Good morning, everyone. I'm Robbie Marcus, MedTech analyst at JPMorgan. Very happy to introduce our next session, which is Integra LifeSciences. We're going to have CEO Pete Arduini doing the presentation. We'll have the management team join us after. Before I hand it over, everybody can go to the conference website to grab their slides. You can ask a question there or email me or chat me on Bloomberg, and I'll do my best to get to all of them in the Q&A session. So with that, Pete, I'm going to hand it over to you, and I'll see you for Q&A.
Thanks, Robbie. And good morning, everyone. The presentation, the first two to three pages, we actually have our safe harbor and forward-looking statements. You can see those for your review on pages two and three. But let's start the presentation. And if you turn to slide four in the slide deck titled Integra at a Glance, I'll start there. We are a global leader in neurosurgery and regenerative tissue technologies, an addressable market of about $8 billion. And our pro forma revenues in 2019 were about $1.5 billion. 30% of our sales are outside of the United States. Down below is a pro forma look of how we run the business. We have two global segments: Codman Specialty Surgical, which we refer to as CSS, and Tissue Technologies.
Codman is the largest, as you can see, at about 66% of the business, and 34% of the business is Tissue Technologies. As of last year, we did have an orthopedics business. I'll talk a little bit more about the divestiture of that and the pending closure of an acquisition in the tissue technology space and what that does to our overall business. But before I do that, turning to slide five, I'd like to update what we announced early this morning. We actually pre-announced our Q4 revenues. Some of you might have seen it. We dropped the press release this morning at 6:30 A.M., and we're pleased with our performance in the fourth quarter. The team executed in line as we expected, and many of us all know that later, as we got into the quarter, the challenges with the pandemic increased.
Our Q4 revenues are expected to be about $387 million-$389 million, which is just slightly down from our 2019 Q4, but at the higher end of our range that we directed investors to in our October call, and so we're pleased with the results of how we ended up here within the quarter. Turning to slide six, I often get the question about, what all did you focus on within 2020, and I'd like to share with you many of our advancements that we made in 2020, despite the setbacks, real setbacks that COVID-19 presented for all of us. We used 2020 as a retooling year, and let me share with you some of those details.
So looking at the page titled Optimizing Integra in 2020, starting with culture and people, from day one, our focus has always been about our employees and patients, making sure as the pandemic hit we could supply critical products for neurosurgery patients as well as any of our reconstructive patients that are out there. And making sure that our employees were safe was a top priority, as well as taking care of. We had a one-team mindset, which meant we did a lot of skip-level meetings and went right to all employees as opposed to a hierarchical way of communicating to make sure folks were tied in. And early on, as we didn't really understand the full extent, all employees took a salary decrease with leadership teams taking a much larger one, coming together to do the right things to shore up the business.
I was very proud of the teams of how they've all come together to do that. We also advanced our inclusion and diversity efforts during the year. From a global operations standpoint, we resolved our tissue technologies capacity and supply issues, which have been a challenge for us over the last couple of years. Coming out of this year, we're in very good shape. We've upgraded talent within the global operations team across many functions and executed on our planned succession of our leader of global operations and bringing in a gentleman, Steve Leonard, that has a significant amount of biopharma, pharma, and medtech capabilities well aligned with the future that we have planned. We also made great advancements within our facilities optimization, finalizing the sale of our dental facilities and also announcing a closure of a site within France.
From an innovation standpoint, we brought in some new capabilities within the organization but in particular, I'd point out the acquisitions of Rebound and Arkis. We remain on track with our programs and our investments, teams coming in on a daily basis, working on those programs and we ring-fenced key R&D programs in TT as well as CSS as different cost shifting obviously took place during the pandemic window. From a sales force capability standpoint, we advanced our teams with virtual collaboration tools, which are being used today and we believe are going to be used into the future. We also took a look at our channels and did some optimization within those, in particular adding digital marketing capabilities to reach our pods of customers from a digital standpoint and also bringing in an inside sales capability within the TT organization.
