Okay, well, thank you. A little bit slow start, but we'll get things rolling here. Again, my name is Sean Browne. I'm the President and CEO of Xtant Medical. And, I'm here today with, actually, Scott Neils, our CFO, and we're really excited to be here presenting in front of the Cowan Group. So let me get this this now. That's the wrong one. We are not. We're having some technical difficulties, and so I'm working from a PDF. Okay, where's it going to go? It's still all right. So, as we will have forward-looking statements, some of the things they'll be talking about, for instance, EBIT is not a non-GAAP deal. And so, again, you'll see our normal disclosure statements listed above. So let me tell you about who we are.
So first of all, we're a leading orthobiologics spine company, focused really on motion preservation as much as possible. When you think about our business and who we are, Xtant Medical was a company that was founded out of Bozeman, Montana. It was a technology transfer that came out of the Montana State University. The business itself went through a merger back in 2015 with Bacterin Biologics and X-spine Technologies. X-spine, it was a hardware company. Bacterin was just a biologics business, company that should have gotten together and should have made a lot of sense, but unfortunately, a couple of things happened. The integration didn't go so well, and how the deal was financed really held the business back. It was done primarily through debt. Happily, we our team came on board about 2019 and have been able to right the ship and really get the business growing.
And so we're really excited about a couple of things that I want you to take away from today. Right now, the business has basically doubled in size from where we were over a year ago. We are a business that's cash flowing, and we're a business that has set up, or I should say, positive adjusted EBITDA as what we have and we will have throughout the year. What I'm really, really excited about is the fact that when you look at the platform that we have for growth and what we built for growth is something that, as you look and see what is possible, you'll see that there's a lot of opportunities for us to grow not only organically, but inorganically as well. So when you look at our product offering, it's a complementary product offering.
The fact that, again, you have the hardware, which makes up about a third of our business, and we have our biologics that make up about two-thirds. The biologics business is one that's really been the lead for what we've done in the years past. But since buying the SurgeLine businesses, they've really given us and really been able to update our hardware line. And the hardware line, for us, there's kind of two big things to it. One, hardware really does a nice job of pulling through our biologics. So on the one end, it's been good, and it will be good for us from an organic perspective. But then secondarily, one of the big things that it'll do for us is the fact that we are a company that does really, really well outside the hospital.
Through some of these acquisitions, specifically the Coflex device, which is a fantastic product line, an interlaminar stabilization device that is used well, it's used throughout both hospital and outpatient and ambulatory surgery centers, but it has really, really good reimbursement outside the hospital. Similarly, so when you think about what we do with our SI fusion product as well as our interspinous device product, really good products used outside the hospital. That's going to be a big part of what we focus on, along with motion preservation systems like Coflex. When you think about what we've been through, you know, this is a slide that when we gave this, let's say, a year ago, it was a slide that talked about what we had to do to turn the business around.
Now what I'm happy about this slide is talking about how we're growing and how we're going and how the business itself is really starting to take off. And, you know, I could walk you through each of these different pieces, but I think I'm going to start really in 2021, where we really grew for the first time. We raised a nice PIPE. The PIPE allowed us to put money back into the business. That's after we had fixed a lot of things that had taken place during 2020, during the COVID years. But 2021 was really we started to take off. In 2022, we brought on a brand new chairman and investor in Stavros G. Vizirgianakis. Stavros had been with Misonix, and Misonix had really gone through the roof, and he had done really great things.
Happily, he saw what we had done by way of turning the business around, and he thought, "This is a great time to invest in the business." And so he has been a godsend in many, many ways. And so happily, we have a fellow investor, for those of you who are looking to invest in the business, who's right alongside you helping manage the business. And then the other part, when we start looking at what took place in 2023, 2023 was really a transformative year for us. Not only did we, you know, acquire three separate businesses, it helped us almost double in size. But more importantly, when you look at what we were doing operationally today, operationally, we've never been clicking at a faster beat.
From an organic growth perspective, we grew mid-single digits, or we've been growing throughout every quarter this past year. And so the other big thing is that and something from our perspective, as we look at 2024 and beyond, 2023 was the starting point of what I call the transformation of Xtant. Well, 2024 is when we become self-sustaining, where we won't need other people's products, where we won't need, hopefully one day, other people's cash. And so this is part of where we as a business look at us as we become cash flow positive.
