Document And Entity Information	9 Months Ended
Document And Entity Information	Sep. 30, 2015	Nov. 12, 2015
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2015
Document Fiscal Year Focus	2015
Document Fiscal Period Focus	Q3
Entity Registrant Name	Xtant Medical Holdings, Inc.
Entity Central Index Key	0001453593
Current Fiscal Year End Date	--12-31
Entity Filer Category	Smaller Reporting Company
Trading Symbol	XTNT
Entity Common Stock, Shares Outstanding		11,886,101

CONDENSED CONSOLIDATED BALANCE SHEETS (USD $)	Sep. 30, 2015	Dec. 31, 2014
Current Assets:
Cash and cash equivalents	$ 7,970,433	$ 4,468,208
Trade accounts receivable, net of allowance for doubtful accounts of $2,416,984 and $1,392,989, respectively	13,318,450	4,427,081
Inventories, net	22,042,508	9,558,648
Prepaid and other current assets	1,039,562	654,140
Total current assets	44,370,953	19,108,077
Non-current inventories	1,681,138	1,934,258
Goodwill	23,997,218	0
Property and equipment, net	11,433,064	4,654,527
Intangible assets, net	42,223,856	655,490
Other assets	2,520,464	1,598,539
Total Assets	126,226,693	27,950,891
Current Liabilities:
Accounts payable	7,485,220	3,876,760
Accounts payable - related party	1,035,449	250,629
Accrued liabilities	6,716,897	1,921,301
Warrant derivative liability	1,399,294	1,320,371
Current portion of capital lease obligations	47,246	61,970
Current portion of royalty liability	0	1,000,750
Current portion of long-term debt	53,172	50,671
Total current liabilities	16,737,278	8,482,452
Long-term Liabilities:
Capital lease obligation, less current portion	18,962	11,808
Long-term royalty liability, less current portion	0	6,361,216
Long-term convertible debt	68,000,000	0
Long-term debt, less current portion	44,301,474	20,870,330
Total Liabilities	129,057,714	35,725,806
Commitments and Contingencies
Stockholders' (Deficit) Equity
Preferred stock, $0.000001 par value; 5,000,000 shares authorized; no shares issued and outstanding	0	0
Common stock, $0.000001 par value; 95,000,000 shares authorized; 11,886,107 shares issued and outstanding as of September 30, 2015 and 6,679,646 shares issued and outstanding as of December 31, 2014	11	7
Additional paid-in capital	81,798,160	63,091,620
Accumulated deficit	(84,629,192)	(70,866,542)
Total Stockholders’ Deficit	(2,831,021)	(7,774,915)
Total Liabilities & Stockholders’ Deficit	$ 126,226,693	$ 27,950,891

CONDENSED CONSOLIDATED BALANCE SHEETS [Parenthetical] (USD $)	Sep. 30, 2015	Dec. 31, 2014
Trade accounts receivable, allowance for doubtful accounts (in dollars)	$ 2,416,984	$ 1,392,989
Preferred stock, par value (in dollars per share)	$ 0.000001	$ 0.000001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.000001	$ 0.000001
Common stock, shares authorized	95,000,000	95,000,000
Common stock, shares issued	11,886,107	6,679,646
Common Stock, shares outstanding	11,886,107	6,679,646

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (USD $)	3 Months Ended		9 Months Ended
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (USD $)	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Revenue
Orthopedic product sales	$ 17,421,397	$ 8,246,325	$ 36,431,354	$ 25,712,586
Other revenue	271,623	207,179	657,395	537,821
Total Revenue	17,693,020	8,453,504	37,088,749	26,250,407
Cost of Sales	6,035,673	3,017,734	12,883,439	9,718,952
Gross Profit	11,657,347	5,435,770	24,205,310	16,531,455
Operating Expenses
General and administrative	3,980,805	2,282,386	8,805,104	6,664,982
Sales and marketing	8,430,303	3,927,028	18,179,552	12,387,459
Research and development	794,464	378,252	1,519,196	955,111
Depreciation and amortization	1,541,220	58,763	1,765,994	216,343
Acquisition and integration related expenses (See Note 2, “Business Combination” below)	3,856,519	0	3,856,519	0
Extinguishment of debt	(2,345,019)	0	(2,345,019)	0
Impairment of assets	233,748	0	233,748	0
Non-cash consulting expense	50,000	39,697	190,869	81,924
Total Operating Expenses	16,542,040	6,686,126	32,205,963	20,305,819
Loss from Operations	(4,884,693)	(1,250,356)	(8,000,653)	(3,774,364)
Other Income (Expense)
Interest expense	(2,111,721)	(1,498,508)	(4,930,941)	(4,216,109)
Change in warrant derivative liability	397,366	1,653,425	(78,923)	1,038,190
Non-cash consideration associated stock agreement	0	0	(558,185)	0
Other income (expense)	(89,926)	(70,344)	(193,052)	(253,289)
Total Other Income (Expense)	(1,804,281)	84,573	(5,761,101)	(3,431,208)
Net Loss from Operations	$ (6,688,974)	$ (1,165,783)	$ (13,761,754)	$ (7,205,572)
Net loss per share:
Basic	$ (0.64)	$ (0.19)	$ (1.70)	$ (1.26)
Dilutive	$ (0.64)	$ (0.19)	$ (1.70)	$ (1.26)
Shares used in the computation:
Basic	10,432,622	6,233,751	8,100,226	5,711,452
Dilutive	10,432,622	6,233,751	8,100,226	5,711,452

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	9 Months Ended
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	Sep. 30, 2015	Sep. 30, 2014
Operating activities:
Net loss	$ (13,761,754)	$ (7,205,572)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	2,403,934	498,343
Non-cash interest	1,665,172	387,294
Extinguishment of debt	(2,345,019)	0
Non-cash consideration associated with stock purchase agreement	558,185	0
Loss on sale of fixed assets	11,377	33,373
Impairment of Assets	233,748	0
Amortization of debt discount	707,281	1,207,859
Non-cash consulting expense/stock option expense	881,681	938,785
Provision for losses on accounts receivable and inventory	805,684	601,190
Change in derivative warrant liability	78,923	(1,038,190)
Changes in operating assets and liabilities:
Accounts receivable	(2,801,124)	346,151
Inventories	477,818	(350,198)
Prepaid and other assets	(325,976)	22,109
Accounts payable	694,326	884,436
Accrued liabilities	1,688,664	(1,495,107)
Net cash used in operating activities	(9,027,080)	(5,169,527)
Investing activities:
Acquisition of X-spine Systems, Inc.	(73,033,049)	0
Purchases of property and equipment and intangible assets	(444,312)	(190,601)
Proceeds from sale of fixed assets	102,587	10,149
Net cash used in investing activities	(73,374,774)	(180,452)
Financing activities:
Net proceeds from the issuance of convertible debt	66,322,366	0
Payment on royalty obligation	(542,905)	0
Net proceeds from equity private placement	515,395	0
Payments on capital leases	(78,490)	0
Net proceeds from issuance of long term debt	17,479,159	4,000,000
Payments on long-term debt	(38,668)	(492,695)
Proceeds from the issuance of capital leases	70,921	(126,686)
Net proceeds from the issuance of stock	2,118,483	5,876,299
Net cash provided by financing activities	85,846,261	9,256,918
Net change in cash and cash equivalents	3,444,407	3,906,939
Cash and cash equivalents at beginning of period	4,468,208	3,046,340
Cash and cash equivalents at end of period	$ 7,970,433	$ 6,953,279

Business Description and Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business Description and Summary of Significant Accounting Policies

(1) Business Description and Summary of Significant Accounting Policies

Business Description

The accompanying consolidated financial statements include the accounts of Xtant Medical Holdings, Inc. (“Xtant”), formerly known as Bacterin International Holdings, Inc., a Delaware corporation, and its wholly owned subsidiaries, Bacterin International, Inc., (“Bacterin”) a Nevada corporation and X-Spine Systems, Inc. (“X-spine”), an Ohio corporation, (Xtant, Bacterin and X-spine are jointly referred to herein as the “Company”). All intercompany balances and transactions have been eliminated in consolidation. Xtant develops, manufactures and markets regenerative orthopedic products for domestic and international markets. Xtant products serve the combined specialized needs of orthopedic and neurological surgeons, including orthobiologics for the promotion of bone healing, implants and instrumentation for the treatment of spinal disease, tissue grafts for the treatment of orthopedic disorders to promote healing following spine, cranial and foot surgeries.

The Company also previously developed and licensed coatings for various medical device applications. As of December 31, 2014, the Company made a strategic decision to discontinue the medical device coatings business which resulted in an impairment of related assets. (See Note 5, “Impairment of Assets” below).

An operating segment is a component of an enterprise whose operating results are regularly reviewed by the enterprise’s chief operating decision maker to make decisions about resources to be allocated to the segment and assess its performance. The primary performance measure used by management is net income or loss. Up until December 31, 2014, the Company operated two distinct lines of business consisting of the biologics and the device divisions; however, due to immaterial revenue from the device division, the Company has reported as one segment.

On July 31, 2015, Xtant acquired all of the outstanding capital stock of X-spine Systems, Inc. for approximately $60 million in cash, repayment of approximately $13 million of X-spine debt, and approximately 4.24 million shares of Xtant common stock (See Note 2, “Business Combination” below). X-spine is engaged in the development, manufacturing and sale of medical devices for use in orthopedic spinal surgeries.

The markets in which the Company competes are highly competitive and rapidly changing. Significant technological advances, changes in customer requirements, or the emergence of competitive products with new capabilities or technologies could adversely affect the Company's operating results. The Company's business could be harmed by a decline in demand for, or in the prices of, its products or as a result of, among other factors, any change in pricing or distribution methods, increased price competition, changes in government regulations or a failure by the Company to keep up with technological change. Further, a decline in available donors could have an adverse impact on our business.

The accompanying interim condensed consolidated financial statements of the Company for the nine months ended September 30, 2015 and 2014 are unaudited and are prepared in accordance with accounting principles generally accepted in the United States of America. They do not include all disclosures required by generally accepted accounting principles for annual financial statements, but in the opinion of management, include all adjustments, consisting only of normal recurring items, necessary for a fair presentation. Interim results are not necessarily indicative of results which may be achieved in the future for the full year ending December 31, 2015.

These financial statements should be read in conjunction with the financial statements and notes thereto which are included in our Annual Report on Form 10-K for the year ended December 31, 2014. The accounting policies set forth in those annual financial statements are the same as the accounting policies utilized in the preparation of these financial statements, except as modified for appropriate interim financial statement presentation.

Name Change

Following the closing of the acquisition, on July 31, 2015, Bacterin International Holdings, Inc. changed its name to Xtant Medical Holdings, Inc.

New Subsidiary

On August 6, 2015 Xtant formed a new wholly owned subsidiary, Xtant Medical, Inc., a Delaware corporation. The creation of the subsidiary will facilitate the integration of Bacterin and X-spine.

Reverse Stock Split

Xtant completed a 1:10 reverse split of its common stock, effective at the close of business on Friday, July 25, 2014 and in effect for trading purposes on Monday, July 28, 2014. The reverse stock split was approved by Xtant shareholders at the 2014 Annual Meeting of Shareholders on June 11, 2014. All references to common stock, stock options, restricted stock units, warrants, and per share amounts have been retroactively adjusted to reflect the reverse stock split for all periods presented.