From portfolio optimization, obviously the biggest pieces are the divestiture of orthopedics, which was a negative grower for the company, and announcing the acquisition of ACell, which will be accretive, along with continued elimination of low-growth, low-margin products, which really will come to an end here in 2021. From a financial agility standpoint, we extended our credit facility till 2025. Many of you also may remember we completed a convertible early on in the year in January, which actually gave us overall better rates and strengthened our balance sheet. With some smart expense management, we're well positioned here as we come into 2021. With digital acceleration, the focus on all of our tools has made it obviously a big deal, as most of us have experienced, are experiencing now how important it is.
We implemented a real-time data analytics tool, which has been a long journey, starting with our ERP conversions many years back. But now we have drill-down capability from my level as CEO to drill down even to a territory in distant countries, as well as sales reps having daily sales and the ability to drive down into their individual account levels. Big deal for agility and speed of decisions, as well as our operations teams having that capability throughout theirs. And so, as you can see, we've made significant progress in these challenging times, all of these positioning the company to accelerate growth here in the future. So turning to slide seven titled, "Where are we going?" Well, it really starts with we've got growing markets and leadership positions. We believe we have significant market expansion opportunities.
I'll talk more about each of these in the segments in neurosurgery as well as in tissue technologies. Our ability in tissue to expand outside of wound reconstruction and beyond that into plastics and other areas within reconstructive surgery with our technologies, we think we're well positioned, and accelerating our organic growth. A host of launches that we launched in 2019 and 2020 really don't reach their peak year of sales for a couple of years yet, and we'll be launching more products this year. Margin expansion, we're well positioned with a mix shift up into higher margin products and nearly all of our new product introductions having higher gross margins than the previous versions, not to mention the portfolio changes of orthopedics and tissue that we implemented this year. And from a financial strength standpoint, we have a credit facility with over $2 billion.
We're very comfortable with our leverage range and have a solid balance sheet. From a capital allocation standpoint, M&A and debt reduction are really top of the list. We believe that we have plenty of external and internal investment opportunity ideas to enhance our growth here into the future. If you turn to slide eight titled Codman Specialty Surgical at a Glance, this gives you an overview of our largest segment. Codman is roughly about $1 billion. We have multiple number one products and franchises within this business and a full continuum of care. You can see in the upper right hand of the chart from Dural Access and Repair through CSF Management, we cover the gamut in neurosurgery. There are two gray shaded boxes I'll talk to in more detail, which we're very excited about bringing new growth opportunities into the portfolio.
The disease states which we compete in, which are brain tumor removal and management, traumatic brain injury, hydrocephalus, and now an entry in the future here into hemorrhagic stroke. And so I'll talk about that and some of this, how this will evolve, we think is going to be quite a big differentiator for this franchise. So we acquired, many of you remember Rebound, and developed the Aurora Surgiscope over the past two years. This acquisition will bring to us two distinct product lines and will leverage a common platform and provide safer and faster capabilities for two different areas. One is minimally invasive neurosurgery, which you can imagine neurosurgery is rather a traumatic access point by itself. And being able to implement it from a minimally invasive standpoint, we believe will provide a safer, faster, and lower trauma capabilities for a surgeon utilizing these technologies.
The second is intracerebral hemorrhage, which will enable a neurosurgeon to have a toolkit to quickly intervene in deep hemorrhagic strokes not attainable by intervascular means. Today, they have minimal tools to be able to implement this. Both the MIS opportunity and the ICH opportunity open up new and expanding markets. In our case, taking our neurosurgery market of about $3.5 billion and extending it out to about $4.5 billion of opportunity. The patented technology is unique and also takes advantage of the consumer cost curve for advanced LED lighting and CCD camera technology. The Aurora Surgiscope will be the first of its kind that will be a single-use sterile pack product with disposable optics and lighting. The benefit is increased access for patients around the world and also in rural towns here in the United States.
