understanding of regulatory guidelines, to determine if it is probable that inventory will be saleable. These quality tests are performed throughout the pre- and post-production processes, and the Company continually gathers information regarding product quality for periods after the manufacturing date. The r-SNM System currently has a maximum estimated shelf life range of 12 to 27 months and, based on sales forecasts, the Company expects to realize the carrying value of the product inventory. In the future, reduced demand, quality issues, or excess supply beyond those anticipated by management may result in a material adjustment to inventory levels, which would be recorded as an increase to cost of sales.

The determination of whether or not inventory costs will be realizable requires estimates by the Company’s management. A critical input in this determination is future expected inventory requirements based on internal sales forecasts. Management then compares these requirements to the expiry dates of inventory on hand. To the extent that inventory is expected to expire prior to being sold, management will write down the value of inventory.

As of December 31, 2019, the Company had $7.0 million, $1.5 million, and $7.2 million of finished goods inventory, work-in-process inventory and raw materials inventory, respectively, on hand net of reserves of $0.1 million. As of December 31, 2018, the Company had $0.9 million and $2.7 million of finished goods inventory and raw materials inventory, respectively, on hand. As of December 31, 2018, there were minimal work-in-process inventory on hand.

Property and Equipment

Property and equipment are stated at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the assets, generally between three and seven years. Leasehold improvements are amortized over the lesser of the life of the lease or the useful life of the improvements. Maintenance and repairs are charged to expense as incurred. 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.

Intangible Asset

The intangible asset represents exclusive rights to an additional field-of-use on the patent suite within the License Agreement with AMF. The additional field-of-use was provided in exchange for 50,000 shares of Series A preferred stock, the fair value of which was $1.0 million in 2013. The intangible asset was recorded at its fair value of $1.0 million at the date contributed. In connection with the IPO, such shares of Series A preferred stock were converted into common stock. Amortization of this asset is recorded over the shorter of the patent or legal life on a straight-line basis. The weighted-average amortization period is 8.71 years. The Company will review the intangible asset for impairment whenever an impairment indicator exists. There have been no intangible asset impairment charges to date.

Impairment of Long-Lived Assets

The Company reviews its long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability is measured by comparing the carrying amount to the future net cash flows that the assets are expected to generate. If said assets are considered to be impaired, the impairment that would be recognized is measured by the amount by which the carrying amount of the assets exceeds the projected discounted future net cash flows arising from the asset. There have been no such impairments of long-lived assets to date.

Leases

Effective January 1, 2018, the Company early adopted ASU No. 2016-02, “Leases (Topic 842)”, the comprehensive new lease standard issued by the FASB. The most significant impact was the recognition of right-of-use (“ROU”) assets and lease liabilities for operating leases. The Company determines if an arrangement is a lease at inception and includes operating leases on the Company’s consolidated balance sheets. The operating lease ROU asset is included within the Company’s other non-current assets, and lease liabilities are included in current or noncurrent liabilities on the Company’s consolidated balance sheets.

The Company has made certain policy elections to apply to its leases executed post-adoption, or subsequent to January 1, 2018. In accordance with Topic 842, components of a lease should be split into three categories: lease components, non-lease components, and non-components. The fixed and in-substance fixed contract consideration (including any consideration related to non-components) must be allocated based on the respective relative fair values to the lease components and non-lease components. Entities may elect not to separate lease and non-lease components. Rather, entities would account for each lease component and related non-lease component together as a single lease component. The Company has elected to account for lease and non-lease components together as a single lease component for all underlying assets and allocate all of the contract consideration to the lease component only. Topic 842 allows for the use of judgment in determining whether the assumed lease term is for a major part of the remaining economic life of the underlying asset and whether the present value of lease payments represents substantially all of the fair value of the underlying asset. The Company applies the bright line thresholds referenced in Topic 842 to assist in evaluating leases for appropriate classification. The aforementioned bright lines are applied consistently to the Company’s entire portfolio of leases.

Operating lease ROU asset and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As the Company’s lease does not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of future payments. The operating lease ROU asset also includes any lease payments made and excludes lease incentives and initial direct costs incurred. The 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. As of December 31, 2019 and 2018, the remaining lease terms for all of the Company’s operating leases were 7.8 years and 6.6 years, respectively. The discount rate used to determine the present value of all of the Company’s operating leases’ future payments was 7.25% (see Note 4 regarding leases).

Research and Development

Research and development costs are charged to operations as incurred. Research and development costs include salary and personnel-related costs, costs of clinical studies and testing, supplies and materials, and outside consultant costs.

Income Taxes

The Company accounts for income taxes using the asset and liability method to compute the difference between the tax basis of assets and liabilities and the related financial amounts, using currently enacted tax rates. The Company has deferred tax assets. The realization of these deferred tax assets is dependent upon the Company’s ability to generate sufficient taxable income in future years. Valuation allowances are established, when necessary, to reduce deferred tax assets to the amount that more likely than not will be realized. The Company evaluates the recoverability of the deferred tax assets annually, and maintains a full valuation allowance on its deferred tax assets. The Company recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities, based on the technical merits of the position. The Company has determined that it has no uncertain tax positions.

Stock-Based Compensation

The Company measures the cost of employee and non-employee services in exchange for an award of equity instruments based on the grant-date fair value of the award and recognizes compensation cost over the requisite service period (typically the vesting period), generally four years. Forfeitures are estimated at the time of the grant and revised in subsequent periods to reflect differences between the estimates and the number of shares that actually become exercisable. The Company uses the Black-Scholes option pricing model to determine the fair value of stock options (as of the date of grant) that have service conditions for vesting. Stock options and restricted shares awards vest based on service conditions, typically over four years.

The Company also grants shares of performance-based restricted stock units that typically cliff vest after one year only if the Company has also achieved certain performance objectives as defined and approved by the Company’s board of directors. Performance awards are expensed over the performance period based on the probability of achieving the performance objectives. In addition, the Company also grants market-based restricted stock units that have combined market conditions and service conditions for vesting, for which the Company uses the Monte Carlo valuation model to value equity awards (as of the date of grant).

Net Loss per Share of Common Stock

Basic net loss per share of common stock is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of shares of common stock outstanding during the period, without consideration for 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 shares of common stock and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, convertible preferred stock, common and preferred stock warrants, common stock options, unvested RSAs and RSUs are considered to be potentially dilutive securities. Because the Company has reported a net loss in all periods presented, diluted net loss per share of common stock is the same as basic net loss per share of common stock for those periods.

For the years ended December 31, 2019 and 2018, there were 1,737,430 and 9,192,127 potentially dilutive weighted-average shares, respectively, that were not included in the computation of diluted weighted-average shares of common stock and common stock equivalent shares outstanding because their effect would have been antidilutive given the Company’s net loss.

Recent Accounting Pronouncements

In June 2018, the FASB issued ASU No. 2018-07, “Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting”, which expands guidance on accounting for share-based payment awards, which includes share-based payment transactions for acquiring goods and services from nonemployees and aligns the accounting for share-based payments for employees and non-employees. This guidance is effective for annual periods beginning after December 15, 2018, which was the Company’s first quarter of fiscal year 2019, with early adoption permitted. The guidance should be applied to new awards granted after the date of adoption. The adoption of this guidance did not have an impact on the Company’s consolidated financial statements or related disclosures.

Property and Equipment

12 Months Ended

Dec. 31, 2019

Property, Plant and Equipment [Abstract]

Property and Equipment

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



	December 31,
	2019			2018
Research and development equipment	$	1,086		$	885
Computer hardware and software	1,418			811
Tools and molds	1,303			1,110
Leasehold improvements	1,500			1,500
Furniture and fixtures	624			462
Construction in progress	176			—
	6,107			4,768
Less: accumulated depreciation and amortization	(3,060		)	(1,984		)
	$	3,047		$	2,784

Depreciation and amortization expense of property and equipment was $1.1 million and $0.8 million for the years ended December 31, 2019 and 2018, respectively.

Intangible Asset

12 Months Ended

Dec. 31, 2019

Goodwill and Intangible Assets Disclosure [Abstract]

Intangible Asset

The intangible asset represents exclusive rights to an additional field-of-use on the patent suite within the License Agreement with AMF. The intangible asset was recorded at its fair value of $1.0 million at the date contributed in 2013, which is the gross carrying amount of the intangible asset at December 31, 2019 and 2018. Accumulated amortization of the intangible asset is $0.7 million and $0.6 million at December 31, 2019 and 2018, respectively. The Company recorded expense for the amortization of intangible assets of $0.1 million during the years ended December 31, 2019 and 2018. The estimated future amortization expense as of December 31, 2019, is as follows (in thousands):



2020	$	115
2021	115
2022	81
	$	311

Commitments and Contingencies

12 Months Ended

Dec. 31, 2019

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

Operating Leases

In August 2014, the Company entered into a five-year operating lease for approximately 12,215 square feet of office space beginning on November 1, 2014, and expiring on October 31, 2019. In June 2019, the lease was amended to extend the expiration date to October 31, 2020. Upon the execution of the amendment, which was deemed to be a lease modification, the Company reassessed the lease liability using the discount rate at the modification date and recorded ROU assets for the same amount. The Company also reassessed the lease classification and concluded that the lease continues to be an operating lease. Under the terms of the lease, the Company is responsible for taxes, insurance, and maintenance expense. The lease contains certain scheduled rent increases. Rent expense is recognized on a straight-line basis over the expected lease term.