Public Offering

In August 2014, Xtant offered 1,143,000 shares of its common stock at $5.70 per share and warrants to purchase 571,500 shares of its common stock at an exercise price of $7.12 per share to the public. Gross proceeds of the offering were approximately $6.5 million. Net proceeds from the offering were approximately $5.9 million and were used for working capital and general corporate purposes. The offering closed on August 6, 2014. The warrants have a five year term and expire on August 6, 2019. We utilize a valuation model to determine the fair market value and account for these warrants as a derivative liability (see "Derivative Instruments" below). (Also, See Note 11, "Warrants" below).

Aspire Capital Transaction

We entered into a Common Stock Purchase Agreement on March 16, 2015, as amended and restated on April 17, 2015 (the “Purchase Agreement”), with Aspire Capital Fund, LLC (“Aspire Capital”), which provides that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital is committed to purchase up to an aggregate of $10.0 million of our shares of common stock over the approximately 24-month term of the Purchase Agreement. Pursuant to the terms of the Purchase Agreement, in the first quarter of 2015 we issued 207,182 shares of our common stock to Aspire Capital for $750,000 in aggregate proceeds, along with 154,189 shares of our common stock which were valued at $3.62 per share and included as $558,185 on the Statement of Operations to Aspire Capital as a commitment fee. In the second quarter of 2015, following the effectiveness of our Registration Statement on Form S-1, we issued 417,000 shares of our common stock to Aspire Capital for $1,387,439 in aggregate proceeds, which were used for working capital and general corporate purposes. (See Note 3, “Equity” below).

Private Placement Offering

During the third quarter of 2015, we issued 140,053 shares of our common stock to certain members of our Board of Directors at the closing price on September 4, 2015, for aggregate proceeds of $515,395 (See Note 3, "Equity" below).

Concentrations and Credit Risk

The Company’s accounts receivable are due from a variety of health care organizations and distributors throughout the world. Approximately 95% and 98% of sales were in the United States respectively for the nine months ended 2015 and 2014. No single customer accounted for more than 10% of revenue or accounts receivable for the comparable periods. The Company provides for uncollectible amounts when specific credit issues arise. Management’s estimates for uncollectible amounts have been adequate during prior periods, and management believes that all significant credit risks have been identified at September 30, 2015.

For the three months ended September 30, 2015, approximately 13% of total cost of goods sold was with one vendor, Norwood Medical (See note 15, “Related Party Transactions”).

Revenue by geographical region is as follows:

	Nine Months Ended
	September 30,
	2015		2014
United States	$	35,419,434	$	25,792,878
Rest of World		1,669,315		457,529
	$	37,088,749	$	26,250,407

Use of Estimates

The preparation of the financial statements requires management of the Company to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the period. Significant estimates include the carrying amount of property and equipment, goodwill, and intangible assets; valuation allowances for trade receivables, inventory valuation, and deferred income tax assets; valuation of the warrant derivative liability; inventory reserve; royalty liability; and estimates for the fair value of stock options grants and other equity awards upon which the Company determines stock-based compensation expense. Actual results could differ from those estimates.

Long-Lived Assets

Long-lived assets, including intangible assets, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the estimated fair value of the assets. See Note 5, “Impairment of Assets”.

Goodwill

Goodwill represents the excess of costs over fair value of assets of businesses acquired. Goodwill and intangible assets acquired in a purchase business combination and determined to have indefinite useful lives are not amortized, instead are tested for impairment at least annually and whenever events or circumstances indicate the carrying amount of the asset may not be recoverable. In its evaluation of goodwill, the Company performs an assessment of qualitative factors to determine if it is more-likely-than-not that goodwill might be impaired and whether it is necessary to perform the two-step goodwill impairment. The Company conducts its annual impairment test on December 31 of each year.

Revenue Recognition

Revenue is recognized when all of the following criteria are met: a) the Company has entered into a legally binding agreement with the customer; b) the products or services have been delivered; c) the Company's fee for providing the products and services is fixed or determinable; and d) collection of the Company’s fee is probable.

The Company’s policy is to record revenue net of any applicable sales, use, or excise taxes. If an arrangement includes a right of acceptance or a right to cancel, revenue is recognized when acceptance is received or the right to cancel has expired.

The Company ships to certain customers under consignment arrangements whereby the Company’s product is stored by the customer. The customer is required to report the use to the Company and upon such notice, the Company invoices the customer and revenue is recognized when above criteria have been met.

The Company also receives royalty revenue from third parties related to licensing agreements which represented less than 1 % of total revenue for the three and nine months ended September 30, 2015 and 2014.

Advertising Costs

The Company expenses advertising costs as incurred. The Company had advertising expense of $93,854 and $29,027 for the nine months ended September 30, 2015 and 2014, respectively.

Research and Development

Research and development costs, which are principally related to internal costs for the development of new regenerative orthopedic products technologies and processes are expensed as incurred.

Net Loss Per Share

Basic net income (loss) per share is computed by dividing net income (loss) by the weighted average number of common shares outstanding. Shares issued during the period and shares reacquired during the period are weighted for the portion of the period that they were outstanding. Diluted net income (loss) per share is computed in a manner consistent with that of basic earnings per share while giving effect to all potentially dilutive common shares outstanding during the period, which include the assumed exercise of stock options and warrants using the treasury stock method. Diluted net loss per share was the same as basic net loss per share for the three and nine months ended September 30, 2015 and 2014, as shares issuable upon the exercise of stock options and warrants were anti-dilutive as a result of the net losses incurred for those periods. Dilutive earnings per share are not reported as their effects of including 1,896,253 and 1,877,948 outstanding stock options and warrants for the nine months ended September 30, 2015 and 2014, respectively, are anti-dilutive.

Fair Value of Financial Instruments

The carrying values of financial instruments, including trade accounts receivable, accounts payable, other accrued expenses and long-term debt, approximate their fair values based on terms and related interest rates.

The Company follows a framework for measuring fair value. The framework provides a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). The three levels of the fair value hierarchy are described below:

Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets.

Level 2: Inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument.

Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement.

A financial instrument's level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. During the three and nine months ended September 30, 2015 and 2014, there was no reclassification in financial assets or liabilities between Level 1, 2 or 3 categories.

The following table sets forth by level, within the fair value hierarchy, our liabilities as of September 30, 2015 and December 31, 2014 that are measured at fair value on a recurring basis:

Warrant derivative liability

	As of		As of
	September 30,		December 31,
	2015		2014
Level 1		-		-
Level 2		-		-
Level 3	$	1,399,294	$	1,320,371

The valuation technique used to measure fair value of the warrant liability is based on a valuation model and significant assumptions and inputs determined by us (See Note 11, “Warrants” below).

Level 3 Changes

The following is a reconciliation of the beginning and ending balances for liabilities measured at fair value on a recurring basis using significant unobservable inputs (Level 3) during the nine months ended September 30, 2015:

Warrant derivative liability

Balance at January 1, 2015	$	1,320,371
Loss recognized in earnings in first half of 2015		476,289
Balance at June 30, 2015		1,796,660
Gain recognized in earnings in third quarter of 2015		(397,366)
Balance at September 30, 2015	$	1,399,294

During the first nine months ended September 30, 2015, the Company did not change any of the valuation techniques used to measure its liabilities at fair value.

Recent Accounting Pronouncements

In November 2014, FASB issued ASU No. 2014-08, Presentation of Financial Statements (Topic 201) and Property, Plant and Equipment (Topic 360) - Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity. The amendments in this Update are effective for the annual period ending after December 15, 2014, and interim periods within those years. Early adoption is permitted only for disposals (or classifications as held for sale) that have not been reported in financial statements previously issued or available for issuance. ASU 2014-08 is not expected to have a material impact on our consolidated financial position, results of operations, or cash flows.

In April 2015, the FASB issued ASU 2015-3, to simplify the presentation of debt issuance costs. This update requires that debt issuance costs be presented in the balance sheet as a direct deduction from the carrying amount of the associated debt liability, consistent with the required presentation for debt discounts. This update is effective for interim and annual periods beginning after December 15, 2015. ASU 2015-3 is not expected to have a

material impact.

- Definition

The entire disclosure for the organization, consolidation and basis of presentation of financial statements disclosure, and significant accounting policies of the reporting entity. May be provided in more than one note to the financial statements, as long as users are provided with an understanding of (1) the significant judgments and assumptions made by an enterprise in determining whether it must consolidate a VIE and/or disclose information about its involvement with a VIE, (2) the nature of restrictions on a consolidated VIE's assets reported by an enterprise in its statement of financial position, including the carrying amounts of such assets, (3) the nature of, and changes in, the risks associated with an enterprise's involvement with the VIE, and (4) how an enterprise's involvement with the VIE affects the enterprise's financial position, financial performance, and cash flows. Describes procedure if disclosures are provided in more than one note to the financial statements.

+ References+ Details

Business Combination

9 Months Ended

Sep. 30, 2015

Business Combinations [Abstract]

Business Combination

(2) Business Combination

On July 31, 2015 (the “Acquisition Date”), the Company completed its acquisition of 100% of the outstanding common stock of X-spine, pursuant to a Stock Purchase Agreement (the “Purchase Agreement”). X-spine was engaged in the development, manufacturing and sale of medical devices for use in orthopedic spinal surgeries. The primary reasons for the X-spine acquisition are to combine the Company’s product lines into regenerative orthopedic product lines, leverage customer call points, expand sales and marketing coverage, increase revenue, and drive operating efficiencies.

Under the terms of the Purchase Agreement, the Company paid the former X-spine stockholders consideration of approximately $60 million in cash and approximately 4.24 million shares of Xtant common stock. The Company also repaid approximately $13 million of X-spine debt.

The cash consideration was financed in part using the net proceeds from the Company’s offering of $68 million aggregate principal amount of 6% Convertible Senior Notes due 2021 (See Note 9, “Long-Term Debt” below).

The Company accounted for the acquisition as a business combination and recorded the assets acquired, liabilities assumed, and the estimated future consideration obligations at their respective fair values as of the Acquisition Date. The assets acquired and liabilities assumed were recorded as of the Acquisition Date at their respective fair values and consolidated with those of the Company. The reported condensed consolidated balance sheet of the Company after completion of the acquisition reflects these fair values; however, the Company may have to reflect any change from an impact after combined operations are experienced. The results of X-spine operations from the Acquisition Date contributed $91,000 of net profit to the Company’s condensed consolidated financial statements for the fiscal quarter ended September 30, 2015.

The components of the aggregate preliminary purchase price for the acquisition were as follows (in thousands):

Cash	$	73,033,018
Fair value of Xtant shares		14,934,146
Total purchase price	$	87,967,164

Net Assets Acquired

The transaction has been accounted for using the acquisition method of accounting, which requires that assets acquired and liabilities assumed be recognized at their fair values as of the Acquisition Date. The following table summarizes the allocation of assets acquired and liabilities assumed as of the Acquisition Date:

			Amortization
	Allocation of		period (in
	purchase price		years)
Accounts receivable	$	5,989,904
Inventories		13,132,697
Prepaids and other current assets		208,116
Property and equipment, net		7,409,667
Cash		57,818
Total tangible assets acquired		26,798,202
Less: liabilities assumed		6,021,756
Net tangible assets less liabilities	$	20,776,446

Intangible assets:
Technology		28,698,700	10
Customer relationships		9,911,000	14
Tradename		4,543,300	10
Non-compete agreements		40,500	3
Goodwill		23,997,218
Total purchase price	$	87,967,164

The assets acquired and liabilities assumed were recorded at their estimated fair values as of the Acquisition Date. We determined the fair value of the inventory based on its estimated selling price less cost to sell and normal profit margin.