Today, most solutions that are utilized in this area are cost prohibitive because of the large upfront capital investments that are required and eliminates the amount of communities that can access it, and we think the Aurora Surgiscope is really going to be a game changer technology in the future in these two particular areas, so turning to slide nine, Codman Specialty Surgical at a Glance, let's just touch on some of the growth drivers. New product introductions, again, the products that we introduced in 2019 and 2020 still have a significant amount of upside and will be introducing a handful of new products in 2021. Speaking of recent products, the DuraGen introduction in Japan did extremely well and has quite a few years in front of us to reach peak year.
And a product such as our CereLink monitor for neurocritical care will be a new launch here in 2021. We're doing quite well in growth markets for us, such as China and Japan, Middle East and Africa. And with our large sales force around the world, we also, outside of our larger acquisitions, have many smaller companies coming to us looking for distribution opportunities. And I think you're going to hear more about this in the future from us. We signed a deal in China for an EVD distribution opportunity, and we think that's just the beginning of bringing more products into local markets with this large organization we have. And so with our strong global relevance and brand recognition, this brings customer access in all of our markets around the world. Turning to slide 10, I'll talk about the new tissue technologies business.
The numbers on this page are a pro forma look, excluding orthopedics and including ACell. As you can see on the pie chart here, we're over $500 million business. We've assembled really the largest diversified regenerative tissue technology portfolio, and we believe we have significant scientific and manufacturing know-how and talent in the team that allows us to expand in this space, and growth rates in our end markets that are mid-single digits to low double digits in nature. The three areas of focus that we talk to and our channels are aligned around are complex wound reconstruction, surgical reconstruction, and peripheral nerve, and within those, there's six disease states that we think all have growth potential. There's acute and trauma. There's chronic wounds such as DFU and also burns. In the surgical reconstruction space, we have plastic and reconstructive opportunities as well as complex hernia repair.
Peripheral nerve is peripheral nerve as well as tendon repair. All six of these areas are benefited by the technologies that are shown below. We have a host of technologies that, with different indications and configurations, can serve all of these disease states. It's one of the benefits of leveraging that from a cost standpoint and also expertise. Really what we're all about here is now building out this broad toolkit for the reconstructive and plastic surgeon to enable him or her to do their job more effectively. If you turn to slide 11, and I'll talk a little bit about the growth drivers in tissue technologies, hitting on four. The first and obvious one are fast-growing end markets, growing mid- to upper mid-single digits and low double digits in all of our segments.
Portfolio changes that we've recently made, the ortho divestiture and the TT acquisition being accretive to our growth profile. The large complementary portfolio that I mentioned and the associated sales forces enable us to reach customers in all of these disease states, as well as enable contracting, particularly in the United States around IDNs that would like to do business that way, and with our extended clinical capabilities to increase our clinical indications in wound reconstruction, but also reach outside of that, further into plastics and also into the nerve space, so there's lots of opportunities to drive innovation with business development, R&D, and clinical indications, and we're quite excited about the new TT. Turning to slide 12, I'm going to walk you through and talk to some of the benefits of the portfolio change that I mentioned when we opened up.
And so then the first slide here I'll go through talks to a little bit about the ortho divestiture and then going through the acquisition of Acell. So if you look at the pie chart on the left, you can see as a reminder, orthopedics was about 17% of the OTT segment and about 6% of sales for total Integra. The chart here with the pro forma is fundamentally taking orthopedics out of our 2019 numbers and talking through what that would represent to the company. So without orthopedics in our 2019 numbers, our pro forma growth would be 50 basis points higher. The reality of it is in previous years, it might be slightly higher than that. Adjusted gross margins was actually a slight negative. Operating expenses would be lower by 170 basis points, and our EBITDA contributions would be up.