In November 2017, the Company entered into a seven-year operating lease for approximately 25,548 square feet of office space beginning on August 1, 2018, and expiring on August 31, 2025. In June 2019, the lease was amended to extend the expiration date to October 31, 2027. Upon the execution of the amendment, which was deemed to be a lease modification, the Company reassessed the lease liability using the discount rate at the modification date and recorded ROU assets for the same amount. The Company also reassessed the lease classification and concluded that the lease continues to be an operating lease. Under the terms of the lease, the Company is responsible for taxes, insurance, and maintenance expense. The lease contains certain scheduled rent increases. Rent expense is recognized on a straight-line basis over the expected lease term. The Company has a renewal option to extend the term of the lease for a period of five years beyond the initial term. Under the terms of the lease, the base rent payable with respect to each renewal term will be equal to the prevailing market rental rent as of the commencement of the applicable renewal term. In the event of a default of certain of the Company’s obligations under the lease, the Company’s landlord would have the right to terminate the lease.

In June 2019, the Company entered into an eight-year operating lease (the “New Lease”) for approximately 32,621 square feet of office space beginning on January 15, 2020 and expiring on January 31, 2028 (the “Initial Term”). The Company intends to use these premises as its new principal executive offices and for general office space. The Company intends to utilize its other currently-leased spaces through the lease expiration dates to conduct the training of its sales team and for manufacturing purposes.

The Company did not control the leased premises under the New Lease before the commencement date. The aggregate base rent due over the Initial Term under the terms of the New Lease is approximately $7.4 million (without giving effect to certain rent abatement terms). The Company is also responsible for the payment of additional rent to cover certain costs, taxes, and insurance (“Additional Rent”). The estimated Additional Rent during the Initial Term of the New Lease is approximately $1.9 million. The Company also paid approximately $0.2 million for leasehold improvements, net of the tenant improvement allowance provided in the New Lease of approximately $2.3 million.

The Company has a renewal option to extend the term of the New Lease for a period of five years (the “Renewal Term”) beyond the Initial Term. Under the terms of the New Lease, the base rent payable with respect to each Renewal Term will be equal to the prevailing market rental rent as of the commencement of the applicable Renewal Term. In the event of a default of certain of the Company’s obligations under the New Lease, the Company’s landlord would have the right to terminate the New Lease.

During the years ended December 31, 2019 and 2018, ROU assets obtained in exchange for new operating lease liabilities were $1.5 million and $3.3 million, respectively. As of December 31, 2019 and 2018, the ROU asset has a balance of $4.2 million and $3.1 million, respectively. The operating lease ROU asset is included within the Company’s other non-current assets, and lease liabilities are included in current or noncurrent liabilities on the Company’s consolidated balance sheets. During the years ended December 31, 2019 and 2018, cash paid for amounts included in operating lease liabilities were $0.9 million and $0.5 million, respectively. Amortization of the ROU asset was $0.4 million and $0.2 million for the years ended December 31, 2019 and 2018, respectively. As of December 31, 2019 and 2018, the weighted-average remaining lease term for all of the Company’s operating leases were 7.8 years and 6.6 years, respectively. The discount rate used to determine the present value of all of the Company’s operating leases’ future payments was 7.25%.

Total lease cost for the years ended December 31, 2019 and 2018 are as follows (in thousands):



	December 31,
	2019		2018
Lease cost
Operating lease cost	$	1,031	$	518
Short-term lease cost	177		154
Variable lease cost	138		6
Total lease cost	$	1,346	$	678

Maturities of operating lease liabilities as of December 31, 2019, are as follows (in thousands):



2020	$	947
2021	735
2022	768
2023	803
2024	840
Thereafter	2,581
	6,674
Less: imputed interest	(1,622		)
	5,052
Less: operating lease liability, current portion	(602		)
Operating lease liability, net of current portion	$	4,450

License Agreement

In October 2013, the Company entered into the License Agreement, pursuant to which AMF licensed the Company certain patents and know-how (collectively, the “AMF IP”) relating to, in relevant part, an implantable pulse generator and related system components in development by AMF as of that date, in addition to any peripheral or auxiliary devices, including all components, that when assembled, comprise such device, excluding certain implantable pulse generators (collectively, the “AMF Licensed Products”). The license to the AMF IP allows the Company to make, have made, lease, offer to lease, use, sell, offer for sale, market, promote, advertise, import, research, develop and commercialize the AMF Licensed Products worldwide for the treatment of (i) chronic pain in humans through the application of electrical energy to the nervous system, (ii) inflammatory conditions of the human body through the application of electrical energy to the vagus nerve, a nerve that interfaces with parasympathic control of the heart, lungs and digestive tract and (iii) bladder and bowel dysfunction in humans through the application of electrical energy anywhere in or on the human body, excluding, in each case, any product or method that involves the placement of electrodes or the administration of electrical stimulation inside the cranial cavity or to the ocular nervous system or the auditory nervous system. The Company has the right to expand the field of use for the AMF Licensed Products to the modulation of digestive process and treatment of digestive conditions in humans through the application of electrical energy anywhere in or on the body, subject to the exclusions described above. Under the License Agreement, for each calendar year beginning in 2018, the Company is obligated to pay AMF a royalty on an AMF Licensed Product-by-AMF Licensed Product basis if one of the following conditions applies: (i) one or more valid claims within any of the patents licensed to the Company by AMF covers such AMF Licensed Products or the manufacture of such AMF Licensed Products or (ii) for a period of 12 years from the first commercial sale anywhere in the world of such AMF Licensed Product, in each case. The foregoing royalty is calculated as the greater of (a) 4% of all net revenue derived from the AMF Licensed Products, and (b) the Minimum Royalty, payable quarterly. The Minimum Royalty will automatically increase each year after 2018, subject to a maximum amount of $200,000 per year. The Company generated net revenue of $13.8 million and $0.7 million during the years ended December 31, 2019 and 2018, respectively, and recorded related royalties of $0.6 million and $0.1 million during the years ended December 31, 2019 and 2018, respectively. This royalty expense is included in operating expenses in the consolidated statements of comprehensive loss.

Legal Matters

On November 4, 2019, Medtronic, Inc., Medtronic Puerto Rico Operations Co., Medtronic Logistics LLC and Medtronic USA, Inc. (collectively, the “Medtronic Affiliates”) filed an initial complaint against the Company in the United States District Court for the Central District of California, Case No. 8:19-cv-2115. The Company refers to this matter as the Medtronic Litigation. The complaint asserts that the Company’s r-SNM System infringes U.S. Patent Nos. 8,036,756, 8,626,314, 9,463,324 and 9,821,112 held by the Medtronic Affiliates (collectively, the “Medtronic Patents”). The complaint requests customary remedies for patent infringement, including (i) a judgment that the Company has infringed and is infringing the Medtronic Patents, (ii) damages, including treble damages for willful infringement, (iii) attorneys’ fees, (iv) a permanent injunction preventing the Company from infringing the Medtronic Patents and (v) costs and expenses. The Company intends to vigorously defend itself against these claims. Given the early stage of the Medtronic Litigation, the Company is unable to predict the likelihood of success of the claims of the Medtronic Affiliates against the Company or to quantify any risk of loss. The Medtronic Litigation could last for an extended period of time and require the Company to dedicate significant financial resources and management resources to its defense. An adverse ruling against the Company could materially and adversely affect its business, financial position, results of operations or cash flows and could also result in reputational harm. Even if the Company is successful in defending against these claims, the Medtronic Litigation could result in delays in future product developments, reputational harm or other collateral consequences.

In addition to the Medtronic Litigation, the Company may be involved in litigation relating to claims arising out of its operations in the normal course of business.

Long-Term Debt

12 Months Ended

Dec. 31, 2019

Debt Disclosure [Abstract]

Long-Term Debt

In February 2018, the Company entered into the Loan and Security Agreement (the “Loan Agreement”), with Silicon Valley Bank, providing for a term loan (the “Term Loan”). Pursuant to the Loan Agreement, the Company may request up to $20.0 million in three tranches of term loans with such drawn obligations maturing on June 1, 2021. The Company requested $10.0 million from the first tranche, simultaneously with the entry into the Loan Agreement, which is currently outstanding. The Company may request (a) an additional $5.0 million (“Tranche B”), after the date commencing on the later of (i) the date that the Company achieves positive three-month results in the Company’s ARTISAN-SNM pivotal study, as confirmed to Silicon Valley Bank by a member of the Company’s management team and a member of its board of directors, and (ii) July 1, 2018, and ending on December 31, 2018 and (b) another $5.0 million (“Tranche C”), after the date commencing on the later of (i) the date that Silicon Valley Bank receives evidence, in form and substance reasonably satisfactory to Silicon Valley Bank, that the Company has received its pre-market approval (“PMA”) in the United States for its r-SNM System or gross proceeds from the sale of its equity securities of not less than $20.0 million, and (ii) January 1, 2019, and ending on March 31, 2019, subject to certain terms and conditions. If either Tranche B or Tranche C is drawn, then the maturity of the Term Loan is automatically extended to December 1, 2021.