The fair value of the technology and tradename intangible assets were determined based upon a “relief from royalty” approach. The “relief from royalty” method is based on the premise that a third party would be willing to pay a royalty to use these assets owned by the subject company. The projected royalties are converted into their present value equivalents through the application of a risk adjusted discount rate. The customer relationships were valued based on an “excess earnings method.” The “excess earnings method” measures the historical customer churn analysis and discussions with management extended until excess earning cash flow approximates zero. The non-compete agreements were valued based on a “with and without” approach. The “with and without” method measures an asset value by estimating the difference in cash flows generated by the business with the asset in-use versus without the asset. The difference in cash flows is attributable to incremental earnings or cost savings associated with the asset. These fair value measurements are based on significant unobservable inputs, based on management’s estimates and assumptions.

The fair value of the identifiable assets, including the intangible assets noted above, may be impacted by the Company’s evaluation of deferred taxes as further discussed below and possibly by future factors that may or may not impact the fair value of the identifiable assets, including the intangible assets noted above.

The Company recorded the excess of the aggregate purchase price over the estimated fair values of the identifiable assets acquired as goodwill, which is not deductible for tax purposes. Goodwill is primarily attributable to the benefits the Company expects to realize by expanding its product offerings and addressable markets, thereby contributing to an expanded revenue base. The Company will also increase the size of its sales organization, while realizing cost synergies associated with eliminating redundant positions, primarily in selling, general and administrative functions.

The assets and liabilities assumed in the acquisition have been included in the Company’s condensed consolidated balance sheet as of September 30, 2015. The results of X-spine operations were included in the Company’s condensed consolidated financial statements from the Acquisition Date.

The Company is currently evaluating the impact of the X-spine acquisition on reportable operating segments requirements.

Acquisition Costs

Acquisition-related expenses were $3.9 million for the three and nine months ended September 30, 2015, and primarily included investment banking, accounting, consulting, legal fees and integration expenses. Integration expenses include samples, travel and meetings, severance due to reduction in force, retention bonuses and software. We anticipate additional integration expenses to occur during the fourth quarter of 2015 and the first quarter of 2016.

Taxes

The Company did not acquire X-spine's net operating loss carryforwards for federal tax purposes because X-spine was an S-corporation tax filer prior to the acquisition and any carryforwards were taken by the former shareholders of X-spine in their federal tax filings. The Company is currently evaluating the realizability of the net deferred tax assets acquired net of the deferred tax liabilities that may arise from the recording of intangible assets as part of the purchase price allocation.

Given its significant prior accumulated tax losses, the Company does not expect to incur U.S. federal tax expense in the year ending December 31, 2015 or the foreseeable future. The Company does, however, expect to incur state tax expense during 2015.

Unaudited Supplemental Pro Forma Financial Information

The unaudited pro forma results presented below include the combined results of both entities as if the acquisition had been consummated as of January 1, 2014. Certain pro forma adjustments have been made to reflect the impact of the purchase transaction, primarily consisting of amortization of intangible assets with determinable lives and interest expense on long-term debt. In addition, certain historical expenses, such as warrant expense and interest expense associated with debt that was immediately repaid, were eliminated from these pro-forma results. The pro forma information does not necessarily reflect the actual results of operations had the acquisition been consummated at the beginning of the fiscal reporting period indicated nor is it indicative of future operating results. The pro forma information does not include any adjustment for potential revenue enhancements, cost synergies or other operating efficiencies that could result from the acquisition.

	Three Months Ended September 30,				Nine Months Ended September 30,
		2015		2014		2015	2014
Revenue	$	20,901,292	$	19,619,310	$	64,401,225	$	58,135,543
Net loss	$	(5,357,091)	$	(2,769,827)	$	(16,061,103)	$	(11,250,171)

- Definition

The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).

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+ Details

Equity

9 Months Ended

Sep. 30, 2015

Equity [Abstract]

Equity

(3) Equity

During the first quarter of 2014, the Company issued 150,000 shares of common stock to an affiliate of ROS Acquisition Offshore LP (“ROS”) pursuant to a Sixth Amendment to our Credit Agreement with ROS whereby we borrowed an additional $4 million under our Credit Agreement. This issuance accounted for as a debt discount and will be amortized over the life of the loan. (See Note 9, “Long-Term Debt” below).

In August 2014, the Company offered 1,143,000 shares of its common stock at $5.70 per share and warrants to purchase 571,500 shares of its common stock at an exercise price of $7.12 per share to the public. Gross proceeds of the offering were approximately $6.5 million. Net proceeds from the offering were approximately $5.9 million and were used for working capital and general corporate purposes. The offering closed on August 6, 2014. The warrants have a five year term and expire on August 6, 2019. The Company utilizes a valuation model to determine the fair market value and accounts for these warrants as a derivative liability (See Note 1, “Fair Value of Financial Instruments" above). (Also, see Note 11, "Warrants" below).

We entered into a Common Stock Purchase Agreement on March 16, 2015, as amended and restated April 17, 2015, with Aspire Capital which provides that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital is committed to purchase up to an aggregate of $10.0 million in shares of our common stock over the 24-month term. The stock purchase transactions are at the Company’s option. Pursuant to the terms and conditions in the Common Stock Purchase Agreement, in the first quarter of 2015, we issued 207,182 shares of our common stock for $750,000 in aggregate proceeds, along with 154,189 shares of our common stock as a commitment fee. In the second quarter of 2015, following the effectiveness of our Registration Statement on Form S-1, we issued 417,000 shares of our common stock to Aspire Capital for $1,387,439 in aggregate proceeds, which were used for working capital and general corporate purposes. The Company did not issue any shares to Aspire Capital in the quarter ending September 30, 2015.

Under the Common Stock Purchase Agreement, we have the right, at our sole discretion, to present Aspire Capital with purchase notices, directing Aspire Capital (as principal) to purchase up to 50,000 shares of our common stock, per trading day, provided that the aggregate price of each such purchase shall not exceed $500,000 per trading day, at a per share price equal to the lesser of:

•

the lowest sale price of our common stock on the purchase date; or

•

the arithmetic average of the three lowest closing sale prices for our common stock during the ten consecutive trading days ending on the trading day immediately preceding the purchase date.

In addition, we also have the right to present Aspire Capital with volume-weighted average price purchase notices directing Aspire Capital to purchase an amount of our common stock equal to up to 30% of the aggregate shares of our common stock on the next trading day, subject to the terms, conditions and limitations in the Purchase Agreement.

The Purchase Agreement may be terminated by us at any time, at our discretion, without any penalty or cost to us. The Purchase Agreement also provides for customary events of default, upon the occurrence of which Aspire Capital may terminate the Purchase Agreement. Aspire Capital has agreed that neither it nor any of its agents, representatives or affiliates shall engage in any direct or indirect short-selling or hedging of our common stock during any time prior to the termination of the Purchase Agreement. Any proceeds we receive under the Purchase Agreement are expected to be used for working capital and general corporate purposes.

On July 31, 2015, the Company acquired all of the outstanding capital stock of X-spine for approximately $60 million in cash, repayment of approximately $13 million in debt and 4,242,655 shares of our common stock.

Related to the acquisition, on October 8, 2015 the Company granted 78,510 restricted stock units to five X-spine employees at $3.19 a share for a total cost of $250,447 to be expensed ratably over twelve months in Acquisition and integration related expenses from the Acquisition Date.

On September 4, 2015, the Company sold an aggregate of 140,053 shares of our common stock to certain members of our Board of Directors in a private placement transaction for aggregate cash proceeds of $515,395.

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

+ References

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-Number Topic 4

-Section C

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-Section E

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-Paragraph 1

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-Paragraph 1

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-Subparagraph (SAB TOPIC 4.E)

-URI http://asc.fasb.org/extlink&oid=27010918&loc=d3e74512-122707

+ Details

Inventories

9 Months Ended

Sep. 30, 2015

Inventory Disclosure [Abstract]

Inventories

(4) Inventories

Inventories consist of the following:

	September 30,		December 31,
	2015		2014
Current inventories
Raw materials	$	4,685,993	$	3,836,635
Work in process		3,089,413		2,484,635
Finished goods		17,639,292		5,163,458
		25,414,698		11,484,728
Reserve for obsolescence		(3,372,190)		(1,926,080)
Current inventories, total		22,042,508		9,558,648
Non-current inventories
Finished goods		2,177,090		2,860,248
Reserve for obsolescence		(495,952)		(925,990)
Non-current inventories, total		1,681,138		1,934,258
Total inventories	$	23,723,646	$	11,492,906

- Definition

The entire disclosure for inventory. This may include, but is not limited to, the basis of stating inventory, the method of determining inventory cost, the major classes of inventory, and the nature of the cost elements included in inventory. If inventory is stated above cost, accrued net losses on firm purchase commitments for inventory and losses resulting from valuing inventory at the lower-of-cost-or-market may also be included. For LIFO inventory, may disclose the amount and basis for determining the excess of replacement or current cost over stated LIFO value and the effects of a LIFO quantities liquidation that impacts net income.

+ References+ Details

Impairment of Assets

9 Months Ended

Sep. 30, 2015

Impairment or Disposal of Tangible Assets Disclosure [Abstract]

Impairment of Assets

(5) Impairment of Assets

During the fourth quarter of 2014, management decided to dispose of a group of components because of a shift in strategy for the Company. The component groups consisted of the inventory and fixed assets associated with the Device Coatings and Cranial Maxillofacial Fixation (CMF) lines of business. Sales for these product lines represented less than 1% of total revenue in both the first nine months of 2015 and 2014. Gross profit associated with these product lines was less than 1% of total gross profit for both periods. Total assets associated with the two lines at December 31, 2014 included $80,042 of related fixed assets, net of depreciation, and related inventory of $832,507 for a total value of $912,549. These assets were transferred to Assets held for Sale and are classified on the balance sheet at December 31, 2014 as part of “Prepaid and other current assets”. After the impairment provision, the net balance of the Assets Held for Sale was $0 at December 31, 2014.

The sale of the CMF inventory occurred during the first quarter of 2015 and did not result in any tangible payment to the Company. The sale of the Device Coatings line of business occurred in the third quarter of 2015. The terms of the sale call for cash consideration to the Company of approximately $250,000, and additional contingent cash consideration of $100,000, both of which are secured by promissory notes. The gain on sale will only be recognized when payment on the promissory notes is received. The final terms of the sale of the Device Coatings line of business resulted in an impairment gain of $51,476.

During the third quarter of 2015, Intangible Assets were reviewed and found to be impaired. The impact, net of amortization, was $285,224.

Property and Equipment, Net

9 Months Ended

Sep. 30, 2015

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

(6) Property and Equipment, Net

Property and equipment, net are as follows:

	September 30,		December 31,
	2015		2014
Buildings	$	1,657,579	$	1,657,579
Equipment		5,279,695		4,724,608
Computer equipment		364,966		225,009
Computer software		469,301		345,039
Furniture and fixtures		256,721		153,834
Leasehold improvements		2,477,281		2,380,617
Vehicles		10,000		41,099
Surgical instruments		6,610,189		-
Total cost		17,125,732		9,527,785
Less: accumulated depreciation		(5,692,668)		(4,873,258)
	$	11,433,064	$	4,654,527

The Company leases certain equipment under capital leases. For financial reporting purposes, minimum lease payments relating to the assets have been capitalized. As of September 30, 2015, the Company has recorded $461,036 gross assets in Equipment, and $199,020 of accumulated depreciation relating to assets under capital leases.

Maintenance and repairs expense for the nine months of 2015 and 2014 was $272,811 and $233,547, respectively. Depreciation expense related to property and equipment, including property under capital lease for the first nine months of 2015 and 2014 was $563,790 and $440,397, respectively.

- Definition

The entire disclosure for long-lived, physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, accounting policies and methodology, roll forwards, depreciation, depletion and amortization expense, including composite depreciation, accumulated depreciation, depletion and amortization expense, useful lives and method used, income statement disclosures, assets held for sale and public utility disclosures.