I think the bigger component overall, though, yet to be seen will be what this does for simplification and focus within the company. It's obvious it allows us to focus more on tissue, but orthopedics, when you do not have scale, creates a significant amount of infrastructure and cost to be able to support it, from the consignment inventory needs to the amount of SKUs needed to have complete sets, and also the capabilities and tools needed to the sales force. It might have been 6% of sales for Integra, but it actually had a burden on the organization that felt closer to 20%-25%. And we believe over time this energy can be funneled back into other growth areas within the company. Turning to slide 13, when ACell closes, what will it add to the organization? Well, it's going to add a complementary set of technologies.
It's a porcine technology platform. And what this slide shows you now is that we will have four complementary technologies that really bring different capabilities to solve different solutions for surgeons. From our engineered collagen matrix, such as Integra Skin, which brings world-class functionality for restoration in face and hands and other areas in the body, to our fetal bovine platform that brings great adaptability, our products such as PriMatrix in wound care, and SurgiMend that is used in plastics as well as hernia repair. And the addition of our amniotic platform, AmnioExcel Plus, which is our tri-layer product that's used in multiple disease states, now complemented with a porcine platform from ACell, which will bring three products: MicroMatrix, Cytal, and Gentrix. MicroMatrix is a powder product, unlike anything that we have within our portfolio, that's used for all types of deeper uneven wound beds.
It's over half of the sales within the company. It can be complemented with the Cytal sheeting matrix. Then the Gentrix Surgical is quite an interesting product for hernia repair, and particularly that it has some indications for use within laparoscopic capabilities, which would be new to our Integra portfolio. So again, our focus is really about building out the reconstructive and plastic surgeons' toolkit. Turning to slide 14, just touching on the portfolio effects of divesting the extremities orthopedics and adding ACell. The chart on the left side here are the numbers that I just went through, the benefits of having orthopedics out of the portfolio. Now with the addition of ACell, you can see ACell will be accretive to our organic growth, accretive to our gross margins. From an EBITDA and EPS standpoint, neutral in year one, but accretive in year two.
From an ROIC standpoint, 78% by year three and pushing 10% by year five. So fundamentally, we sold a $90 million-$100 million business that wasn't growing, didn't have scale, and really was a drag on our EBITDA. Then we're in the process of buying a $90 million-$100 million business that's going to be accretive to gross, growth to margins, complementary to our portfolio, and allow us to take benefits of scale here in the future. Turning to our final slide, slide 15, I'll make some closing comments before we go into Q&A. These four metrics we feel very confident in: 5%-7% organic growth, over 70% gross margins, 28%-30% EBITDA margins, and double-digit adjusted EPS growth. The portfolio changes we've made obviously position us well for these. Our sales force capabilities and enhancements that we've added.
Our end market expansion, whether it be the extension of neurosurgery or the focus within tissue technologies and our capabilities, as well as our new products set us up well, not only in 2021, but obviously into the future with the changes that we've made. I think it's important to understand that even two years ago, our total market was roughly $2 million smaller than it is today. And our growth rates within those markets have increased with the changing demographics, but also some of the new capabilities that we've added into our portfolio. And so I'll end with the following to just say, it's like we exit 2020 a very different company than we entered it, and we're optimistic about the future and our ability to make a difference in more patients' lives. So with that, we'll open it up for Q&A.
Great. Thanks, Pete and we'll welcome the rest of the management team. We got Carrie Anderson, the CFO, and Glenn Coleman, COO. Glenn, I feel like there are some other titles I'm missing. I know you do a lot, but we'll save all the hard questions for you. Pete, maybe we could start off. There's a lot that's gone on at Integra over, let's say, the past 12 to 24 months. There's been a lot of changes. Some businesses sold, some added. How do you feel about the positioning of Integra going into 2021 versus maybe going into 2020 or 2019?