The Loan Agreement provides for monthly interest payments through December 31, 2018; provided that, (i) if the Company requests and Silicon Valley Bank funds Tranche B or Tranche C, this interest-only period automatically extends through June 30, 2019, and (ii) if the Company has received a PMA in the United States for its r-SNM System and the Company requests and Silicon Valley Bank funds Tranche C, the interest-only period automatically extends through December 31, 2019. On the first day of the end of the interest-only period, the Company will be required to repay the Term Loan in equal monthly installments of principal plus interest through maturity. Outstanding principal balances under the Term Loan bear interest at the prime rate plus 1.75%.

In October 2018, the Company and Silicon Valley Bank entered into an amendment to the Loan Agreement (the “Loan Amendment”) in connection with which the Company requested the full $5.0 million from Tranche B and the full $5.0 million from Tranche C. The Company received the $10.0 million from both tranches in October 2018. Pursuant to the Loan Amendment, Silicon Valley Bank agreed to (i) extend the interest only period from June 30, 2019 to December 31, 2019, without requiring the receipt of the Company’s PMA in the United States for the r-SNM System, and (ii) make Tranche C available immediately instead of January 1, 2019. In addition, pursuant to the Loan Amendment, Silicon Valley Bank added a fee of $100,000 in the event that the Company did not (i) consummate the IPO, with proceeds of no less than $75.0 million, (ii) receive PMA approval in the United States for the r-SNM System, or (iii) receive gross proceeds of at least $40.0 million from the sale of equity securities, in each case on or prior to June 30, 2019, which will not be owed since the Company completed the IPO offering in October 2018. In addition, as a result of the Company’s request of the full $5.0 million from Tranche B and the full $5.0 million from Tranche C, the maturity of the Term Loan has been automatically extended to December 1, 2021. The transaction was accounted for as a debt modification. See Note 6 for discussion regarding stock warrants granted in connection with the Term Loan.

In December 2019, the Company and Silicon Valley Bank entered into a second amendment to the Loan Agreement (the “Second Amendment”). Pursuant to the Second Amendment, Silicon Valley Bank agreed to extend the interest only period from December 31, 2019 to December 31, 2020. In connection with the Second Amendment, the Company paid Silicon Valley Bank a non-refundable fee of $0.2 million. The transaction was accounted for as a debt modification.

The Company may prepay amounts outstanding under the Term Loan in increments of $5.0 million at any time with 30 days prior written notice to Silicon Valley Bank. However, all prepayments of the Term Loan prior to maturity, whether voluntary or mandatory (acceleration or otherwise), are also subject to the payment of a prepayment fee equal to (i) for a prepayment made on or after the closing date through and including the first anniversary of the closing date, 3.00% of the principal amount of the Term Loan being prepaid, (ii) for a prepayment made after the date which is the first anniversary of the closing date through and including the second anniversary of the closing date, 2.00% of the principal amount of the Term Loan being prepaid, and (iii) for a prepayment made after the date which is the second anniversary of the closing date and before the maturity date, 1.00% of the principal amount of the Term Loan being prepaid. Additionally, on the earliest to occur of (i) the maturity date of the Term Loan, (ii) the acceleration of the Term Loan, or (iii) the prepayment of the Term Loan, the Company will be required to make a final payment equal to the original principal amount of such tranche multiplied by 7.50%. The Company is currently accruing the portion of the final payment calculated based on the amount outstanding under the Term Loan.

All obligations under the Term Loan are secured by a first priority lien on substantially all of the Company’s assets, excluding intellectual property assets and more than 65% of the shares of voting capital stock of any of its foreign subsidiaries. The Company has agreed with Silicon Valley Bank not to encumber its intellectual property assets without Silicon Valley Bank’s prior written consent unless a security interest in the underlying intellectual property is necessary to have a security interest in the accounts and proceeds that are part of the assets securing the Term Loan, in which case the Company’s intellectual property shall automatically be included within the assets securing the Term Loan. As of December 31, 2019, the Company was in compliance with all debt covenant requirements under the Term Loan.

Debt, net of unamortized debt issuance costs, consists of the following (in thousands) at:



	December 31,
	2019			2018
Debt, principal	$	20,000		$	20,000
Accrued loan fees	1,500			1,500
Debt, total	21,500			21,500
Less: unamortized debt issuance costs	(1,164		)	(2,037		)
Debt, net of unamortized debt issuance costs	$	20,336		$	19,463

Expected future principal payments for the term loan as of December 31, 2019, are as follows (in thousands):



2020	$	—
2021	21,500
	$	21,500

Stockholders' Equity

12 Months Ended

Dec. 31, 2019

Equity [Abstract]

Stockholders' Equity

Stockholders’ Equity

Preferred Stock

Prior to the IPO, the Company had outstanding 12,219,315 shares of convertible preferred stock. Upon closing of the Company’s IPO on October 31, 2018, all shares of outstanding convertible preferred stock were automatically converted to 15,813,297 shares of the Company’s common stock. As of December 31, 2019, the Company is authorized to issue 10,000,000 shares of preferred stock with a par value of $0.0001 per share.

Common Stock

The following summarizes the rights of holders of our common stock:

Voting

The holders of our common stock are entitled to one vote per share. The number of authorized shares of common stock may be increased or decreased (but not below the number of shares thereof then outstanding) by the affirmative vote of the holders of a majority of the voting power of our capital stock entitled to vote, irrespective of the provisions of Section 242(b)(2) of the DGCL.

Dividends

Subject to preferences that may be applicable to the holders of outstanding shares of preferred stock and subject to applicable law, dividends may be declared and paid on the holders of our common stock when and as determined by our board of directors out of assets legally available for dividends.

As a Delaware corporation, the Company will be subject to certain restrictions on dividends under the DGCL. Generally, a Delaware corporation may only pay dividends either out of “surplus” or out of the current or the immediately preceding year’s net profits. Surplus is defined as the excess, if any, at any given time, of the total assets of a corporation over its total liabilities and statutory capital. The value of a corporation’s assets can be measured in a number of ways and may not necessarily equal their book value.

Liquidation Rights

Upon our voluntary or involuntary liquidation, dissolution or winding up, after satisfaction of all our liabilities and the payment of any liquidation preference of any outstanding preferred stock, the holders of shares of common stock will be entitled to share in all of our assets legally remaining for distribution after payment of all debt and other liabilities, subject to preferences that may be applicable to the holders of outstanding shares of preferred stock.

Redemption Rights

There are no redemption or sinking fund provisions applicable to our common stock.

Preemptive Rights and Conversion Rights

There are no preemptive or conversion rights applicable to our common stock.

Stock-Based Compensation Expense

Stock-based compensation expense included in the Company’s consolidated statements of comprehensive loss is allocated as follows (in thousands):



	Years Ended December 31,
	2019		2018
Research and development	$	1,725	$	197
General and administrative	3,950		361
Sales and marketing	3,045		48
	$	8,720	$	606

Stock Option Activity

2014 Stock Option Plan

In 2014, the Company established its 2014 Stock Option Plan (the “2014 Plan”), which provides for the granting of stock options to employees, directors, and consultants of the Company. As of December 31, 2019 and 2018, a total of 3,156,295 and 3,178,593 shares have been reserved for issuance under the 2014 Plan, respectively. As of December 31, 2019 and 2018, there were no shares available for grant under the 2014 Plan. The 2018 Omnibus Incentive Plan was adopted upon our IPO and replaced the 2014 Stock Option Plan for future grants.

2018 Omnibus Incentive Plan

On October 18, 2018, the Company adopted the 2018 Omnibus Incentive Plan (the “2018 Plan”), under which the Company may grant cash and equity incentive awards to eligible service providers in order to attract, motivate and retain the talent for which it competes. The 2018 Plan provides for awards based on shares of the Company’s common stock. Subject to adjustment by the Company’s board of directors, the total number of shares authorized to be awarded under the 2018 Plan may not exceed 4,562,317. As of December 31, 2019 and 2018, there were 1,965,500 and 4,391,819 shares available for grant under the 2018 Plan, respectively.

The Company had shares of common stock reserved for future issuance as follows at:



	December 31,
	2019	2018
Options outstanding under the 2014 Plan	1,126,140	1,416,147
Options and restricted stock-based awards outstanding under the 2018 Plan	2,560,232	148,200
Options and restricted stock-based awards remaining under the 2018 Plan for future issuance	1,965,500	4,391,819
	5,651,872	5,956,166

The fair value of each stock option is measured as of the date of grant, and compensation expense is recognized over the period during which the recipient renders the required services to the Company (typically the vesting period). Stock-based compensation expense recognized is based on the estimated number of stock options that are expected to ultimately become exercisable. Forfeitures are estimated at the time of the grant and revised in subsequent periods to reflect differences between the estimates and the number of shares that actually become exercisable.