+ References+ Details

Intangible Assets

9 Months Ended

Sep. 30, 2015

Goodwill and Intangible Assets Disclosure [Abstract]

Intangible Assets

(7) Intangible Assets

The Company has applied for various patents with regards to processes for its products.

The following table sets forth information regarding intangible assets:

	September 30,		December 31,
	2015		2014
Intellectual Property
Gross carrying value	$	43,691,182	$	1,036,580
Accumulated amortization		(1,467,326)		(381,090)
Net carrying value	$	42,223,856	$	655,490

Aggregate amortization expense:	$	1,423,983	$	77,022

The following is a summary of estimated future amortization expense for intangible assets as of September 30, 2015:

Remainder of 2015	$	2,050,466
2016		4,465,216
2017		4,625,114
2018		4,640,027
2019		4,531,176
Thereafter		21,911,857
Total	$	42,223,856

Long-Term Debt

9 Months Ended

Sep. 30, 2015

Debt Disclosure [Abstract]

Long-term Debt

(9) Long-Term Debt

On March 6, 2014, we entered into a Sixth Amendment to our Credit Agreement with ROS whereby we borrowed an additional $4.0 million under our Credit Agreement with ROS and issued 150,000 shares to an affiliate of ROS. We used the proceeds for working capital and general corporate purposes.

On July 31, 2015, concurrent with the acquisition of X-spine, we completed an offering of $65.0 million aggregate principal amount of 6.00% convertible senior unsecured notes due 2021 (the “Notes”) in a private offering to qualified institutional buyers, as defined in Rule 144A under the Securities Act of 1933, as amended. Certain private investment funds for which OrbiMed Advisors LLC, serves as the investment manager, purchased $52.0 million aggregate principal amount of the Notes directly from the Company in the offering. On August 10, 2015, the initial purchaser exercised its option with respect to an additional $3 million aggregate principal amount of Notes.

The Notes bear interest at a rate equal to 6.00% per year. Following the first interest payment date, which will be on April 15, 2016, interest on the Notes will be payable semiannually in arrears on January 15 and July 15 of each year. Interest will accrue on the Notes from the last date to which interest has been paid or duly provided for or, if no interest has been paid or duly provided for, from July 31, 2015. Unless earlier converted or repurchased, the Notes will mature on July 15, 2021.

At any time prior to the close of business on the second business day immediately preceding the maturity date, holders may convert their Notes into shares of Xtant common stock (together with cash in lieu of fractional shares) at an initial conversion rate of 257.5163 shares per $1,000 principal amount of Notes (which represents an initial conversion price of approximately $3.88 per share). However, a Note will not be convertible to the extent that such convertibility or conversion would result in the holder of that Note or any of its affiliates being deemed to beneficially own in excess of 9.99% of the then-outstanding shares of Xtant common stock. The conversion rate will be subject to adjustment as described in the Indenture. In addition, Xtant will, in certain circumstances, increase the conversion rate for holders who convert their Notes in connection with a “make-whole fundamental change” (as defined in the Indenture). No sinking fund is provided for the Notes. Xtant may not redeem the Notes at its option prior to their maturity. If a “fundamental change” (as defined in the Indenture) occurs, holders will have the right, at their option, to require us to repurchase their Notes at a cash price equal to 100% of the principal amount of the Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date, subject to the right of holders of Notes on a record date to receive accrued and unpaid interest.

The Notes are Xtant’s senior, unsecured obligations, rank equal in right of payment with its existing and future unsecured indebtedness that is not junior to the Notes, are senior in right of payment to any of its existing and future indebtedness that is expressly subordinated to the Notes, and are effectively subordinated to its existing and future secured indebtedness to the extent of the value of the collateral securing such indebtedness. The Notes are structurally subordinated to all existing and future indebtedness and other liabilities, including trade payables, and (to the extent Xtant is not a holder thereof) preferred equity, if any, of its subsidiaries.

Amended and Restated Credit Agreement

On July 31, 2015, we refinanced approximately $24 million in existing term loans and borrowed an additional $18 million pursuant to an Amended and Restated Credit Agreement with ROS (the “New Facility”). The maturity date of the New Facility is July 31, 2020 (the “Maturity Date”). Interest under the New Facility is bifurcated into a “cash pay” portion and a “payment-in-kind” (“PIK”) portion. Until June 30, 2018 (the “First Period”), interest on loans outstanding under the New Facility will accrue at a rate equal to the sum of (a) 9% per annum, which portion of interest will be payable in cash, plus (b) additional interest (“PIK Interest”) in an amount equal to (i) the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, minus (ii) 9% per annum, which portion of interest will be payable “in kind.” During the portion of the First Period before December 31, 2015 (the “Optional PIK Period”), we may elect at our option to have all or any portion of interest on loans outstanding under the New Facility to accrue during the Optional PIK Period at a rate equal to the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, which portion of interest will be payable “in kind.” On or after June 30, 2018 until the New Facility is repaid in full (the “Second Period”), interest on loans outstanding under the New Facility will accrue at a rate equal to the sum of (a) 12% per annum, which portion of interest will be payable in cash, plus (b) PIK Interest in an amount equal to the difference of (i) the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, minus (ii) 12% per annum, which portion of interest will be payable “in kind.” In both the First Period and the Second Period, the portion of accrued interest constituting PIK Interest will not be payable in cash but will instead be added to the principal amount outstanding under the New Facility. However, at our option, we may choose to make any “payment-in-kind” interest payment in cash. Until the third anniversary of the closing date of the New Facility, we will not be allowed to voluntarily prepay the New Facility. Whenever loans outstanding under the New Facility are prepaid or paid, whether voluntarily, involuntarily or on the Maturity Date, a fee of 7.5% on the amount paid will be due and payable. The New Facility contains financial and other covenant requirements, including, but not limited to, financial covenants that require the Company to maintain revenue and liquidity at levels set forth in the New Facility and ensure that the Company’s senior consolidated leverage ratio does not exceed levels set forth in the New Facility. The New Facility also restricts us from making any payment or distribution with respect to, or purchasing, redeeming, defeasing, retiring or acquiring, the Notes other than payments of scheduled interest on the Notes, issuance of shares of our common stock upon conversion of the Notes, and payment of cash in lieu of fractional shares. The loans under the New Facility are guaranteed by Xtant and its current and future subsidiaries and are secured by substantially all of the current and future assets of Xtant and its subsidiaries. The additional amount borrowed under the New Facility was used to pay a portion of the X-spine acquisition, with the balance being available for general corporate purposes.

We accounted for the Notes and for the New Facility with ROS in accordance with ASC Subtopic 470-50, Debt Modifications and Extinguishments, and ASC Subtopic 470-60, Troubled Debt Restructurings by Debtors. Based on the facts and circumstances surrounding the changes to the loan and applying the calculation methodology per the above mentioned ASC subtopics, the Company recognized a gain from the extinguishment of debt of $2,345,019. The expense consists of the write-off of the royalty liability offset by the debt discount and capitalized expenses associated with the original debt agreement, including amendments, with ROS.

In addition, the Company calculated a fair value of the New Facility on a non-recurring basis by taking the five year cash flow and discounting it at a market interest rate. There was no significant difference between the calculated value and the stated value of the New Facility.

Approximately $4.8 million of expenses were incurred in conjunction with the acquisition, the issuance of convertible debt and the amendment and restatement of our credit facility with ROS. Of that amount, approximately $2.2 million of debt issuance costs will be capitalized and amortized over the life of the debt and we expensed approximately $2.6 million in the third quarter of 2015 related to the acquisition itself.

Long-term debt consists of the following:

	September 30,		December 31,
	2015		2014
Loan payable to ROS Acquisition Offshore (See details above)	$	42,000,000	$	24,000,000
Adjustment fee was payable to ROS Acquisition Offshore, due in August 2019		-		700,000
6% convertible senior unsecured notes due 2021 (See details above)		68,000,000
PIK Interest payable to ROS		1,067,500
6.00% loan payable to Valley Bank of Belgrade, $10,746 monthly payments including interest, maturing December 24, 2030; secured by building		1,287,146		1,325,814
		112,354,646		26,025,814
Less: current portion		(53,172)		(50,671)
Debt discount		-		(5,104,813)
Long-term debt	$	112,301,474	$	20,870,330

The following is a summary of maturities due on the debt as of September 30, 2015:

Remainder of 2015	$	12,953
2016		53,796
2017		57,114
2018		60,637
2019		64,377
Thereafter		112,105,769
Total	$	112,354,646

Stock-Based Compensation

9 Months Ended

Sep. 30, 2015

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Stock-Based Compensation

(10) Stock-Based Compensation

The Amended and Restated Xtant Medical Equity Incentive Plan ("The Plan") provides for stock awards, including options and performance stock awards, to be granted to employees, consultants, independent contractors, officers and directors. The purpose of the Plan is to enable us to attract, retain and motivate key employees, directors and, on occasion, independent consultants, by providing them with stock options and restricted stock grants. Stock options granted under the Plan may be either incentive stock options to employees, as defined in Section 422A of the Internal Revenue Code of 1986, or non-qualified stock options. The Plan is administered by the compensation committee of our Board of Directors. Stock options granted under the Plan are generally not transferable, vest in installments over the requisite service period and are exercisable during the stated contractual term of the option only by such optionee. The exercise price of all incentive stock options granted under the Plan must be at least equal to the fair market value of the shares of common stock on the date of the grant. 1,400,000 shares are authorized under the Plan and at September 30, 2015, we had approximately 480,000 shares available for issuance which are authorized, but unissued or reacquired shares.

Stock compensation expense recognized in the statement of operations for the nine months ended September 30, 2015 and 2014 is based on awards ultimately expected to vest and reflects an estimate of awards that will be forfeited. ASC 718 requires forfeitures to be estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates.

The estimated fair value of stock options granted is done using the Black-Scholes-Merton method applied to individual grants. Key assumptions used to estimate the fair value of stock awards are as follows:

	Nine Months Ended		Nine Months Ended
	September 30, 2015		September 30, 2014
Risk-free interest rate	1.30	%		1.81	%
Expected volatility	75	%		58	%
Expected term	6.0	Years		5.25	Years
Expected forfeiture rate	20	%		20	%
Dividend yield	0	%		0	%

In July 2014, the Company granted the President of Bacterin an option to purchase 55,000 shares of our common stock outside of the Plan, and in August 2013, the Company granted our Chief Executive Officer an option to purchase 200,000 shares of our common stock outside of the Plan (collectively the “Non-Plan Grants”).

Stock option activity, including options granted under the Plan and the Non-Plan Grants, was as follows:

	2015					2014
				Weighted					Weighted
				Average					Average
		Weighted		Fair			Weighted		Fair
		Average		Value at			Average		Value at
		Exercise		Grant			Exercise		Grant
	Shares	Price		Date		Shares	Price		Date
Outstanding at January 1	695,336	$	11.09	$	5.35	758,328	$	14.90	$	8.60
Granted	45,000		4.00		2.81	169,200		5.78		5.00
Exercised	-		-		-	(6,666)		10.00		.04
Cancelled or expired	(31,604)		12.71		6.02	(147,396)		19.95		9.20
Outstanding at September 30	708,732	$	10.54	$	5.29	773,466	$	11.99	$	7.10
Exercisable at September 30	388,498	$	13.53	$	6.43	297,962	$	17.03	$	6.50

The aggregate intrinsic value of options outstanding and the aggregate intrinsic value of exercisable options as of September 30, 2015 were approximately $26,000 and are equal because no options were exercisable at September 30, 2015. As of September 30, 2015, there were 320,234 unvested options with a weighted average fair value at the grant date of $3.90 per option. As of September 30, 2015, we had approximately $799,901 in compensation expense related to unvested awards not yet recognized.