Yeah, Rob, you'll comment, and then maybe let Glenn jump in. I purposely had the slide on, I think it was the fourth or fifth slide that talked about all the changes we made to kind of give investors a perspective of the work we did. I mean, we made a conscious decision to shore up the company and say, "Okay, with the time we have in 2020, what are the things we need to do so as we come out of this we're in a very good spot?" And I think we're well positioned. The portfolio changes alone really give us some nice tailwinds and capabilities versus what the company configuration looked like in the past. But there's quite a few things that I mentioned in digital and other areas that have made a big difference. And maybe Glenn, you'd like to expand a little bit more on that.
Yeah, sure. I mean, the portfolio optimization piece is a big deal for us. Getting rid of an asset that is slower growing, not profitable, and replacing it with a faster growing, more profitable business with ACell, we feel quite good about, along with advancing our life cycle management and SKU optimization work. And so I think on the portfolio front, we feel really good heading into 2021. On the global operations side, where I spend a lot of my time, getting supply in good shape was a key priority for us in 2020. And clearly, we've done that across our regenerative plants in particular, where we had challenges in 2019. And that included building out some increased capacity in these plants to support very fast-growing areas in our tissue technology business. In addition, we advanced a number of things on our manufacturing optimization front.
So we decided to accelerate a plant closure and plans around that for a plant outside the U.S. We are moving forward with closing several non-manufacturing facilities as well to reduce our overall cost and infrastructure moving forward, which we think is going to help our overall operating margins as a company. Pete laid out a lot of the digitalization work that we're doing to accelerate our marketing efforts. We created a corporate marketing digital team, and we've done a lot around enhancing our sales force capabilities between this inside selling team in our technologies business and rolling out virtual collaboration tools for our KOLs, for our sales force training, and so forth. And you saw the benefit of that in our actual numbers. I mean, sequentially, our revenues improved significantly from Q2 to Q3, and we saw another sequential improvement here in the fourth quarter.
One of the key principles we had coming into the pandemic was making sure we preserved the long-term investments of the company that were going to be required to grow 5%-7%. And that included funding key clinical programs, key new product introductions. And we did not cut any of those programs. Robbie, as you know, back in the second quarter, we had to make some very tough decisions around cutting costs. And we preserved as many full-time jobs as possible. We preserved these long-term investments. But we took out about 30% of our operating expenses in a short period of time between salary cuts, furloughs, reduced hours, cutting all discretionary programs, T&E, and so forth. But we think we're very well positioned when we look at the longer-term investments in the business to grow into that 5%-7% once we come through the pandemic.
And just lastly, we did a lot of really good work around shoring up the balance sheet and financial flexibility, providing more flexibility to the company to support our strategy. Carrie, maybe you want to comment just on a couple of those items. But the bottom line is I think we made significant progress in a very challenging year with all these efforts really positioning the company for faster growth and expanded margins once we move past the pandemic.
Yeah. Yeah, I would just add, Pete hit on those. That in hindsight, I think we timed the amended extension of our credit facility and doing the $575 million convert very wisely. We got that done basically in February ahead of when the peak of COVID hit. But as we were going through the peak of COVID back in April, we just, I think, did a really nice job collectively as a global organization to respond to weather the storm, basically to manage costs effectively, as both Glenn and Pete have mentioned. And I've just been really quite impressed with the resiliency of our business model in terms of our ability to still generate some nice cash flow during these last couple of quarters. And so I think we're ending the year on a very strong note from a balance sheet perspective.
Even during a year where revenues on a reported basis are down about 10%, still being able to expand margins, I think, is a testament to the team and our investment thesis.
Great. I have a couple of questions that have come in, but maybe quickly before we get to those. Pete, as we think about the performance in fourth quarter, can you give us any sense of how it trended throughout fourth quarter, October, November, December, and how the neuro business did relative to the OTT business?
Carrie, do you want to give a little bit? I think, Robbie, we're not going to give a whole lot of details on the call, but maybe you can give a little bit of texture to it.