The option awards issued under the 2014 and 2018 Plans were measured based on fair value. The Company’s fair value calculations were made using the Black-Scholes option pricing model with the following assumptions:



	Years Ended December 31,
	2019	2018
Expected term (in years)	5.07 - 6.16	5.00 - 6.96
Stock volatility	70.02% - 77.52%	68.04% - 77.03%
Risk-free interest rate	1.42% - 2.56%	2.26% - 3.07%
Dividend rate	—	—

The Company used the simplified method of determining the expected term of stock options. The expected stock price volatility assumption was determined by examining the historical volatilities for industry peers, as the Company did not have sufficient trading history for the Company’s common stock. The Company will continue to analyze the historical stock price volatility and expected term assumption as more historical data for the Company’s common stock becomes available. 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. The expected dividend assumption is based on the Company’s history and expectation of dividend payouts. The assumptions regarding the expected term of the options and the expected volatility of the stock price are subjective, and these assumptions have a significant effect on the estimated fair value amounts. The weighted-average grant date fair value of options granted was $13.79 and $3.62 for the years ended December 31, 2019 and 2018, respectively.

As of December 31, 2019 and 2018, there was $19.5 million and $2.2 million, respectively, of total unrecognized compensation cost related to unvested stock options that is expected to be recognized over a weighted-average period of approximately 3.2 and 2.5 years, respectively.

The following table summarizes stock option activity under the 2014 and 2018 Plans (in thousands, except share and per share data):



	Number of Options		Weighted-Average Exercise Price Per Share		Aggregate Intrinsic Value
Outstanding at December 31, 2017	903,857		$	1.18
Options granted	668,380		3.55
Options exercised	(55,840	)	1.47		$	23	⁽¹⁾
Options forfeited	(2,050	)	1.23
Outstanding at December 31, 2018	1,514,347		2.22
Options granted	1,671,044		21.28
Options exercised	(281,744	)	1.79		$	7,386	⁽¹⁾
Options forfeited	(56,546	)	13.43
Outstanding at December 31, 2019	2,847,101		$	13.22	$	43,478	⁽²⁾
Options exercisable at December 31, 2019	1,031,534		$	2.16	$	26,453	⁽²⁾

_____________________________________________


(1)	Represents the total difference between the Company’s closing stock price at the time of exercise and the stock option exercise price, multiplied by the number of options exercised.


(2)	Represents the total difference between the Company’s closing stock price on the last trading day of 2019 and the stock option exercise price, multiplied by the number of in-the-money options as of December 31, 2019. The amount of intrinsic value will change based on the fair market value of the Company’s stock.

The weighted-average remaining contractual term of options outstanding and exercisable is 7.6 years and 8.4 years at December 31, 2019 and 2018, respectively.

Restricted Shares Awards Activity

As of December 31, 2019 and 2018, there was $11.8 million and $0.4 million, respectively, of total unrecognized compensation cost related to unvested restricted shares awards that is expected to be recognized over a weighted-average period of approximately 3.3 years and 3.8 years, respectively.

The following table summarizes restricted shares awards activity:



	Number of Restricted Shares Awards		Weighted-Average Fair Value Per Share at Grant Date
Outstanding at December 31, 2017	—		$	—
Restricted shares awards granted	50,000		14.48
Outstanding at December 31, 2018	50,000		14.48
Restricted shares awards granted	580,667		24.08
Restricted shares awards vested	(27,551	)	18.80
Restricted shares awards forfeited	(16,950	)	21.09
Outstanding at December 31, 2019	586,166		$	23.59

Restricted Stock Units Activity

As of December 31, 2019, there was $4.3 million of total unrecognized compensation cost related to unvested restricted stock units that is expected to be recognized over a weighted-average period of approximately 1.5 years.

The following table summarizes restricted stock units activity:



	Number of Restricted Stock Units	Weighted-Average Fair Value Per Share at Grant Date
Outstanding at December 31, 2018	—	$	—
Restricted stock units granted	248,104	21.48
Outstanding at December 31, 2019	248,104	$	21.48

The restricted stock units granted in 2019 can only be settled in common shares of the Company and accordingly have been accounted for as equity instruments.

Stock Subscriptions Receivable

As of December 31, 2017 and throughout 2018, several members of management of the Company exercised stock options covering 1,685,597 shares of common stock, in exchange for promissory notes with a principal balance of $1.8 million. These promissory notes bore interest at a rate of 4.5% per annum and were due in full in 2020 to 2022. The promissory notes could have become due earlier if the shares of common stock received from the option exercises are sold, the employee terminates employment with the Company, or pursuant to other provisions specified in the notes. The notes were secured by the shares of common stock received from the option exercises. On October 4, 2018, the Company entered into agreements with each noteholder to terminate each of their respective promissory notes and to forgive all respective obligations for payment thereof in connection with the Company’s IPO. As a result, on October 4, 2018, the Company forgave all outstanding stock subscriptions receivable referenced above in the aggregate amount of $1.8 million plus accrued interest, which amount was recorded as compensation expense.

Stock Warrants

In February 2018, in connection with the Company’s entry into the Loan Agreement (as defined below), the Company issued warrants to Silicon Valley Bank and Life Science Loans II, LLC, its counterparty. Each warrant entitles the holder thereof to purchase up to 33,333 shares of the Series C Preferred Stock at an exercise price of $9.00 per share. Initially, each warrant was exercisable for 16,667 shares of Series C Preferred Stock. In connection with the Term Loan Amendment in October 2018, the Company drew on Tranche B and C, and an additional 16,666 shares became exercisable under each warrant. Each warrant will expire on February 6, 2028. In connection with the IPO, the Company’s outstanding warrants to purchase shares of Series C convertible Preferred Stock were automatically converted into warrants to purchase up to an aggregate of 80,000 shares of common stock at an exercise price of $7.50 per share.

In 2018 and prior to the IPO, warrants to purchase 66,666 shares of the Company’s Series C Preferred Stock were outstanding and are considered liabilities, the value of which was recorded in current liabilities and was adjusted to fair value at each reporting period with the change reflected in the statements of comprehensive loss. The fair value of the warrants in 2018 at grant date and prior to the IPO approximated $1.0 million using the Black-Scholes option pricing model with the following assumptions: expected life of 10 years, risk-free interest rate of 2.5% and stock volatility of 68.5%. The values of the warrants are accounted for as deferred loan costs and amortized to interest expense on an effective interest method. In connection with the Company’s IPO, the conversion of preferred stock into common stock, and the conversion of the warrants to purchase Series C preferred stock into warrants to purchase common stock, the warrant liability of $1.0 million was reclassified to additional paid-in-capital. The change in fair value of the warrants in 2018 prior to their conversion to permanent equity totaled $0.3 million, which is recorded in interest and other expense.

On July 16, 2019, the Company issued and sold 32,529 shares of our common stock to SVB Financial Group (“SVB”) in connection with the exercise by SVB of its right to purchase 40,000 shares of our common stock under that certain warrant, dated as of February 6, 2018. The exercise price per share was $7.50, and was paid by SVB via forfeiture of shares pursuant to a cashless exercise provision in the warrant.

On May 29, 2019, the Company issued and sold 31,071 shares of our common stock to Life Science Loans II, LLC (“Life Science Loans”) in connection with the exercise by Life Science Loans of its right to purchase 40,000 shares of our common stock under that certain warrant, dated as of February 6, 2018. The exercise price per share was $7.50, and was paid by Life Science Loans via forfeiture of shares pursuant to a cashless exercise provision in the warrant.

No warrants are outstanding at December 31, 2019.

Noncontrolling Interest	12 Months Ended
Noncontrolling Interest	Dec. 31, 2019
Noncontrolling Interest [Abstract]
Noncontrolling Interest	Noncontrolling Interest For less-than-wholly-owned consolidated subsidiaries, noncontrolling interest is the portion of equity not attributable, directly or indirectly, to the Company. The Company evaluates whether noncontrolling interests possess any redemption features outside of the Company’s control. If such features are determined to exist, the noncontrolling interests are presented outside of permanent equity on our consolidated balance sheets within mezzanine equity. Prior to the Company’s IPO, the Company’s noncontrolling interest related to the portion of Axonics Europe S.A.S. not owned by the Company. The Company presented noncontrolling interest as mezzanine equity on the consolidated balance sheet at December 31, 2017 due to the Share Exchange Agreement that provided the holders of the equity in Axonics Europe S.A.S. (excluding the Company) the unilateral right to exchange its equity interest in Axonics Europe S.A.S. for Preferred Stock of the Company at any time. The Company’s Preferred Stock was presented as mezzanine equity at December 31, 2017, and as such, the rights under the Share Exchange Agreement required the noncontrolling interest to be presented as mezzanine equity as well. Prior to the Company’s IPO, the comprehensive loss attributable to the noncontrolling interest in Axonics Europe S.A.S. were absorbed by the Company since the investors are protected from any losses in this entity due to the conversion right. Changes in amounts attributable to the redeemable noncontrolling interest were presented in the Company’s consolidated statements of mezzanine equity during the year ended December 31, 2017. In conjunction with the Company’s IPO, the interests held by the other investors in Axonics Europe S.A.S. were converted into a fixed number of shares of the Company’s preferred stock pursuant to the terms of the Share Exchange Agreement. These preferred stock shares were then automatically converted into 4,221,715 shares of common stock, and as such, Axonics Europe S.A.S. is the Company’s wholly-owned subsidiary at December 31, 2018.