From time to time we may grant stock options and stock grants to consultants. We account for consultant stock options in accordance with ASC 505-50. Consulting expense for the grant of stock options to consultants is determined based on the estimated fair value of the stock options at the measurement date as defined in ASC 505-50 and is recognized over the vesting period.

The Company recognized non-cash consulting expense for the nine months ended September 30, 2015 and 2014 as $190,869 and $81,924, respectively.

Total share based compensation recognized for employees, directors and consultants was $479,289 and $938,785 for the nine months ended September 30, 2015 and 2014, respectively.

On November 10, 2014, the company granted 39,312 shares of restricted stock units to the independent Directors of the Company. These restricted shares vested on July 1, 2015 and were issued when the stock price was $4.07 per share. The total expense of $160,000 was recognized ratably over the period as General and administrative expense.

On July 1, 2015, the company granted 58,820 restricted stock units to the independent Directors of the Company. These restricted shares vest on July 1, 2016 and were granted when the stock price was $3.40 per share. The total expense of $200,000 is being recognized ratably over the period as General and administrative expense. In the period ending September 30, 2015, $50,000 was expensed.

On October 8, 2015 the Company granted 78,510 restricted stock units to five X-spine employees at $3.19 a share for a total cost of $250,447 to be expensed ratably from the Acquisition Date over twelve months as Acquisition and integration related expense. In the period ending September 30, 2015, $41,741 was expensed.

- Definition

The entire disclosure for compensation-related costs for equity-based compensation, which may include disclosure of policies, compensation plan details, allocation of equity compensation, incentive distributions, equity-based arrangements to obtain goods and services, deferred compensation arrangements, employee stock ownership plan details and employee stock purchase plan details.

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Warrants

9 Months Ended

Sep. 30, 2015

Warrants and Rights Note Disclosure [Abstract]

Warrants

(11)

Warrants

The following table summarizes our warrant activities for the period ended September 30, 2015:

			Weighted
	Common		Average
	Stock		Exercise
	Warrants		Price
Outstanding as of January 1, 2014		1,087,820	$	16.20
Issued		571,500		7.12
Expired		(4,000)		20.00
Outstanding at January 1, 2015		1,655,320	$	13.06
Issued		-		-
Expired		(467,799)		22.55
Outstanding at September 30, 2015		1,187,521	$	9.32

We utilize a valuation model to determine the fair market value of the warrants accounted for as liabilities. The valuation model accommodates the probability of exercise price adjustment features as outlined in the warrant agreements. We recorded an unrealized loss of $78,923 resulting from the change in the fair value of the warrant derivative liability for the first nine months of 2015. Under the terms of some of our warrant agreements, at any time while the warrant is outstanding, the exercise price per share can be reduced to the price per share of future subsequent equity sales of our common stock or a common stock equivalent that is lower than the exercise price per share as stated in the warrant agreement.

The estimated fair value was derived using the valuation model with the following weighted-average assumptions:

	Nine Months ended
	September 30,
	2015			2014
Value of underlying common stock (per share)	$	3.26		$	4.48
Risk free interest rate		1.37	%		1.81	%
Expected term		4.25	years		5.25	years
Volatility		75	%		58	%
Dividend yield		0	%		0	%

The following table summarizes our activities related to warrants accounted for as a derivative liability for the nine months ended September 30, 2015 and 2014:

	2015		2014
Balance at January 1,		1,171,692		600,192
Derivative warrants issued		-		571,500
Derivative warrants exercised		-		-
Balance at September 30,		1,171,692		1,171,692

Commitments and Contingencies

9 Months Ended

Sep. 30, 2015

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

(12) Commitments and Contingencies

Operating Leases

We lease three office facilities under non-cancelable operating lease agreements with expiration dates in 2016, 2019 and 2023. We have the option to extend the three leases for up to another ten year term and for one facility, we have the right of first refusal on any sale. We lease additional office space under a month-to-month arrangement. Future minimum payments for the next five years and thereafter as of September 30, 2015, under these leases, are as follows:

Remainder of 2015	$	175,055
2016		609,317
2017		280,527
2018		286,754
2019		166,940
Thereafter		559,000
Total	$	2,077,593

Rent expense was $484,064 and $245,884 for the nine months ended September 30, 2015 and 2014, respectively. Rent expense is determined using the straight-line method of the minimum expected rent paid over the term of the agreement. We have no contingent rent agreements.

In October of 2015, we entered into a sale leaseback transaction (See Note 16, “Subsequent Events” below).

Indemnifications

Our arrangements generally include limited warranties and certain provisions for indemnifying customers against liabilities if our products or services infringe a third-party's intellectual property rights. To date, we have not incurred any material costs as a result of such warranties or indemnification provisions and have not accrued any liabilities related to such obligations in the accompanying financial statements.

We have also agreed to indemnify our directors and executive officers for costs associated with any fees, expenses, judgments, fines and settlement amounts incurred by any of these persons in any action or proceeding to which any of those persons is, or is threatened to be, made a party by reason of the person's service as a director or officer, including any action by us, arising out of that person's services as our director or officer or that person's services provided to any other company or enterprise at our request.

Litigation

Other than as previously disclosed in our Form 10-Q for the quarterly period ended June 30, 2015, there is no material litigation pending to which we are a party or to which our property is subject, other than ordinary routine litigation incidental to our business, including product liability disputes.

- Definition

The entire disclosure for commitments and contingencies.

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Income Taxes

9 Months Ended

Sep. 30, 2015

Income Tax Disclosure [Abstract]

Income Taxes

(13)

Income Taxes

In evaluating the realizability of the net deferred tax assets, we take into account a number of factors, primarily relating to the ability to generate taxable income. Where it is determined that it is likely that we will be unable to realize deferred tax assets, a valuation allowance is established against the portion of the deferred tax asset. Because it cannot be accurately determined when or if we will become profitable, a valuation allowance was provided against the entire deferred income tax asset balance.

The 2011 through 2014 tax years remain open to examination by the Internal Revenue Service and the 2009 to 2014 tax years remain open to the Montana Department of Revenue and Ohio Department of Revenue. These taxing authorities have the authority to examine those tax years until the applicable statute of limitations expire.

The Company did not recognize any interest or penalties related to income taxes for the nine months ended September 30, 2015 and 2014.

- Definition

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

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Supplemental Disclosure of Cash Flow Information

9 Months Ended

Sep. 30, 2015

Supplemental Cash Flow Elements [Abstract]

Supplemental Disclosure of Cash Flow Information

(14) Supplemental Disclosure of Cash Flow Information

Supplemental cash flow information is as follows:

	Nine months Ended
	September 30,
	2015		2014
Supplemental disclosure of cash flow information
Cash paid during the period for:
Interest	$	2,372,453	$	2,379,439
Non-cash activities:
Issuance of shares related to debt issuance	$	-	$	1,094,999
Issuance of capital leases	$	70,020	$	-
Issuance of share for non-cash consulting expense	$	190,869	$	81,924
Issuance of restricted stock to employees	$	41,741	$	142,601
Issuance of shares in conjunction with the acquisition of X-spine	$	14,934,146	$	-

Related Party Transactions

9 Months Ended

Sep. 30, 2015

Related Party Transactions

(15) Related Party Transactions

Darrel Holmes, our Chief Operating Officer, and Mitchell Godfrey, a former director, serve on the board of American Donor Services Inc. (“ADS”), and Mr. Godfrey also serves as secretary and treasurer for ADS. Mssrs. Godfrey and Holmes each receive $5,000 per year for their service to ADS. ADS recovers tissue from donors and we reimburse ADS for its recovery fees, which are comprised primarily of labor costs. The approximate aggregate amount of all transactions with ADS for the nine months ended September 30, 2015 and 2014 was $1,367,487 and $1,900,952 respectively. Our relationship with ADS has benefited us, as ADS provides us with current donors and a pipeline for future donors, which is necessary to our success.

Certain of X-spine’s former shareholders, now own over 10% of our common stock as of the Acquisition Date, and have owned a controlling interest of X-spine’s largest supplier, Norwood Tool Company d/b/a Norwood Medical. For the three months ended September 30, 2015, Norwood Medical sold approximately $337,000 of supplies to the Company (See Item 1A. Risk Factors - Risks Related to X-spine’s Business, “X-spine’s business depends, in part, on a relationship with a key supplier, which is a related party” below).

Unless delegated to the Compensation Committee by the Board of Directors, the Audit Committee or the disinterested members of the full Board of Directors reviews and approves all related party transactions.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

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Subsequent Events

9 Months Ended

Sep. 30, 2015

Subsequent Events [Abstract]

Subsequent Events

(16) Subsequent Events

On October 23, 2015, the Company entered into a sale-leaseback transaction for the property located at 664 Cruiser Lane, Belgrade, Montana, 59714 which formerly secured the 6% loan payable to Valley Bank of Belgrade (See Note 9, “Long-Term Debt” above) Our new lease agreement has a ten year term with an option to extend for two additional five year terms for a total of ten years.

On October 19, 2015, our common stock began trading on the NYSE MKT under the new symbol “XTNT”.

Business Description and Summary of Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Name Change

Name Change

Following the closing of the acquisition, on July 31, 2015, Bacterin International Holdings, Inc. changed its name to Xtant Medical Holdings, Inc.

New Subsidiary

New Subsidiary

On August 6, 2015 Xtant formed a new wholly owned subsidiary, Xtant Medical, Inc., a Delaware corporation. The creation of the subsidiary will facilitate the integration of Bacterin and X-spine.

Reverse Stock Split

Reverse Stock Split

Public Offering

Public Offering

Aspire Capital Transaction

Aspire Capital Transaction

Private Placement Offering

Private Placement Offering

Concentrations and Credit Risk

Concentrations and Credit Risk

For the three months ended September 30, 2015, approximately 13% of total cost of goods sold was with one vendor, Norwood Medical (See note 15, “Related Party Transactions”).

Revenue by geographical region is as follows:

	Nine Months Ended
	September 30,
	2015		2014
United States	$	35,419,434	$	25,792,878
Rest of World		1,669,315		457,529
	$	37,088,749	$	26,250,407

Use of Estimates

Use of Estimates

Long-Lived Assets

Long-Lived Assets

Goodwill

Goodwill

Revenue Recognition

Revenue Recognition

Advertising Costs

Advertising Costs

The Company expenses advertising costs as incurred. The Company had advertising expense of $93,854 and $29,027 for the nine months ended September 30, 2015 and 2014, respectively.

Research and Development

Research and Development

Research and development costs, which are principally related to internal costs for the development of new regenerative orthopedic products technologies and processes are expensed as incurred.

Net Loss Per Share

Net Loss Per Share

Fair Value of Financial Instruments

Fair Value of Financial Instruments

Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets.

Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement.

The following table sets forth by level, within the fair value hierarchy, our liabilities as of September 30, 2015 and December 31, 2014 that are measured at fair value on a recurring basis:

Warrant derivative liability

	As of		As of
	September 30,		December 31,
	2015		2014
Level 1		-		-
Level 2		-		-
Level 3	$	1,399,294	$	1,320,371

The valuation technique used to measure fair value of the warrant liability is based on a valuation model and significant assumptions and inputs determined by us (See Note 11, “Warrants” below).