Yeah. I mean, in terms of the trends during the quarter, I would say we didn't see the typical December strength that we would have normally seen in any normal year. But even with that, I think there was really nice resiliency in our sales channels. And I think it's effectively, again, hospitals managing quite well through COVID and prioritizing both keeping some of the surgical procedures going as well as keeping in the forefront the health of COVID patients. And I would say that largely the performance in the fourth quarter, we mentioned that capital would lag. It was still a laggard in the fourth quarter. And if you exclude capital, we were essentially flat year over year on an organic basis across the company. So I think that's pretty impressive.
I do think that capital will continue to lag a little bit as we go into 2021 compared to the rest of the portfolio as we work through the remnants of COVID here before we get a good portion of the population vaccinated. I do think, again, if you think about Q4, CSS and OTT did about in line with the corporate average, with OTT doing a little bit less declines than CSS. As you think about it, CSS does have the capital in it. That should be where I would think we would expect. Overall, if you look at CSS excluding capital, certainly in the U.S., we saw growth. There was, again, a resiliency in those neuro procedures in Q4.
On the OTT side, we saw some nice, actually, about some growth year over year growth in our inpatient wound area, offset by a little bit of declines in our surgical recon business.
Robbie, I would just add that I think the team, when we forecasted back in October what the Q4 would look like, I think we were pretty close. And with the capital comments that Carrie made, as well as just this capacity challenge that exists in the ICUs when you have COVID maybe taking priority over a neuro procedure, hospitals have gotten significantly better. And I think we called it right. I think the first few months of the year probably have some of those similar demand characteristics as we saw in December. But we're optimistic that once we get through some of the vaccine levels here, we don't need to have herd immunity.
What we really need to have is that those folks that end up in the ICU get vaccinated, and that opens up more capacity to grow our neurosurgery business, which we believe is going to take place here sometime in the early part of the year.
Yeah. It's impressive because what we've heard from a lot of your peers here at the conference is that anything that involves long hospital stays has been more impacted. And I mean, I can't think of burns and skin replacement and neurosurgery that requires longer hospital stays. So it's an impressive result. Maybe against some of the questions here, Carrie, you've had two equally sized revenue businesses swap out the ortho business. The extremity business has been sold. You brought in ACell. I think it's a good upgrade in the product portfolio and the margin components of the business. So I think what a lot of people are looking for, and I've had several questions come in, is what's the net impact to EPS from the swap out?
Yeah. I think we provided that on one of Pete's slides, and we had talked about that earlier when we announced the acquisition. For the first year, we're expecting it to be neutral from an EPS perspective and accretive in the following year. We obviously haven't closed the transaction yet, so we are anticipating it to close sometime in Q1. So we won't have the full benefit of that acquisition in our Q1 numbers. And we've got to integrate. So the good news is we have an integration plan. This is in our sweet spot in terms of execution of acquisitions. There's a lot of common thread as we think about our infrastructure, our call points, so opportunities for synergies. So give us some time basically to integrate it. And priority number one is to preserve the integrity of the revenue.
Basically, we want to make sure that we keep that ACell revenue. And that's going to be our focus as we integrate in 2021 and then expect it to be accretive by year two.
Great. And I just want to make sure those comments, is that just ACell standalone, or is that combining the?
Combining. Yeah. That's on a pro forma basis. It's essentially kind of thinking about combined on a as you think about the benefits of the ortho business coming out, which is accretive to EPS, and then obviously having some integration time in 2021 basically offsets that. We expect for the company to be neutral on a net impact of the two.
Great. And this also slims down your selling channels, right? It allows you to focus more on the core business rather than hitting up with different sales forces, different call points.
We absolutely have a similar call point, so that will be an area for opportunity as we integrate the team. Yes.
Great. Another question that came in. Pete, how do you go about, and I don't know if this is the right way to phrase it, but the question is regaining market share in the wound care space from new entrants. I don't believe you've been losing share, but would love your thoughts on the competitiveness and the go-forward in the wound care space.