When you look at the team that I was blessed with, quite frankly, a group of guys that really not only were either from the industry, a guy like Kevin Brandt, our Chief Commercial Officer, who spent over 35 years in the industry, to guys like Scott here, who works tireless hours in helping us make sure financially we are able to get through a lot of these really complex transactions. And then, of course, Mark Schallenberger, who has been a person who has literally helped us transform everything that we're producing, so much so that when you start to see the profit by which we will be producing in the years to come because of the new products we can do, you'll see that he has been a real godsend to this company.
When you think about where we've been, so from 2020 through COVID into 2021, modest growth, but again, this is a business that was losing over 20% a year prior to us getting there. And in 2021, we grew for the first time. 2022, we had had a great year, but we didn't have enough people. We were running only about 50% -60% of the people that we needed in the operation. So by 2024 or 2023, had the people in place, we had the plant rocking, we actually expanded our capacity. So we had organic growth. Even through third quarter of this past year, we have not announced our fourth quarter yet. That'll be coming here in the next week or so, two weeks. But again, mid-double-digit organic growth. All of that was really what we were doing on the biologic side.
So everything that we're doing is really going in the right direction when you look at, again, transforming Xtant. So the big thing that I, as I mentioned earlier, that I would love for you to walk away with when you think about us and us as an investment is what have we created in way of how do we build this business to be something very substantial? And so when you think about our growth platform, our growth platform is one of over 450 IDNs in every major GPO. So we've got over 90% of the beds in America covered in way of contract access. Two, over 650 independent agents that work for us today. A typical independent agent has four to six different people that work for them.
We've got an expanding biologics production capabilities, and I'll talk about that a little bit later in a slide or two. But this is really, really important for us because the tissue bank that we run is the starting point for a lot of big things that we can do in the years to come. The managed care capabilities that we picked up in our acquisition of Coflex, this is something that will serve us well in the years ahead. The international distribution business that we picked up, or at least the distribution network that we put and the organization in Europe today that we decided to bet on, and it's going to turn out to be a very good bet for us, as part of the SurgeLine acquisition.
And then last but not least, also within that SurgeLine acquisition and the coflex acquisition, we picked up a number of motion preservation assets that are really, really interesting, that are ones that, quite frankly, I think that will continue to help us differentiate who we are in the years ahead. Now, when you look at the global spine market in the orthobiologics world, it's about a $10 billion market. Again, what's nice about this is the fact that a year ago, I would say, "Don't worry about the international market. Just worry about the U.S.
market." Today, I can sit here and say, "No, we have a hand in a way to go after the entire market across the globe." When we look at specifically the biologics market, one of the big things that we were able to do or able to at least add back in 2021 was three new product categories. Before, all we did was the allograft and the demineralized bone is all we really sold as a biologics business. So in 2021, we added stem cells or viable bone matrix, a synthetic, as well as we also added, last but not least, a growth factor product. And so we're now able and we're one of the few companies that a spine surgeon can go to that has everything that they might need in how they treat a patient.
So when you think about our expanding biologics capabilities, where today I can't even say today because it's changed, where a year ago, all we were making was the allograft, and we were only making demineralized bone. Now, as of actually this month, we'll be doing amnio. We already do synthetics because we bought that through the Nanoss acquisition. And then we'll have both the stem cell or Viable Bone Matrix in the third quarter or thereabouts, second half of the year, and the same thing with growth factor. So these are products that today we were buying and getting 55%-60% margins. Today, now, or at least as we manufacture, we're looking at things in the high 80s to mid 90s in way of margin.
So the margin improvement and the profile for our business is going to change fairly dramatically in the next 12-24 months. And then when you think about our growth strategy, our growth strategy, and this is a slide that we've had since really 2020, this is what my team said. They said, "This is how we're going to grow. We're going to grow both organically with the first three pillars and inorganically in the fourth pillar." So organically, you got to roll out new products. If you don't if you don't have new products going on, you're not a healthy business. And so this is something, at least from our perspective, we're going to put a lot of time and energy into continuing to roll out new products. Two, you got to continue to expand your distribution access and footprint.
So I'll talk a little bit about what that means. And then three, leveraging the adjacent markets. What that is for us is that because we run a tissue bank, there are markets that we touch today where we make products that can be used in other markets. And so this is really our OEM opportunity that we have. And then last but not least, the inorganic pillar, which is really the M&A. And M&A is something that, again, when you think about the platform we've created and the opportunities that we give other companies that may be subscale or are capital constrained, we give them a really terrific exit. So I'll get into each one of these right now.