Level 3 Changes

Warrant derivative liability

Balance at January 1, 2015	$	1,320,371
Loss recognized in earnings in first half of 2015		476,289
Balance at June 30, 2015		1,796,660
Gain recognized in earnings in third quarter of 2015		(397,366)
Balance at September 30, 2015	$	1,399,294

During the first nine months ended September 30, 2015, the Company did not change any of the valuation techniques used to measure its liabilities at fair value.

Recent Accounting Pronouncements

Recent Accounting Pronouncements

material impact.

Business Description and Summary of Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Revenues by Geographic Region

Revenue by geographical region is as follows:

	Nine Months Ended
	September 30,
	2015		2014
United States	$	33,857,591	$	25,792,878
Rest of World		3,231,158		457,529
	$	37,088,749	$	26,250,407

Schedule of Assets and Liabilities Measured on Recurring Basis

Warrant derivative liability

	As of		As of
	September 30,		December 31,
	2015		2014
Level 1		-		-
Level 2		-		-
Level 3	$	1,399,294	$	1,320,371

Schedule of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

Warrant derivative liability

Balance at January 1, 2015	$	1,320,371
Loss recognized in earnings in first half of 2015		476,289
Balance at June 30, 2015		1,796,660
Gain recognized in earnings in third quarter of 2015		(397,366)
Balance at September 30, 2015	$	1,399,294

- Definition

Tabular disclosure of the fair value measurement of liabilities using significant unobservable inputs (Level 3), a reconciliation of the beginning and ending balances, separately presenting changes attributable to the following: (1) total gains or losses for the period (realized and unrealized), segregating those gains or losses included in earnings (or changes in net assets), and gains or losses recognized in other comprehensive income (loss) and a description of where those gains or losses included in earnings (or changes in net assets) are reported in the statement of income (or activities); (2) purchases, sales, issues, and settlements (each type disclosed separately); and (3) transfers in and transfers out of Level 3 (for example, transfers due to changes in the observability of significant inputs) by class of liability.

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Business Combination (Tables)

9 Months Ended

Sep. 30, 2015

Business Combinations [Abstract]

Schedule of Business Combinations Purchase Price Allocation

The components of the aggregate preliminary purchase price for the acquisition were as follows (in thousands):

Cash	$	73,033,018
Fair value of Xtant shares		14,934,146
Total purchase price	$	87,967,164

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

The following table summarizes the allocation of assets acquired and liabilities assumed as of the Acquisition Date:

			Amortization
	Allocation of		period (in
	purchase price		years)
Accounts receivable	$	5,989,904
Inventories		13,132,697
Prepaids and other current assets		208,116
Property and equipment, net		7,409,667
Cash		57,818
Total tangible assets acquired		26,798,202
Less: liabilities assumed		6,021,756
Net tangible assets less liabilities	$	20,776,446

Intangible assets:
Technology		28,698,700	10
Customer relationships		9,911,000	14
Tradename		4,543,300	10
Non-compete agreements		40,500	3
Goodwill		23,997,218
Total purchase price	$	87,967,164

Business Acquisition, Pro Forma Information

	Three Months Ended September 30,				Nine Months Ended September 30,
		2015		2014		2015	2014
Revenue	$	20,901,292	$	19,619,310	$	64,401,225	$	58,135,543
Net loss	$	(5,357,091)	$	(2,769,827)	$	(16,061,103)	$	(11,250,171)

Inventories (Tables)

9 Months Ended

Sep. 30, 2015

Inventory Disclosure [Abstract]

Schedule of Inventories

Inventories consist of the following:

	September 30,		December 31,
	2015		2014
Current inventories
Raw materials	$	4,685,993	$	3,836,635
Work in process		3,089,413		2,484,635
Finished goods		17,639,292		5,163,458
		25,414,698		11,484,728
Reserve for obsolescence		(3,372,190)		(1,926,080)
Current inventories, total		22,042,508		9,558,648
Non-current inventories
Finished goods		2,177,090		2,860,248
Reserve for obsolescence		(495,952)		(925,990)
Non-current inventories, total		1,681,138		1,934,258
Total inventories	$	23,723,646	$	11,492,906

Property and Equipment, Net (Tables)

9 Months Ended

Sep. 30, 2015

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment, Net

Property and equipment, net are as follows:

	September 30,		December 31,
	2015		2014
Buildings	$	1,657,579	$	1,657,579
Equipment		5,279,695		4,724,608
Computer equipment		364,966		225,009
Computer software		469,301		345,039
Furniture and fixtures		256,721		153,834
Leasehold improvements		2,477,281		2,380,617
Vehicles		10,000		41,099
Surgical instruments		6,610,189		-
Total cost		17,125,732		9,527,785
Less: accumulated depreciation		(5,692,668)		(4,873,258)
	$	11,433,064	$	4,654,527

Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2015

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Intangible Assets

The following table sets forth information regarding intangible assets:

	September 30,		December 31,
	2015		2014
Intellectual Property
Gross carrying value	$	43,691,182	$	1,036,580
Accumulated amortization		(1,467,326)		(381,090)
Net carrying value	$	42,223,856	$	655,490

Aggregate amortization expense:	$	1,423,983	$	77,022

Schedule of Estimated Amortization Expense for Intangible Assets

The following is a summary of estimated future amortization expense for intangible assets as of September 30, 2015:

Remainder of 2015	$	2,050,466
2016		4,465,216
2017		4,625,114
2018		4,640,027
2019		4,531,176
Thereafter		21,911,857
Total	$	42,223,856

Long-Term Debt (Tables)

9 Months Ended

Sep. 30, 2015

Debt Disclosure [Abstract]

Schedule of Long-term Debt

Long-term debt consists of the following:

	September 30,		December 31,
	2015		2014
Loan payable to ROS Acquisition Offshore (See details above)	$	42,000,000	$	24,000,000
Adjustment fee was payable to ROS Acquisition Offshore, due in August 2019		-		700,000
6% convertible senior unsecured notes due 2021 (See details above)		68,000,000
PIK Interest payable to ROS		1,067,500
6.00% loan payable to Valley Bank of Belgrade, $10,746 monthly payments including interest, maturing December 24, 2030; secured by building		1,287,146		1,325,814
		112,354,646		26,025,814
Less: current portion		(53,172)		(50,671)
Debt discount		-		(5,104,813)
Long-term debt	$	112,301,474	$	20,870,330

Schedule of Maturities of Long-term Debt

The following is a summary of maturities due on the debt as of September 30, 2015:

Remainder of 2015	$	12,953
2016		53,796
2017		57,114
2018		60,637
2019		64,377
Thereafter		112,105,769
Total	$	112,354,646

Stock-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2015

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions

Key assumptions used to estimate the fair value of stock awards are as follows:

	Nine Months Ended		Nine Months Ended
	September 30, 2015		September 30, 2014
Risk-free interest rate	1.30	%		1.81	%
Expected volatility	75	%		58	%
Expected term	6.0	Years		5.25	Years
Expected forfeiture rate	20	%		20	%
Dividend yield	0	%		0	%

Schedule of Share-based Compensation, Stock Options, Activity

Stock option activity, including options granted under the Plan and the Non-Plan Grants, was as follows:

	2015					2014
				Weighted					Weighted
				Average					Average
		Weighted		Fair			Weighted		Fair
		Average		Value at			Average		Value at
		Exercise		Grant			Exercise		Grant
	Shares	Price		Date		Shares	Price		Date
Outstanding at January 1	695,336	$	11.09	$	5.35	758,328	$	14.90	$	8.60
Granted	45,000		4.00		2.81	169,200		5.78		5.00
Exercised	-		-		-	(6,666)		10.00		.04
Cancelled or expired	(31,604)		12.71		6.02	(147,396)		19.95		9.20
Outstanding at September 30	708,732	$	10.54	$	5.29	773,466	$	11.99	$	7.10
Exercisable at September 30	388,498	$	13.53	$	6.43	297,962	$	17.03	$	6.50

Warrants (Tables)

9 Months Ended

Sep. 30, 2015

Warrants and Rights Note Disclosure [Abstract]

Schedule of Warrant Activity

The following table summarizes our warrant activities for the period ended September 30, 2015:

			Weighted
	Common		Average
	Stock		Exercise
	Warrants		Price
Outstanding as of January 1, 2014		1,087,820	$	16.20
Issued		571,500		7.12
Expired		(4,000)		20.00
Outstanding at January 1, 2015		1,655,320	$	13.06
Issued		-		-
Expired		(467,799)		22.55
Outstanding at September 30, 2015		1,187,521	$	9.32

Schedule of Warrant Valuation Assumptions

The estimated fair value was derived using the valuation model with the following weighted-average assumptions:

	Nine Months ended
	September 30,
	2015			2014
Value of underlying common stock (per share)	$	3.26		$	4.48
Risk free interest rate		1.37	%		1.81	%
Expected term		4.25	years		5.25	years
Volatility		75	%		58	%
Dividend yield		0	%		0	%

Schedule of Warrants Activities Used In Derivative Liability

The following table summarizes our activities related to warrants accounted for as a derivative liability for the nine months ended September 30, 2015 and 2014:

	2015		2014
Balance at January 1,		1,171,692		600,192
Derivative warrants issued		-		571,500
Derivative warrants exercised		-		-
Balance at September 30,		1,171,692		1,171,692

Commitments and Contingencies (Tables)

9 Months Ended

Sep. 30, 2015

Commitments and Contingencies Disclosure [Abstract]

Schedule of Future Minimum Rental Payments for Operating Leases

Future minimum payments for the next five years and thereafter as of September 30, 2015, under these leases, are as follows:

Remainder of 2015	$	175,055
2016		609,317
2017		280,527
2018		286,754
2019		166,940
Thereafter		559,000
Total	$	2,077,593

Supplemental Disclosure of Cash Flow Information (Tables)

9 Months Ended

Sep. 30, 2015

Supplemental Cash Flow Elements [Abstract]

Supplemental Disclosure of Cash Flow Information

Supplemental cash flow information is as follows:

	Nine months Ended
	September 30,
	2015		2014
Supplemental disclosure of cash flow information
Cash paid during the period for:
Interest	$	2,372,453	$	2,379,439
Non-cash activities:
Issuance of shares related to debt issuance	$	-	$	1,094,999
Issuance of capital leases	$	70,020	$	-
Issuance of share for non-cash consulting expense	$	190,869	$	81,924
Issuance of restricted stock to employees	$	41,741	$	142,601
Issuance of shares in conjunction with the acquisition of X-spine	$	14,934,146	$	-

Business Description and Summary of Significant Accounting Policies (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total Revenues	$ 17,693,020	$ 8,453,504	$ 37,088,749	$ 26,250,407
US [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total Revenues			35,419,434	25,792,878
Rest Of World [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total Revenues			$ 1,669,315	$ 457,529

Business Description and Summary of Significant Accounting Policies (Details 1) (USD $)	Sep. 30, 2015	Dec. 31, 2014
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	$ 1,399,294	$ 1,320,371
Fair Value, Inputs, Level 1 [Member] \| Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	0	0
Fair Value, Inputs, Level 2 [Member] \| Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	0	0
Fair Value, Inputs, Level 3 [Member] \| Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	$ 1,399,294	$ 1,320,371

- Definition

Fair value, after the effects of master netting arrangements, of a financial liability or contract with one or more underlyings, notional amount or payment provision or both, and the contract can be net settled by means outside the contract or delivery of an asset, expected to be settled within one year or normal operating cycle, if longer. Includes assets not subject to a master netting arrangement and not elected to be offset.