Income Taxes

12 Months Ended

Dec. 31, 2019

Income Tax Disclosure [Abstract]

Income Taxes

The Company’s effective tax rate of approximately 0% differs from the federal statutory tax rate due primarily to providing a full valuation allowance on deferred tax assets.

Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company’s net deferred tax assets are as follows (in thousands) as of:



	December 31,
	2019			2018
Compensation accruals	$	404		$	154
Depreciation and amortization	48			(399		)
Lease liability	252			262
Net operating loss carryforwards	45,484			26,627
R&D tax credit carryforwards	1,957			1,582
Other	1,795			436
Total deferred tax assets	49,940			28,662
Less: valuation allowance	(49,940		)	(28,662		)
Total net deferred tax assets	$	—		$	—

At December 31, 2019, the Company had federal and California net operating loss (“NOL”) carryforwards of approximately $162.5 million. Pursuant to Sections 382 and 383 of the Internal Revenue Code of 1986, as amended (the “Internal Revenue Code”), use of the Company’s NOL carryforwards may be limited if the Company experiences a cumulative change in ownership of greater than 50% in a rolling three-year period. The Company has not performed an analysis of changes in ownership for purposes of these Internal Revenue Code sections. Ownership changes could impact the Company’s ability to utilize NOL carryforwards remaining at an ownership change date. The Company’s NOL carryforwards were generated from domestic operations. NOLs expire between 2033 and 2039. At December 31, 2019, the Company also had research and development tax credit carryforwards of approximately $2.0 million, which will expire in 2036 to 2039. Approximately $0.9 million and $0.6 million of these research and development tax credit carryforwards are included in prepaid expenses and other current assets on the Company’s consolidated balance sheets at December 31, 2019 and 2018, respectively, as they are expected to be utilized in 2020 as a credit to offset payroll taxes. The remaining amount of research and development tax credit carryforwards are included in net deferred tax assets. Income tax expense, consisting of state income taxes in California, were minimal during the years ended December 31, 2019 and 2018.

The reconciliation between the Company’s effective tax rate and the statutory tax rate is as follows:



	Years Ended December 31,
	2019		2018
Tax at statutory federal rate	21.0	%	21.0	%
State tax, net of federal benefit	7.0	%	7.0	%
Excess tax benefits related to stock-based compensation	(1.0	)%	(0.4	)%
Change in valuation allowance	(26.5	)%	(27.4	)%
Other	(0.5	)%	(0.2	)%
Effective tax rate	—	%	—	%

Employee Benefit Plan	12 Months Ended
Employee Benefit Plan	Dec. 31, 2019
Retirement Benefits [Abstract]
Employee Benefit Plan	Employee Benefit Plan The Company sponsors a defined contribution retirement savings plan under Section 401(k) of the Internal Revenue Code. This plan covers all employees who meet minimum age and service requirements, and allows participants to defer a portion of their annual compensation on a pre- or post-tax basis. Contributions to the plan by the Company may be made at the discretion of the board of directors. During the years ended December 31, 2019 and 2018, the Company contributions to the plan amounted to $1.1 million and $0.3 million, respectively.

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2019
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions The Company has a License Agreement and corresponding royalties incurred with AMF, which is also a stockholder of the Company. John Petrovich, a former member of the Company’s board of directors is the President, Chief Executive Officer, Senior Vice President, Business Development, and General Counsel of AMF. For additional information, see Note 4. The Company incurred minimal amounts and $0.1 million during the years ended December 31, 2019 and 2018, respectively, to a scientific advisor who is also a non-management stockholder of the Company. There were no amounts payable to this advisor at December 31, 2019. Amounts payable to this advisor were minimal at December 31, 2018. The Company incurred $0.1 million and $0.3 million during the years ended December 31, 2019 and 2018, respectively, for engineering and design services to a company that is owned by a non-management stockholder of the Company. There were no amounts payable to this company at December 31, 2019. Amounts payable to this company were minimal at December 31, 2018. The 2014 Plan allowed for certain members of management to purchase vested options and unvested options (subject to repurchase rights) through a full recourse promissory note and stock pledge agreement. The promissory notes outstanding were recorded as “Stock subscriptions receivable” in the accompanying consolidated balance sheet. On October 4, 2018, the Company entered into agreements with certain officers and directors to terminate each of their respective promissory notes and to forgive all respective obligations for payment thereof in connection with the Company’s IPO. As a result, on October 4, 2018, the Company forgave all outstanding stock subscriptions receivable referenced above in the aggregate amount of $1.8 million plus accrued interest, which amount was recorded as compensation expense.

Nature of Operations and Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2019

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Principles of Consolidation

Basis of Presentation

Stock Split and Charter Amendment

Use of Estimates

Revenue Recognition

Allowance for Doubtful Accounts

Cash and Cash Equivalents

Fair Value of Financial Instruments


•	Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities.


•	Level 2: Inputs are quoted prices for similar assets and liabilities in active markets or quoted prices for identical or similar instruments in markets that are not active and model-derived valuations in which all significant inputs and significant value drivers are observable in active markets.

•

Investment Securities

Foreign Currency Translation

Inventory, Net

Property and Equipment

Intangible Asset

Impairment of Long-Lived Assets

Leases

Research and Development

Income Taxes

Stock-Based Compensation

Net Loss per Share of Common Stock

Recent Accounting Pronouncements

Nature of Operations and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2019

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Revenue Disaggregated by Geographic Market

The following table provides additional information pertaining to net revenue disaggregated by geographic market for the years ended December 31, 2019 and 2018:



	Years Ended December 31,
	2019		2018
United States	$	8,376	$	—
International markets	5,444		707
Total net revenue	$	13,820	$	707

Schedule of Fair Value Hierarchy for Assets Measured on Recurring Basis

The following table presents the fair value hierarchy for those assets measured at fair value on a recurring basis as of December 31, 2019 and 2018 (in thousands):



	Fair Value Measurements at December 31, 2019
Assets:	Level 1		Level 2		Level 3		Total
Commercial paper	$	—	$	7,195	$	—	$	7,195
Corporate notes	2,018		—		—		2,018
U.S. government and agency securities	3,379		—		—		3,379
	$	5,397	$	7,195	$	—	$	12,592



	Fair Value Measurements at December 31, 2018
Assets:	Level 1		Level 2		Level 3		Total
Commercial paper	$	—	$	32,163	$	—	$	32,163
Corporate notes	12,606		3,156		—		15,762
U.S. government and agency securities	11,293		—		—		11,293
	$	23,899	$	35,319	$	—	$	59,218

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2019

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment, Net

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



	December 31,
	2019			2018
Research and development equipment	$	1,086		$	885
Computer hardware and software	1,418			811
Tools and molds	1,303			1,110
Leasehold improvements	1,500			1,500
Furniture and fixtures	624			462
Construction in progress	176			—
	6,107			4,768
Less: accumulated depreciation and amortization	(3,060		)	(1,984		)
	$	3,047		$	2,784

Intangible Asset (Tables)

12 Months Ended

Dec. 31, 2019

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Estimated Future Amortization Expense

The estimated future amortization expense as of December 31, 2019, is as follows (in thousands):



2020	$	115
2021	115
2022	81
	$	311

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2019

Commitments and Contingencies Disclosure [Abstract]

Schedule of Total Lease Cost

Total lease cost for the years ended December 31, 2019 and 2018 are as follows (in thousands):



	December 31,
	2019		2018
Lease cost
Operating lease cost	$	1,031	$	518
Short-term lease cost	177		154
Variable lease cost	138		6
Total lease cost	$	1,346	$	678

Schedule of Maturities of Lease Liabilities

Maturities of operating lease liabilities as of December 31, 2019, are as follows (in thousands):



2020	$	947
2021	735
2022	768
2023	803
2024	840
Thereafter	2,581
	6,674
Less: imputed interest	(1,622		)
	5,052
Less: operating lease liability, current portion	(602		)
Operating lease liability, net of current portion	$	4,450

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2019

Debt Disclosure [Abstract]

Schedule of Debt, Net of Unamortized Debt Issuance Costs

Debt, net of unamortized debt issuance costs, consists of the following (in thousands) at:



	December 31,
	2019			2018
Debt, principal	$	20,000		$	20,000
Accrued loan fees	1,500			1,500
Debt, total	21,500			21,500
Less: unamortized debt issuance costs	(1,164		)	(2,037		)
Debt, net of unamortized debt issuance costs	$	20,336		$	19,463

Schedule of Expected Future Principal Payments for Term Loan

Expected future principal payments for the term loan as of December 31, 2019, are as follows (in thousands):



2020	$	—
2021	21,500
	$	21,500

- 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

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
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-Name Accounting Standards Codification
-Topic 835
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-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28541-108399