Yeah. I'll make some comments, and maybe Glenn, you can jump in on this as well. I think to your point, really over the last couple of years, where we've been most challenged has been typically in our ability to supply to the higher end to actually take share, candidly. If you look at our amniotic portfolio, we've got a really nice demand, but we were kind of capped out on supply. Glenn and team corrected that here in 2020, and we actually had some issues with overall capacity in some of our other products. And so we had to kind of have a maintain or four-quarter strategy, if you will, to kind of protect our core business, but we're now in a great position that we can actually go after share, and so some of this is the supply component.
And then when you have the supply component, it allows you to actually start contracting, particularly in the United States, at some of these larger IDNs that opens you up to come in with a broader portfolio and be able to offer more products out there. And I think the addition of the recently announced deal will fit into that as well. But I think we're well set up from that standpoint to be able to go forward. Glenn, I don't know if you want to add some further comments on the channel.
No, I mean, supply has been a big constraint in terms of our growth and capitalizing on the opportunity, so I would agree with you 100% on the amniotic tissue side. We've done some things to shore up supply, but we've also expanded capacity at our Memphis site, so we've added more clean rooms. We've increased the amount of sourcing of placentas into the company, adding more partners, and so we've done a lot of things just around the manufacturing process there to build out more capability to support the growth that we see in that part of our business, and then on the Boston front, where we make SurgiMend and PriMatrix, very fast-growing areas, we've done similar things to make significant investments in that facility to support the growth plans over the next five years.
In addition to that, I think the other key thing is we've added a really nice complementary technology with the ACell platform, which is a porcine urinary bladder matrix that goes very well with our collagen-based technology platform and amniotics. And so now, as Pete used the word, we have a full toolkit for our customers. I think it's going to help drive more market share gains going forward because there's not a single product that solves every wound healing. And so I think now we've got the full broad portfolio. We've got the toolkit and some very nice complementary products that we can take to our customers.
Great. So if I package that all together, it sounds like coming out of COVID, obviously during COVID is a question mark, but coming out of COVID, you feel highly confident in the 5%-7% organic growth range with the addition of ACell and some improved manufacturing capacity in the wound care business?
Without a doubt. I think as a long-term number, that plus our margin targets, we absolutely do. And so how that plays out in 2021 is going to be a question about how long the COVID overhang impacts how many months in 2021. But as you think about, we get beyond COVID, that is the underlying growth, absolutely. And again, I think the portfolio change gives us a good head start, so to speak, with that change. But there's a lot of the underlying mechanics, some that Glenn just talked about, are really what's going to drive the more sustainable changes over time.
Great. One last question here. We've seen a lot of portfolio activity from you. That's not a surprise given the legacy of Integra, but you've definitely been active with some portfolio management lately. Are you still on the hunt to potentially be adding over the course of 2021, or do you think we'll see more integration rather than addition subtraction over the course of next year?
We're always looking for tuck-in opportunities. I think particularly within our CSS portfolio, whether in instruments or neuro, we have room for tuck-in products into that line that can be easily fit with minimal integration challenges. I would say even within TT, once we integrate this recently announced deal, I think there's other products that can fit into the bag. We have capacity within the sales channel. I think thinking tuck-in is probably more of how we're thinking about acquisition strategies going forward.
And I would just add that I think I'm very comfortable with where we are in terms of our total consolidated leverage ratio. We've talked about a range of two and a half to three and a half. And I think we'll squarely be in the middle of that range, which the free cash flow generation of the business has really held up well in the second half of the year as we've gone through the COVID recovery. And so I do think we have room there to continue to think about and prioritize M&A, as Pete mentioned, looking opportunistically at opportunities that make the right fit for us.
Great. Well, unfortunately, we're out of time. I look forward to seeing the fourth quarter results and hopefully for patients and for Integra, trends improve in 2021. So thank you so much for joining today, and hope everybody has a great day.
Thanks, Robbie.
Thanks, Robbie.