+ References+ Details

Business Description and Summary of Significant Accounting Policies (Details 2) (Warrant [Member], Derivative [Member], USD $)	3 Months Ended	6 Months Ended
	Sep. 30, 2015	Jun. 30, 2015
Warrant [Member] \| Derivative [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Balance at January 1, 2015	$ 1,796,660	$ 1,320,371
Loss recognized in earnings	(397,366)	476,289
Balance at September 30, 2015	$ 1,399,294	$ 1,796,660

Business Description and Summary of Significant Accounting Policies (Details Textual) (USD $)	0 Months Ended	1 Months Ended		3 Months Ended			9 Months Ended				1 Months Ended	3 Months Ended				0 Months Ended	1 Months Ended	0 Months Ended		9 Months Ended
	Aug. 06, 2014	Jul. 31, 2015	Jul. 28, 2014	Sep. 30, 2015	Sep. 30, 2014	Mar. 31, 2014	Sep. 30, 2015	Sep. 30, 2014	Dec. 31, 2014	Dec. 31, 2013	Jul. 31, 2015 Debt [Member]	Sep. 30, 2015 Aspire Capital Fund LLC [Member]	Jun. 30, 2015 Aspire Capital Fund LLC [Member]	Mar. 31, 2015 Aspire Capital Fund LLC [Member]	Mar. 16, 2015 Aspire Capital Fund LLC [Member]	Aug. 06, 2014 Common Stock [Member]	Jul. 31, 2015 Common Stock [Member]	Sep. 04, 2015 Private Placement [Member] Common Stock [Member]	Aug. 06, 2014 August 2014 Warrants [Member]	Sep. 30, 2015 Geographic Concentration Risk [Member] Sales Revenue, Net [Member] US [Member]	Sep. 30, 2014 Geographic Concentration Risk [Member] Sales Revenue, Net [Member] US [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Concentration Risk, Percentage																				95.00%	98.00%
Advertising Expense							$ 93,854	$ 29,027
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount							1,896,253	1,877,948
Royalty Revenue Description							The Company also receives royalty revenue from third parties related to licensing agreements whichrepresented less than 1% of total revenue for the three and nine months ended September 30, 2015 and 2014.
Proceeds From Issuance Or Sale Of Equity Gross	6,500,000
Stock Issued During Period, Shares, New Issues						150,000						417,000	417,000	207,182		1,143,000		140,053
Shares Issued, Price Per Share																$ 5.70
Class of Warrant or Right, Number of Securities Called by Warrants or Rights																			571,500
Class of Warrant or Right, Exercise Price of Warrants or Rights				$ 9.32			$ 9.32		$ 13.06	$ 16.2									$ 7.12
Proceeds from Issuance or Sale of Equity, Total	5,900,000
Class Of Warrant Or Right Term																			5 years
Stockholders' Equity, Reverse Stock Split			1:10 reverse split
Common Stock To Be Issued For Commitment Fee														154,189
Common Stock, Shares Subscribed but Unissued															10,000,000
Stock Issued During Period, Value, New Issues												1,387,439	1,387,439	750,000
Share Price														$ 3.62
Other Non Cash Expense Associated With Stock Purchase Agreement				0	0		558,185	0						558,185
Business Combination, Consideration Transferred		60,000,000
Other Payments to Acquire Businesses											13,000,000
Business Acquisition Number Of Shares Acquired																	4,240,000
Proceeds from Issuance of Private Placement							$ 515,395	$ 0										$ 515,395

Business Combination (Details) (USD $) In Thousands, unless otherwise specified	Sep. 30, 2015
Cash	$ 73,033,018
Fair value of Xtant shares	14,934,146
Total purchase price	$ 87,967,164

Business Combination (Details 1) (USD $)			9 Months Ended
Business Combination (Details 1) (USD $)	Sep. 30, 2015	Dec. 31, 2014	Sep. 30, 2015 Technology-Based Intangible Assets [Member]	Sep. 30, 2015 Customer Relationships [Member]	Sep. 30, 2015 Trade Names [Member]	Sep. 30, 2015 Noncompete Agreements [Member]	Sep. 30, 2015 Accounts Receivable [Member]	Sep. 30, 2015 Inventories [Member]	Sep. 30, 2015 Prepaids And Other Current Assets [Member]	Sep. 30, 2015 Property And Equipment Net [Member]	Sep. 30, 2015 Cash [Member]
Total tangible assets acquired	$ 26,798,202						$ 5,989,904	$ 13,132,697	$ 208,116	$ 7,409,667	$ 57,818
Less: liabilities assumed	6,021,756
Net tangible assets less liabilities	20,776,446
Intangible assets			28,698,700	9,911,000	4,543,300	40,500
Goodwill	23,997,218	0
Total purchase price	$ 87,967,164,000
Amortization period (in years)			10 years	14 years	10 years	3 years

Business Combination (Details 2) (USD $)	3 Months Ended		9 Months Ended
Business Combination (Details 2) (USD $)	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Revenue	$ 20,901,292	$ 19,619,310	$ 64,401,225	$ 58,135,543
Net loss	$ (5,357,091)	$ (2,769,827)	$ (16,061,103)	$ (11,250,171)

Business Combination (Details Textual) (USD $) Share data in Millions, unless otherwise specified	1 Months Ended	3 Months Ended		9 Months Ended		1 Months Ended
	Jul. 31, 2015	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014	Jul. 31, 2015 Xspine [Member]	Jul. 31, 2014 Xspine [Member]
Payments to Acquire Businesses, Gross				$ 250,000		$ 60,000,000
Other Payments to Acquire Businesses						13,000,000
Stock Issued During Period, Shares, Acquisitions							4.24
Debt Instrument, Face Amount	65,000,000					68,000,000
Debt Instrument, Interest Rate During Period	6.00%					6.00%
Net Income (Loss) Attributable to Parent, Total		(6,688,974)	(1,165,783)	(13,761,754)	(7,205,572)	91,000
Business Combination, Acquisition Related Costs		$ 3,900,000		$ 3,900,000

- Definition

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

+ References+ Details

Equity (Details Textual) (USD $)	0 Months Ended	3 Months Ended	9 Months Ended					0 Months Ended			0 Months Ended	1 Months Ended	3 Months Ended			0 Months Ended	1 Months Ended
Equity (Details Textual) (USD $)	Aug. 06, 2014	Mar. 31, 2014	Sep. 30, 2015	Sep. 30, 2014	Dec. 31, 2014	Dec. 31, 2013	Jul. 31, 2015 Restricted Stock [Member]	Oct. 08, 2015 Subsequent Event [Member] Restricted Stock [Member]	Aug. 06, 2014 Common Stock [Member]	Aug. 06, 2014 August 2014 Warrants [Member]	Sep. 04, 2015 Private Placement [Member] Common Stock [Member]	Mar. 16, 2015 Aspire Capital Fund LLC [Member]	Sep. 30, 2015 Aspire Capital Fund LLC [Member]	Jun. 30, 2015 Aspire Capital Fund LLC [Member]	Mar. 31, 2015 Aspire Capital Fund LLC [Member]	Oct. 08, 2015 X Sspine [Member] Subsequent Event [Member] Restricted Stock [Member]	Jul. 31, 2015 X Sspine [Member] Common Stock [Member]
Schedule of Equity Method Investments [Line Items]
Stock issued (in shares)		150,000						78,510	1,143,000		140,053		417,000	417,000	207,182	78,510	4,242,655
Stock Issued During Period, Price Per Share								$ 3.19								$ 3.19
Proceeds from Issuance or Sale of Equity, Total	$ 5,900,000
Proceeds From Issuance Or Sale Of Equity Gross	6,500,000
Shares Issued, Price Per Share							$ 3.40		$ 5.70
Proceeds from Lines of Credit		4,000,000
Class of Warrant or Right, Number of Securities Called by Warrants or Rights										571,500
Class of Warrant or Right, Exercise Price of Warrants or Rights			$ 9.32		$ 13.06	$ 16.2				$ 7.12
Common Stock, Shares Subscribed but Unissued												10,000,000
Stock Issued During Period, Value, New Issues								250,447					1,387,439	1,387,439	750,000	250,447	60,000,000
Common Stock To Be Issued For Commitment Fee															154,189
Maximum Common Stock To Be Issued Per Trading Day												50,000
Maximum Common Stock Value To Be Issued Per Trading Day												500,000
Maximum Percentage Of Common Stock Weighted Average Price												30.00%
Warrant Expiration Period, Description	The warrants have a five year term and expire on August 6, 2019.
Proceeds from Issuance of Private Placement			515,395	0							515,395
Repayments of Debt																	$ 13,000,000

Inventories (Details) (USD $)	Sep. 30, 2015	Dec. 31, 2014
Current inventories
Raw materials	$ 4,685,993	$ 3,836,635
Work in process	3,089,413	2,484,635
Finished goods	17,639,292	5,163,458
Inventory, Gross	25,414,698	11,484,728
Reserve for obsolescence	(3,372,190)	(1,926,080)
Current inventories, total	22,042,508	9,558,648
Non-current inventories
Finished goods	2,177,090	2,860,248
Reserve for obsolescence	(495,952)	(925,990)
Non-current inventories, total	1,681,138	1,934,258
Total inventories	$ 23,723,646	$ 11,492,906

Impairment of Assets (Details Textual) (USD $)	3 Months Ended		9 Months Ended		12 Months Ended
Impairment of Assets (Details Textual) (USD $)	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014	Dec. 31, 2014
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Disposal Group, Including Discontinued Operation, Property, Plant and Equipment					$ 80,042
Disposal Group, Including Discontinued Operation, Inventory					832,507
Disposal Group, Including Discontinued Operation, Assets					0
Asset Impairment Charges	233,748	0	233,748	0	912,549
Payments to Acquire Businesses, Gross			250,000
Contingent Payment			100,000
Depreciation, Amortization and Accretion, Net, Total	285,224
Gain (Loss) on Sale of Assets and Asset Impairment Charges			$ 51,476
Gross Profit [Member] \| Minimum [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Concentration Risk, Percentage			1.00%	1.00%
Sales Revenue, Net [Member] \| Minimum [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Concentration Risk, Percentage			1.00%	1.00%

Property and Equipment, Net (Details) (USD $)	Sep. 30, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Total cost	$ 17,125,732	$ 9,527,785
Less: accumulated depreciation	(5,692,668)	(4,873,258)
Property and equipment, net	11,433,064	4,654,527
Building [Member]
Property, Plant and Equipment [Line Items]
Total cost	1,657,579	1,657,579
Equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	5,279,695	4,724,608
Computer equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	364,966	225,009
Computer software[Member]
Property, Plant and Equipment [Line Items]
Total cost	469,301	345,039
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Total cost	256,721	153,834
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Total cost	2,477,281	2,380,617
Vehicles [Member]
Property, Plant and Equipment [Line Items]
Total cost	10,000	41,099
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Total cost	$ 6,610,189	$ 0

Property and Equipment, Net (Details Textual) (USD $)	9 Months Ended
Property and Equipment, Net (Details Textual) (USD $)	Sep. 30, 2015	Sep. 30, 2014
Property, Plant and Equipment [Line Items]
Capital Leased Assets, Gross	$ 461,036
Capital Leases, Lessee Balance Sheet, Assets by Major Class, Accumulated Depreciation	199,020
Cost of Property Repairs and Maintenance	272,811	233,547
Depreciation	$ 563,790	$ 440,397

Intangible Assets (Details) (USD $)	9 Months Ended	12 Months Ended
Intangible Assets (Details) (USD $)	Sep. 30, 2015	Dec. 31, 2014
Intellectual Property
Gross carrying value	$ 43,691,182	$ 1,036,580
Accumulated amortization	(1,467,326)	(381,090)
Net carrying value	42,223,856	655,490
Aggregate amortization expense:	$ 1,423,983	$ 77,022