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 505
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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-Subparagraph (SX 210.4-08.(e),(f))
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Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 505
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-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21538-112644

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 942
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-Section 50
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-URI http://asc.fasb.org/extlink&oid=75038535&loc=d3e64711-112823

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
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-Topic 835
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-URI http://asc.fasb.org/extlink&oid=114775985&loc=d3e28878-108400

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
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-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21475-112644

+ Details

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2019

Equity [Abstract]

Schedule of Stock-based Compensation Expense

Stock-based compensation expense included in the Company’s consolidated statements of comprehensive loss is allocated as follows (in thousands):



	Years Ended December 31,
	2019		2018
Research and development	$	1,725	$	197
General and administrative	3,950		361
Sales and marketing	3,045		48
	$	8,720	$	606

Schedule of Common Stock Reserved for Future Issuance

The Company had shares of common stock reserved for future issuance as follows at:



	December 31,
	2019	2018
Options outstanding under the 2014 Plan	1,126,140	1,416,147
Options and restricted stock-based awards outstanding under the 2018 Plan	2,560,232	148,200
Options and restricted stock-based awards remaining under the 2018 Plan for future issuance	1,965,500	4,391,819
	5,651,872	5,956,166

Schedule of Stock Option Award Valuation Assumptions



	Years Ended December 31,
	2019	2018
Expected term (in years)	5.07 - 6.16	5.00 - 6.96
Stock volatility	70.02% - 77.52%	68.04% - 77.03%
Risk-free interest rate	1.42% - 2.56%	2.26% - 3.07%
Dividend rate	—	—

Schedule of Stock Option Activity

The following table summarizes stock option activity under the 2014 and 2018 Plans (in thousands, except share and per share data):



	Number of Options		Weighted-Average Exercise Price Per Share		Aggregate Intrinsic Value
Outstanding at December 31, 2017	903,857		$	1.18
Options granted	668,380		3.55
Options exercised	(55,840	)	1.47		$	23	⁽¹⁾
Options forfeited	(2,050	)	1.23
Outstanding at December 31, 2018	1,514,347		2.22
Options granted	1,671,044		21.28
Options exercised	(281,744	)	1.79		$	7,386	⁽¹⁾
Options forfeited	(56,546	)	13.43
Outstanding at December 31, 2019	2,847,101		$	13.22	$	43,478	⁽²⁾
Options exercisable at December 31, 2019	1,031,534		$	2.16	$	26,453	⁽²⁾

_____________________________________________


(1)	Represents the total difference between the Company’s closing stock price at the time of exercise and the stock option exercise price, multiplied by the number of options exercised.


(2)	Represents the total difference between the Company’s closing stock price on the last trading day of 2019 and the stock option exercise price, multiplied by the number of in-the-money options as of December 31, 2019. The amount of intrinsic value will change based on the fair market value of the Company’s stock.

Schedule of Restricted Shares Awards and Restricted Stock Units Activity

The following table summarizes restricted stock units activity:



	Number of Restricted Stock Units	Weighted-Average Fair Value Per Share at Grant Date
Outstanding at December 31, 2018	—	$	—
Restricted stock units granted	248,104	21.48
Outstanding at December 31, 2019	248,104	$	21.48

The following table summarizes restricted shares awards activity:



	Number of Restricted Shares Awards		Weighted-Average Fair Value Per Share at Grant Date
Outstanding at December 31, 2017	—		$	—
Restricted shares awards granted	50,000		14.48
Outstanding at December 31, 2018	50,000		14.48
Restricted shares awards granted	580,667		24.08
Restricted shares awards vested	(27,551	)	18.80
Restricted shares awards forfeited	(16,950	)	21.09
Outstanding at December 31, 2019	586,166		$	23.59

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2019

Income Tax Disclosure [Abstract]

Schedule of Net Deferred Tax Assets

Significant components of the Company’s net deferred tax assets are as follows (in thousands) as of:



	December 31,
	2019			2018
Compensation accruals	$	404		$	154
Depreciation and amortization	48			(399		)
Lease liability	252			262
Net operating loss carryforwards	45,484			26,627
R&D tax credit carryforwards	1,957			1,582
Other	1,795			436
Total deferred tax assets	49,940			28,662
Less: valuation allowance	(49,940		)	(28,662		)
Total net deferred tax assets	$	—		$	—

Schedule of Effective Income Tax Rate Reconciliation

The reconciliation between the Company’s effective tax rate and the statutory tax rate is as follows:



	Years Ended December 31,
	2019		2018
Tax at statutory federal rate	21.0	%	21.0	%
State tax, net of federal benefit	7.0	%	7.0	%
Excess tax benefits related to stock-based compensation	(1.0	)%	(0.4	)%
Change in valuation allowance	(26.5	)%	(27.4	)%
Other	(0.5	)%	(0.2	)%
Effective tax rate	—	%	—	%

Nature of Operations and Summary of Significant Accounting Policies - Narrative (Details)				1 Months Ended	12 Months Ended			84 Months Ended
	Nov. 22, 2019 USD ($) $ / shares shares	Nov. 02, 2018 USD ($) $ / shares shares	Oct. 31, 2018 shares	Oct. 31, 2018 $ / shares shares	Dec. 31, 2019 USD ($) shares	Dec. 31, 2018 USD ($) shares	Dec. 31, 2013 USD ($) shares	Dec. 31, 2019 USD ($) shares	Nov. 30, 2018 shares	Sep. 30, 2018 shares
Basis of Presentation:
Common stock authorized (shares) \| shares			20,500,000	20,500,000	50,000,000	50,000,000		50,000,000	50,000,000	17,500,000
Stock split ratio				1.2
Qualified IPO minimum share price (USD per share) \| $ / shares				$ 12
Preferred stock authorized (shares) \| shares					10,000,000	10,000,000		10,000,000	10,000,000
Investment Securities:
Unrealized gain (loss) on investment securities					$ 0	$ 0
Inventory:
Finished goods inventory					7,000,000	900,000		$ 7,000,000
Work-in-process inventory					1,500,000	0		1,500,000
Raw materials inventory					7,200,000	$ 2,700,000		7,200,000
Inventory reserves					100,000			100,000
Intangible Asset:
Shares issued for purchase of intangible asset (shares) \| shares							50,000
Fair value of shares issued for purchase of intangible asset							$ 1,000,000.0
Finite-lived intangible asset acquired							$ 1,000,000
Finite-lived intangible assets, weighted-average amortization period							8 years 8 months 16 days
Impairment of finite-lived intangible asset								$ 0
Impairment of Long-Lived Assets:
Impairment of long-lived assets					$ 0
Leases:
Operating lease remaining term of contract					7 years 10 months	6 years 7 months		7 years 10 months
Discount rate on operating lease (as a percent)					7.25%			7.25%
Share-Based Compensation
Unrecognized compensation cost, period for recognition					4 years
Net Loss per Share of Common Stock:
Potentially dilutive weighted-average shares not included in computation of diluted weighted-average shares (in shares) \| shares					1,737,430	9,192,127
Minimum
Inventory:
Inventory shelf life					12 months
Property and Equipment:
Property and equipment useful life					3 years
Maximum
Inventory:
Inventory shelf life					27 months
Property and Equipment:
Property and equipment useful life					7 years
Initial Public Offering
Initial Public Offering [Abstract]
Stock issued (shares) \| shares		9,200,000
Sale of stock, stock price (USD per share) \| $ / shares		$ 15
Net proceeds from sale of stock		$ 126,000,000
Common Stock Issued upon Exercise of Underwriters Option
Initial Public Offering [Abstract]
Stock issued (shares) \| shares	750,000	1,200,000
Follow-on Offering
Initial Public Offering [Abstract]
Stock issued (shares) \| shares	5,345,000
Sale of stock, stock price (USD per share) \| $ / shares	$ 22
Net proceeds from sale of stock	$ 110,400,000
Common Stock
Initial Public Offering [Abstract]
Conversion of preferred stock to common stock (shares) \| shares		15,813,297	15,813,297			15,813,297
Number of common stock warrants converted from preferred stock warrants (shares) \| shares		80,000	80,000	80,000
Stock Option and Restricted Stock-Based Awards
Share-Based Compensation
Vesting period					4 years
Restricted Stock Units
Share-Based Compensation
Unrecognized compensation cost, period for recognition					1 year 6 months
Vesting period					1 year

Nature of Operations and Summary of Significant Accounting Policies - Revenue by Geographic Market (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Disaggregation of Revenue [Line Items]
Net revenue	$ 13,820	$ 707
United States
Disaggregation of Revenue [Line Items]
Net revenue	8,376	0
International markets
Disaggregation of Revenue [Line Items]
Net revenue	$ 5,444	$ 707

Nature of Operations and Summary of Significant Accounting Policies - Fair Value Hierarchy (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	$ 12,592	$ 59,218
Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	5,397	23,899
Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	7,195	35,319
Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	0	0
Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	7,195	32,163
Commercial paper \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	0	0
Commercial paper \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	7,195	32,163
Commercial paper \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	0	0
Corporate notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	2,018	15,762
Corporate notes \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	2,018	12,606
Corporate notes \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	0	3,156
Corporate notes \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	0	0
U.S. government and agency securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	3,379	11,293
U.S. government and agency securities \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	3,379	11,293
U.S. government and agency securities \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	0	0
U.S. government and agency securities \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Investments	$ 0	$ 0