So when we think about our first the new growth initiative, we have both on the orthobiologics side as well as on the spinal fixation side, we got a number of big things that are happening. One, on the orthobiologics, we're going to be upgrading many of the versions of the products that we've had that have been very, very good, but we're making them actually better. And then second big areas, we're going to look to expand into natural areas for the tissue bank. So there's some areas, like for instance, amnio. Amnio is an area today that's used a little bit in spine, but it's used a lot in other markets. And so we, as an OEM supplier, can actually supply this and actually do very well financially.
And then improve existing offerings of things that we sell today by us making them ourselves and making our own formulas, things like our viable bone matrix, even our growth factor, and even synthetics. All of these are things that we're looking to improve, take things to the next level. And then on the spinal hardware side, again, continue to focus where possible on delivering great solutions for the out-of-hospital ambulatory surgery center world and outpatient clinics, things that really make sense, like our Coflex. We're going to really, really focus a lot on that, focus a lot on some of the other products that we acquired through our Paradigm acquisition, which is part of the SurgeLine acquisition in Europe.
They've got 3 motion preservation systems there today that are absolutely outstanding, that we're going to start making the work or doing the work to bring them here to the United States. So when we think about pillar number 2, expanding our distribution network, contract access is everything. You know, over the course of the last year or a year ago, when I would have given this slide, we would have had about 385 IDN agreements, which, again, very, very good for a subscale company like we were. Today, 450+ with all the major GPOs, we're getting the access that our distributors need. And quite frankly, it's the kind of thing that starts to put a moat around why your distributors won't leave you, right? Those are the things that make it hard for them to leave.
And then step two is building that national distribution network. We have an open distribution model. It's actually something that works really, really well for us. It's something that, at least from our perspective, it allows other companies to pull some of the unique products that we have, like our growth factor product or our Coflex product. And they may be selling for another big company, but they don't have that solution like we do. And so we'll continue to have those offerings, and those will be things that will help us expand our distribution even further. And then when we think about pillar three, this is our OEM opportunity.
This is where we actually take the products we make in our factory today and start selling them into other segments, such as sports medicine, what we do with our tendons, or such as what we do with our amnio products that could go into the wound care world. So there's a lot of different areas that we can touch, but we don't necessarily have to hire a distribution you know group or anything like that. We can actually be somebody who can service those markets and do actually financially very well in them. Our pillar four, as I mentioned before, this is where we really are focusing in on the inorganic, or how do we become that integrator of enabling technologies.
When you look at the number of companies that are out there today that are subscale, that are cash constrained, that their growth projections and exit projections are looking dimmer and dimmer, quite frankly. But coming on with a company like ours, we can take them, put them in with our 650 distributors and our 450 IDN agreements. We can take technologies that are subscale today and really add a lot to our own offering. So when we, again, thinking about what we're looking at or what we're targeting, the pipeline we have today is actually very, very good. And the things that we're trying to find are those companies that give us either greater capabilities, greater capacity, and always, because this is something that's very important to us as a business, is something that's going to help us with the cash flows and profitability, if you will.
So again, it's almost like the three C's: capabilities, capacities, and cash flows. Those are the things we're looking for when we think about targeted acquisitions. So in summary, I think that you're looking at a company that's positioned for sustainable long-term growth. You know, we're a business that's strategically we are absolutely leaning forward. The platform we've created is one that I think is not only something we can build on, but one that we can start snapping or adding on other partners and other technologies. I think that when you look at the chairman and our board, we're very, very well aligned with the interests of our you know, our investors, right? So you have people that are on our board today that have real money in our in the game.
Then operationally, you know, one of the things I think I'm most proud of is the fact that over the course of the last four years, we've been able to really operationally tighten down and start building our own to make the operation itself significantly more profitable. I think that when you look at financially, 50%+ you know growth in way of revenue, organically, again, mid double digits. When you think the fact that we are cash flow positive and we have a clean balance sheet, I think we've got a pretty compelling profile for future investors. So with that said, I've got a few minutes here. Can I answer any questions? Okay. I'll take that silence. It's my time to go. Thank you for coming. If you have any questions, I'll be up here in the front.