Intangible Assets (Details 1) (USD $)	Sep. 30, 2015
Estimated amortization expense:
Remainder of 2015	$ 2,050,466
2016	4,465,216
2017	4,625,114
2018	4,640,027
2019	4,531,176
Thereafter	21,911,857
Total	$ 42,223,856

Accrued Liabilities (Details) (USD $)	Sep. 30, 2015	Dec. 31, 2014
Accrued Liabilities [Line Items]
Accrued stock compensation	$ 91,741	$ 0
Wages/commissions payable	2,547,860	1,434,743
Accrued Integration Expense	241,132	0
Other accrued expenses	3,836,164	486,558
Accrued Liabilities Current	$ 6,716,897	$ 1,921,301

- Definition

Carrying value as of the balance sheet date of obligations, excluding pension and other postretirement benefits, incurred through that date and payable for perquisites provided to employees pertaining to services received from them. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

+ References+ Details

- Definition

Carrying value as of the balance sheet date of obligations incurred through that date and payable arising from transactions not otherwise specified in the taxonomy. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

+ References+ Details

Long-Term Debt (Details) (USD $)	Sep. 30, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Loan Payable	$ 112,354,646	$ 26,025,814
Less: current portion	(53,172)	(50,671)
Debt discount	0	(5,104,813)
Long-term debt	44,301,474	20,870,330
Ros Acquisition Offshore [Member]
Debt Instrument [Line Items]
Loan Payable	42,000,000	24,000,000
Adjustment fee payable to ROS Acquisition Offshore, due in August 2019	0	700,000
Valley Bank Of Belgrade [Member]
Debt Instrument [Line Items]
Loan Payable	1,287,146	1,325,814
Convertible Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Loan Payable	68,000,000
Payment in Kind (PIK) Note [Member]
Debt Instrument [Line Items]
Loan Payable	$ 1,067,500

Long-Term Debt (Details 1) (USD $)	Sep. 30, 2015
Schedule of maturities due on debt [Line Items]
Remainder of 2015	$ 12,953
2016	53,796
2017	57,114
2018	60,637
2019	64,377
Thereafter	112,105,769
Total	$ 112,354,646

Long-Term Debt (Details Textual) (USD $)	1 Months Ended	3 Months Ended			9 Months Ended		1 Months Ended	9 Months Ended	0 Months Ended	1 Months Ended		9 Months Ended	0 Months Ended
Long-Term Debt (Details Textual) (USD $)	Jul. 31, 2015	Sep. 30, 2015	Sep. 30, 2014	Mar. 31, 2014	Sep. 30, 2015	Sep. 30, 2014	Jul. 31, 2015 New Facility [Member]	Sep. 30, 2015 New Facility [Member]	Aug. 10, 2015 Convertible Notes Payable [Member]	Jul. 31, 2015 Convertible Notes Payable [Member]	Jul. 31, 2015 Term Loan [Member]	Sep. 30, 2015 Valley Bank Of Belgrade [Member]	Mar. 06, 2014 Ros Acquisition Offshore [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage												6.00%
Debt Instrument, Periodic Payment												$ 10,746
Debt Conversion, Converted Instrument, Shares Issued													150,000
Proceeds from Lines of Credit				4,000,000									4,000,000
Line of Credit Facility, Current Borrowing Capacity							18,000,000				24,000,000
Debt Instrument, Face Amount	65,000,000									52,000,000
Debt Instrument, Interest Rate During Period	6.00%									6.00%
Debt Instrument Purchase Of Additional Notes									3,000,000
Conversion of Stock, Shares Converted										257.5163
Conversion of Stock, Amount Converted										1,000
Debt Instrument, Convertible, Conversion Price										$ 3.88
Business Acquisition, Percentage of Voting Interests Acquired	100.00%
Business Combination Conjunction Related Expenses	4,800,000
Payments of Debt Issuance Costs	2,200,000
Business Combination Expenses Related To Future Acquisition		2,600,000			2,600,000
Debt Instrument, Maturity Date	Jul. 15, 2021
Debt Instrument, Maturity Date, Description												December 24, 2030
Line of Credit Facility, Expiration Date							Jul. 31, 2020
Gains (Losses) on Extinguishment of Debt, Total		$ 2,345,019	$ 0		$ 2,345,019	$ 0		$ 2,345,019

Stock-Based Compensation (Details)	9 Months Ended
Stock-Based Compensation (Details)	Sep. 30, 2015	Sep. 30, 2014
Risk-free interest rate	1.30%	1.81%
Expected volatility	75.00%	58.00%
Expected term	6 years	5 years 3 months
Expected forfeiture rate	20.00%	20.00%
Dividend yield	0.00%	0.00%

Stock-Based Compensation (Details 1) (Stock Option, USD $)	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Stock Option
Schedule of activity under stock option plans [Line Items]
Outstanding at January 1, 2015, Shares	695,336	758,328
Granted, Shares	45,000	169,200
Exercised, Shares	0	(6,666)
Cancelled or expired, Shares	(31,604)	(147,396)
Outstanding at June 30, 2015, Shares	708,732	773,466
Exercisable at June 30, 2015, Shares	388,498	297,962
Outstanding at January 1, 2015, Weighted Average Exercise Price	$ 11.09	$ 14.90
Granted, Weighted Average Exercise Price	$ 4.00	$ 5.78
Exercised, Weighted Average Exercise Price	$ 0	$ 10.00
Cancelled or expired, Weighted Average Exercise Price	$ 12.71	$ 19.95
Outstanding at June 30, 2015, Weighted Average Exercise Price	$ 10.54	$ 11.99
Exercisable at June 30, 2015, Weighted Average Exercise Price	$ 13.53	$ 17.03
Outstanding at January 1, 2015, Weighted Average Fair Value At Grant Date	$ 5.35	$ 8.60
Granted, Weighted Average Fair Value At Grant Date	$ 2.81	$ 5.00
Exercised, Weighted Average Fair Value At Grant Date	$ 0	$ 0.04
Cancelled or expired, Weighted Average Fair Value At Grant Date	$ 6.02	$ 9.20
Outstanding at June 30, 2015, Weighted Average Fair Value At Grant Date	$ 5.29	$ 7.10
Exercisable at June 30, 2015, Weighted Average Fair Value At Grant Date	$ 6.43	$ 6.50

Stock-Based Compensation (Details Textual) (USD $)	3 Months Ended	9 Months Ended		1 Months Ended		9 Months Ended	0 Months Ended	1 Months Ended	9 Months Ended			0 Months Ended
Stock-Based Compensation (Details Textual) (USD $)	Mar. 31, 2014	Sep. 30, 2015	Sep. 30, 2014	Aug. 31, 2013 Chief Executive Officer [Member]	Jul. 31, 2014 President [Member]	Sep. 30, 2015 Employee Stock Option [Member]	Nov. 10, 2014 Restricted Stock [Member]	Jul. 31, 2015 Restricted Stock [Member]	Sep. 30, 2015 Restricted Stock [Member]	Sep. 30, 2014 Restricted Stock [Member]	Sep. 30, 2015 Restricted Stock [Member] General and Administrative Expense [Member]	Oct. 08, 2015 Restricted Stock [Member] Subsequent Event [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Shares authorized under the Plan		1,400,000
Aggregate intrinsic value of options outstanding		480,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Intrinsic Value						$ 26,000
Allocated Share-based Compensation Expense		479,289	938,785						190,869	81,924
Employee Service Share-based Compensation, Nonvested Awards, Total Compensation Cost Not yet Recognized, Stock Options						320,234
Share-Based Compensation Arrangement By Share-Based Payment Award, Equity Instruments Other Than Options, Grants In Period							39,312
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options							160,000	200,000	41,741		50,000
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Issue Price On Grand Date							$ 4.07
Options granted				200,000	55,000
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures, Total								58,820
Shares Issued, Price Per Share								$ 3.40
Stock Issued During Period, Value, New Issues												250,447
Stock Issued During Period, Shares, New Issues	150,000											78,510
Stock Issued During Period, Price Per Share												$ 3.19
Share-Based Compensation Arrangement By Share-Based Payment Award, Options, Exercisable, Weighted Average Exercise Price						$ 3.90
Employee Service Share-based Compensation, Tax Benefit from Compensation Expense						$ 799,901

Warrants (Details) (USD $)	9 Months Ended	12 Months Ended
Warrants (Details) (USD $)	Sep. 30, 2015	Dec. 31, 2014
Warrant activity [Line Items]
Outstanding	1,655,320	1,087,820
Issued, Shares	0	571,500
Expired, Shares	(467,799)	(4,000)
Outstanding	1,187,521	1,655,320
Outstanding Weighted Average Exercise Price	$ 13.06	$ 16.2
Issued, Weighted Average Exercise Price	$ 0	$ 7.12
Expired, Weighted Average Exercise Price	$ 22.55	$ 20
Outstanding Weighted Average Exercise Price	$ 9.32	$ 13.06

Warrants (Details 1) (Warrant [Member], USD $)	9 Months Ended
Warrants (Details 1) (Warrant [Member], USD $)	Sep. 30, 2015	Sep. 30, 2014
Warrant [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Value of underlying common stock (per share)	$ 3.26	$ 4.48
Risk free interest rate	1.37%	1.81%
Expected term	4 years 3 months	5 years 3 months
Volatility	75.00%	58.00%
Dividend yield	0.00%	0.00%

Warrants (Details 2)	9 Months Ended	12 Months Ended	9 Months Ended
Warrants (Details 2)	Sep. 30, 2015	Dec. 31, 2014	Sep. 30, 2015 Warrant [Member]	Sep. 30, 2014 Warrant [Member]
Class of Warrant or Right [Line Items]
Outstanding	1,655,320	1,087,820	1,171,692	600,192
Derivative warrants issued	0	571,500	0	571,500
Derivative warrants exercised			0	0
Outstanding	1,187,521	1,655,320	1,171,692	1,171,692

Commitments and Contingencies (Details) (USD $)	Sep. 30, 2015
Schedule of future minimum payments by operating lease [Line Items]
Remainder of 2015	$ 175,055
2016	609,317
2017	280,527
2018	286,754
2019	166,940
Thereafter	559,000
Total	$ 2,077,593

Supplemental Disclosure of Cash Flow Information (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Cash paid during the period for:
Interest			$ 2,372,453	$ 2,379,439
Non-cash activities:
Issuance of shares related to debt issuance			0	1,094,999
Issuance of capital leases			70,020	0
Issuance of share for non-cash consulting expense	50,000	39,697	190,869	81,924
Issuance of restricted stock to employees			41,741	142,601
Issuance of shares in conjunction with the acquisition of X-spine			$ 14,934,146	$ 0

Related Party Transactions (Details Textual) (USD $)	9 Months Ended
Related Party Transactions (Details Textual) (USD $)	Sep. 30, 2015	Sep. 30, 2014
Chief Operating Officer [Member]
Related Party Transaction [Line Items]
Amount of related party transaction	$ 5,000
American Donor Services [Member]
Related Party Transaction [Line Items]
Amount of related party transaction	1,367,487	1,900,952
Xspine [Member]
Related Party Transaction [Line Items]
Amount of related party transaction	$ 337,000

Warrants (Details Textual) (USD $)	9 Months Ended
Warrants (Details Textual) (USD $)	Sep. 30, 2015
Class of Warrant or Right [Line Items]
Unrealized Loss On Warranty Derivative Liability	$ 78,923

Commitments and Contingencies (Details Textual) (USD $)	9 Months Ended
Commitments and Contingencies (Details Textual) (USD $)	Sep. 30, 2015	Sep. 30, 2014
Schedule of commitment and contingencies [Line Items]
Operating Leases, Rent Expense, Net	$ 484,064	$ 245,884