Property and Equipment - Summary (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 6,107	$ 4,768
Less: accumulated depreciation and amortization	(3,060)	(1,984)
Property and equipment, net	3,047	2,784
Research and development equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,086	885
Computer hardware and software
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,418	811
Tools and molds
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,303	1,110
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,500	1,500
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, gross	624	462
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 176	$ 0

Property and Equipment - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Depreciation and amortization expense	$ 1,191	$ 946
Property and Equipment
Property, Plant and Equipment [Line Items]
Depreciation and amortization expense	$ 1,100	$ 800

Intangible Asset - Narrative (Details) - USD ($)	12 Months Ended
Intangible Asset - Narrative (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2013
Goodwill and Intangible Assets Disclosure [Abstract]
Fair value of intangible assets			$ 1,000,000
Gross carrying value of intangible assets	$ 1,000,000	$ 1,000,000
Accumulated amortization of intangible assets	700,000	600,000
Amortization expense of intangible assets	$ 100,000	$ 100,000

Intangible Asset - Estimated Future Amortization Expense (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets, Amortization Expense, Maturity Schedule [Abstract]
2020	$ 115
2021	115
2022	81
Estimated future amortization expense	$ 311	$ 426

Commitments and Contingencies - Narrative (Details)		1 Months Ended	12 Months Ended
Commitments and Contingencies - Narrative (Details)	Jun. 30, 2019 USD ($) ft²	Oct. 31, 2013	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)	Nov. 30, 2017 ft²	Aug. 31, 2014 ft²
Loss Contingencies [Line Items]
Operating lease remaining term of contract			7 years 10 months	6 years 7 months
Right-of-use assets obtained in exchange for operating lease liabilities			$ 1,500,000	$ 3,300,000
Right-of-use asset			4,200,000	3,100,000
Operating lease payments			900,000	500,000
Operating lease ROU asset amortization			$ 400,000	200,000
Discount rate on operating lease (as a percent)			7.25%
Period after first sale royalty is due		12 years
Net revenue due as royalty (as a percent)		4.00%
Revenues			$ 13,820,000	707,000
Royalty expense			600,000	$ 100,000
Maximum
Loss Contingencies [Line Items]
Royalty commitments			$ 200,000
First Lease
Loss Contingencies [Line Items]
Operating lease remaining term of contract						5 years
Net rentable area (square feet) \| ft²						12,215
Second Lease
Loss Contingencies [Line Items]
Operating lease remaining term of contract					7 years
Net rentable area (square feet) \| ft²					25,548
Operating lease renewal term of contract					5 years
Third Lease
Loss Contingencies [Line Items]
Operating lease remaining term of contract	8 years
Net rentable area (square feet) \| ft²	32,621
Operating lease renewal term of contract	5 years
Base rent	$ 7,400,000
Additional rent expense on operating leases	1,900,000
Net leasehold improvements	200,000
Tenant improvements allowance	$ 2,300,000

Commitments and Contingencies - Total Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Operating lease cost	$ 1,031	$ 518
Short-term lease cost	177	154
Variable lease cost	138	6
Total lease cost	$ 1,346	$ 678

Commitments and Contingencies - Future Minimum Lease Payments for Operating Lease (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
2020	$ 947
2021	735
2022	768
2023	803
2024	840
Thereafter	2,581
Total lease payments	6,674
Less: imputed interest	(1,622)
Operating lease liability	5,052
Less: operating lease liability, current portion	(602)	$ (768)
Operating lease liability, net of current portion	$ 4,450	$ 3,281

Long-Term Debt - Narrative (Details)	1 Months Ended		12 Months Ended
Long-Term Debt - Narrative (Details)	Oct. 31, 2018 USD ($)	Feb. 28, 2018 USD ($) tranche	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)
Debt Instrument [Line Items]
Face amount of debt instrument			$ 20,000,000	$ 20,000,000
Minimum gross proceeds from sale of equity securities	$ 40,000,000
Minimum proceeds from IPO	75,000,000
Voting capital stock of foreign subsidiaries excluded from first priority lien (more than) (as a percent)			65.00%
Term Loans \| Term Loan
Debt Instrument [Line Items]
Long-term debt issuable		$ 20,000,000
Number of tranches \| tranche		3
Maximum prepayments of amounts outstanding allowed			$ 5,000,000
Period of prior written notice before prepayment of amounts outstanding			30 days
Final payment fee (as a percent)			7.50%
Term Loans \| Term Loan \| Period One
Debt Instrument [Line Items]
Prepayment fee (as a percent)			3.00%
Term Loans \| Term Loan \| Period Two
Debt Instrument [Line Items]
Prepayment fee (as a percent)			2.00%
Term Loans \| Term Loan \| Period Three
Debt Instrument [Line Items]
Prepayment fee (as a percent)			1.00%
Term Loans \| Term Loan \| Prime Rate
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)		1.75%
Term Loans \| Term Loan - Tranche A
Debt Instrument [Line Items]
Face amount of debt instrument		$ 10,000,000
Term Loans \| Term Loan - Tranche B & C
Debt Instrument [Line Items]
Face amount of debt instrument	10,000,000
Non-refundable collateral fee	100,000
Term Loans \| Term Loan - Tranche B
Debt Instrument [Line Items]
Long-term debt issuable		5,000,000
Face amount of debt instrument	5,000,000
Term Loans \| Term Loan - Tranche C
Debt Instrument [Line Items]
Long-term debt issuable		5,000,000
Face amount of debt instrument	$ 5,000,000
Minimum gross proceeds from sale of equity securities		$ 20,000,000.0
Term Loans \| Second Amendment
Debt Instrument [Line Items]
Non-refundable fee			$ 200,000

Long-Term Debt - Debt, Net of Unamortized Costs (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Debt Disclosure [Abstract]
Debt, principal	$ 20,000	$ 20,000
Accrued loan fees	1,500	1,500
Debt, total	21,500	21,500
Less: unamortized debt issuance costs	(1,164)	(2,037)
Debt, net of unamortized debt issuance costs	$ 20,336	$ 19,463

Long-Term Debt - Expected Future Principal Payments for Term Loan (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Debt Disclosure [Abstract]
2020	$ 0
2021	21,500
Debt, total	$ 21,500	$ 21,500

Stockholders' Equity - Preferred Stock Narrative (Details) - $ / shares			12 Months Ended
	Nov. 02, 2018	Oct. 31, 2018	Dec. 31, 2018	Dec. 31, 2019	Nov. 30, 2018	Oct. 30, 2018
Conversion of Stock [Line Items]
Preferred stock outstanding (shares)			0	0		12,219,315
Preferred stock authorized (shares)			10,000,000	10,000,000	10,000,000
Preferred stock, par value (USD per share)			$ 0.0001	$ 0.0001
Common Stock
Conversion of Stock [Line Items]
Stock issued upon conversion of preferred stock (shares)	15,813,297	15,813,297	15,813,297

Stockholders' Equity - Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation expense	$ 8,720	$ 606
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation expense	1,725	197
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation expense	3,950	361
Sales and marketing
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation expense	$ 3,045	$ 48

Stockholders' Equity - Stock Option Narrative (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options grants in period, weighted average grant date fair value (USD per share)	$ 13.79	$ 3.62
Unrecognized compensation cost, period for recognition	4 years
Options outstanding weighted average remaining contractual term	7 years 7 months	8 years 5 months
Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 19.5	$ 2.2
Unrecognized compensation cost, period for recognition	3 years 2 months	2 years 6 months
2014 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock reserved for issuance (shares)	3,156,295	3,178,593
Options and restricted stock-based awards remaining for future issuance (shares)	0	0
2018 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock reserved for issuance (shares)	4,562,317
Options and restricted stock-based awards remaining for future issuance (shares)	1,965,500	4,391,819

Stockholders' Equity - Common Stock Reserved for Future Issuance (Details) - shares	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and restricted stock-based awards outstanding (shares)	2,847,101	1,514,347	903,857
Common stock reserved for future issuance (shares)	5,651,872	5,956,166
2014 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and restricted stock-based awards remaining for future issuance (shares)	0	0
2018 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and restricted stock-based awards remaining for future issuance (shares)	1,965,500	4,391,819
Stock Option \| 2014 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and restricted stock-based awards outstanding (shares)	1,126,140	1,416,147
Stock Option and Restricted Stock-Based Awards \| 2018 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options and restricted stock-based awards outstanding (shares)	2,560,232	148,200
Options and restricted stock-based awards remaining for future issuance (shares)	1,965,500	4,391,819

Stockholders' Equity - Fair Value Assumptions (Details)	12 Months Ended
Stockholders' Equity - Fair Value Assumptions (Details)	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Stock volatility, minimum (as a percent)	70.02%	68.04%
Stock volatility, maximum (as a percent)	77.52%	77.03%
Risk-free interest rate, minimum (as a percent)	1.42%	2.26%
Risk-free interest rate, maximum (as a percent)	2.56%	3.07%
Dividend rate (as a percent)	0.00%	0.00%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected term (in years)	5 years 26 days	5 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected term (in years)	6 years 1 month 28 days	6 years 11 months 16 days

Stockholders' Equity - Stock Option Activity (Details) - USD ($)
$ / shares in Units, $ in Thousands

12 Months Ended

Dec. 31, 2019

Dec. 31, 2018

Number of Options

Outstanding at beginning of period (shares)

1,514,347

903,857

Options granted (shares)

1,671,044

668,380

Options exercised (shares)

(281,744)

(55,840)

Options forfeited (shares)

(56,546)

(2,050)

Outstanding at end of period (shares)

2,847,101

1,514,347

Options exercisable (shares)

1,031,534

Weighted-Average Exercise Price Per Share

Outstanding at beginning of period (USD per share)

$ 2.22

$ 1.18

Options granted (USD per share)

21.28

3.55

Options exercised (USD per share)

1.79

1.47

Options forfeited (USD per share)

13.43

1.23

Outstanding at end of period (USD per share)

13.22

$ 2.22

Options exercisable (USD per share)

$ 2.16

Share-based Compensation Arrangement by Share-based Payment Award, Options, Additional Disclosures [Abstract]

Options exercised intrinsic value

^[1]

$ 7,386

$ 23

Options outstanding intrinsic value

^[2]

43,478

Options exercisable intrinsic value

^[2]

$ 26,453

[1]	Represents the total difference between the Company’s closing stock price at the time of exercise and the stock option exercise price, multiplied by the number of options exercised.
[2]	Represents the total difference between the Company’s closing stock price on the last trading day of 2019 and the stock option exercise price, multiplied by the number of in-the-money options as of December 31, 2019. The amount of intrinsic value will change based on the fair market value of the Company’s stock.

Stockholders' Equity - Stock Subscriptions Receivable (Details) - USD ($) $ in Thousands		12 Months Ended
	Oct. 04, 2018	Dec. 31, 2018
Equity [Abstract]
Exercised stock options in exchange for promissory notes (shares)	1,685,597
Stock subscriptions receivable	$ 1,800
Promissory notes interest rate	4.50%
Loan forgiveness of stock subscription receivable	$ 1,800	$ 1,824

Stockholders' Equity - Restricted Shares Award Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost, period for recognition	4 years
Restricted Shares Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 11.8	$ 0.4
Unrecognized compensation cost, period for recognition	3 years 3 months	3 years 9 months

Stockholders' Equity - Restricted Shares Awards Activity (Details) - Restricted Shares Awards - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Number of Restricted Shares Awards
Outstanding at beginning of period (shares)	50,000	0
Granted (shares)	580,667	50,000
Vested (shares)	(27,551)
Forfeited (shares)	(16,950)
Outstanding at end of period (shares)	586,166	50,000
Weighted-Average Fair Value Per Share at Grant Date
Outstanding at beginning of period (USD per share)	$ 14.48	$ 0.00
Granted (USD per share)	24.08	14.48
Vested (USD per share)	18.80
Forfeited (USD per share)	21.09
Outstanding at end of period (USD per share)	$ 23.59	$ 14.48

Stockholders' Equity - Restricted Stock Units Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2019 USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost, period for recognition	4 years
Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 4.3
Unrecognized compensation cost, period for recognition	1 year 6 months

Stockholders' Equity - Restricted Stock Units Activity (Details) - Restricted Stock Units	12 Months Ended
	Dec. 31, 2019 $ / shares shares
Number of Restricted Stock Units
Outstanding at beginning of period (shares) \| shares	0
Granted (shares) \| shares	248,104
Outstanding at end of period (shares) \| shares	248,104
Weighted-Average Fair Value Per Share at Grant Date
Outstanding at beginning of period (USD per share) \| $ / shares	$ 0.00
Granted (USD per share) \| $ / shares	21.48
Outstanding at end of period (USD per share) \| $ / shares	$ 21.48

Stockholders' Equity - Stock Warrants (Details) $ / shares in Units, $ in Thousands			10 Months Ended	12 Months Ended
	Jul. 16, 2019 $ / shares shares	May 29, 2019 $ / shares shares	Oct. 30, 2018 USD ($) shares	Dec. 31, 2019 USD ($) shares	Dec. 31, 2018 USD ($)	Nov. 02, 2018 shares	Oct. 31, 2018 $ / shares shares	Feb. 28, 2018 $ / shares shares
Class of Warrant or Right [Line Items]
Fair value of warrants outstanding \| $			$ 1,000
Warrants term			10 years
Change in fair value of warrants \| $			$ 300	$ 0	$ 254
Warrants
Class of Warrant or Right [Line Items]
Exercise price of warrants (USD per share) \| $ / shares	$ 7.5	$ 7.5
Warrants issued (shares)	32,529	31,071
Warrants exercised (shares)	40,000	40,000
Warrants outstanding (shares)				0
Common Stock
Class of Warrant or Right [Line Items]
Exercise price of warrants (USD per share) \| $ / shares							$ 7.50
Number of common stock warrants converted from preferred stock warrants (shares)						80,000	80,000
Series C Convertible Preferred Stock \| Liabilities
Class of Warrant or Right [Line Items]
Number of common stock warrants converted from preferred stock warrants (shares)			66,666
Risk Free Interest Rate
Class of Warrant or Right [Line Items]
Fair value measurement of warrants (as a percent)			0.025
Price Volatility
Class of Warrant or Right [Line Items]
Fair value measurement of warrants (as a percent)			0.685
Silicon Valley Bank Warrants \| Series C Convertible Preferred Stock
Class of Warrant or Right [Line Items]
Number of shares called by warrants issued and issuable (shares)								33,333
Exercise price of warrants (USD per share) \| $ / shares								$ 9
Number of common stock warrants converted from preferred stock warrants (shares)								16,667
Silicon Valley Bank Warrants \| Series C Convertible Preferred Stock \| Term Loan - Tranche B & C
Class of Warrant or Right [Line Items]
Number of common stock warrants converted from preferred stock warrants (shares)							16,666
Life Science Loans II, LLC \| Series C Convertible Preferred Stock
Class of Warrant or Right [Line Items]
Number of shares called by warrants issued and issuable (shares)								33,333
Exercise price of warrants (USD per share) \| $ / shares								$ 9.00
Number of common stock warrants converted from preferred stock warrants (shares)								16,667
Life Science Loans II, LLC \| Series C Convertible Preferred Stock \| Term Loan - Tranche B & C
Class of Warrant or Right [Line Items]
Number of common stock warrants converted from preferred stock warrants (shares)							16,666

Noncontrolling Interest - Narrative (Details) - Common Stock - shares			12 Months Ended
	Nov. 02, 2018	Oct. 31, 2018	Dec. 31, 2018
Noncontrolling Interest [Line Items]
Conversion of preferred stock to common stock (shares)	15,813,297	15,813,297	15,813,297
Axonics Europe S.A.S.
Noncontrolling Interest [Line Items]
Conversion of preferred stock to common stock (shares)			4,221,715

Income Taxes - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
Income Taxes - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2019	Dec. 31, 2018
Income Tax Contingency [Line Items]
Annual effective tax rate (as a percent)	0.00%	0.00%
Operating loss carryforwards	$ 162.5
Research Tax Credit Carryforward
Income Tax Contingency [Line Items]
Tax credit carryforwards	2.0
Research Tax Credit Carryforward \| Prepaid Expenses and Other Current Assets
Income Tax Contingency [Line Items]
Tax credit carryforwards	$ 0.9	$ 0.6

Income Taxes - Net Deferred Tax Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Compensation accruals	$ 404	$ 154
Depreciation and amortization	48	(399)
Lease liability	252	262
Net operating loss carryforwards	45,484	26,627
R&D tax credit carryforwards	1,957	1,582
Other	1,795	436
Total deferred tax assets	49,940	28,662
Less: valuation allowance	(49,940)	(28,662)
Total net deferred tax assets	$ 0	$ 0

Income Taxes - Effective Income Tax Rate Reconciliation (Details)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Tax at statutory federal rate (as a percent)	21.00%	21.00%
State tax, net of federal benefit (as a percent)	7.00%	7.00%
Excess tax benefits related to stock-based compensation (as a percent)	(1.00%)	(0.40%)
Change in valuation allowance (as a percent)	(26.50%)	(27.40%)
Other (as a percent)	(0.50%)	(0.20%)
Effective tax rate (as a percent)	0.00%	0.00%

Employee Benefit Plan - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Retirement Benefits [Abstract]
Contributions by employer	$ 1.1	$ 0.3

Related Party Transactions - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Oct. 04, 2018
Related Party Transaction [Line Items]
Stock subscriptions receivable forgiven			$ 1,800,000
Scientific Advisory
Related Party Transaction [Line Items]
Expenses from transactions with related parties	$ 0	$ 100,000
Accounts payable to related parties	0	0
Engineering and Design Services
Related Party Transaction [Line Items]
Expenses from transactions with related parties	100,000	300,000
Accounts payable to related parties	$ 0	$ 0