United States securities and exchange commission logo





                              August 3, 2021

       Jonathon M. Singer
       Chief Financial and Operating Officer
       Surgalign Holdings, Inc.
       520 Lake Cook Road , Suite 315
       Deerfield, Illinois 60015

                                                        Re: Surgalign Holdings,
Inc.
                                                            Form 10-K for the
Fiscal Year Ended December 31, 2020
                                                            Filed March 16,
2021
                                                            Form 10-Q for the
Quarterly Period Ended March 31, 2021
                                                            Filed May 10, 2021
                                                            File No. 001-38832

       Dear Mr. Singer:

              We have limited our review of your filing to the financial
statements and related
       disclosures and have the following comments. In some of our comments, we
may ask you to
       provide us with information so we may better understand your disclosure.

              Please respond to these comments within ten business days by
providing the requested
       information or advise us as soon as possible when you will respond. If
you do not believe our
       comments apply to your facts and circumstances, please tell us why in
your response.

                                                        After reviewing your
response to these comments, we may have additional comments.

       Form 10-K for the Fiscal Year Ended December 31, 2020

       Management's Discussion and Analysis of Financial Condition and Results
of Operations
       Results of Operations
       2020 Compared to 2019
       Costs of Goods Sold , page 38

   1.                                                   We note that you
present costs of goods sold adjusted for the impact of one-time purchase
                                                        accounting step-up and
inventory write-offs. Please note that this disclosure creates a non-
                                                        GAAP measure under Item
10(e) of Regulation S-K. Accordingly, please revise future
                                                        filings to provide the
disclosures required by Item 10(e) of Regulation S- K or revise the
                                                        discussion to avoid
presentation of the non-GAAP measure, costs of goods sold adjusted
                                                        for the impact of
one-time purchase accounting step-up and inventory write-offs.
 Jonathon M. Singer
FirstName   LastNameJonathon M. Singer
Surgalign Holdings, Inc.
Comapany
August      NameSurgalign Holdings, Inc.
        3, 2021
August
Page 2 3, 2021 Page 2
FirstName LastName
Non-GAAP Financial Measures , page 41

2.       Please tell us and revise future filings to explain your basis for
including the net change in
         your valuation allowance in your adjusted net loss. Refer to
Compliance and Disclosure
         Interpretation 100.04.
Exhibits and Financial Statement Schedules, page 54

3.       The consent of Deloitte & Touche LLP included in Exhibit 23.1 refers
to RTI Surgical
         Holdings, Inc. Please amend your filing to have Deloitte & Touche LLP
provide a
         consent that refers to the correct registrant.
2. Summary of Significant Accounting Policies
Inventories, page 71

4.       You state that inventories are stated at the lower of cost or market,
with cost determined
         using the first-in, first-out method. Please tell us why you believe
your accounting policy
         is consistent with ASC 330-10-35-1B.
Notes to the Consolidated Financial Statements
6. Revenue from Contracts with Customers
Disaggregation of Revenue, page 78

5.       Please tell us why disclosure of revenues by each product or group of
similar products is
         not required to be disclosed pursuant to ASC 280-10-50-40. In this
respect, we note on
         page 33 that you estimate that your current portfolio addresses nearly
87% of all surgeries
         utilizing spinal hard implants and approximately 70% of the
biomaterials used in spine-
         related uses.
9. Holo Surgical Acquisition, page 82

6.       We note that you have accounted for the Holo Surgical transaction as
an asset acquisition.
         Please address the following:
             Tell us why your accounting treatment for contingent consideration
in the Holo
             Surgical asset acquisition is appropriate. In this regard, please
address if the
             contingent consideration is a derivative under ASC 815, including
a thorough
             analysis thereof. If the contingent consideration is not a
derivative, please tell us why
             accounting under ASC 450 is not appropriate.
             You include Holo Surgical in your disclosure on page 70 as a
wholly-owned
             subsidiary. Please tell us why that disclosure is appropriate if
the acquisition has been
             accounted for as an asset acquisition.
 Jonathon M. Singer
Surgalign Holdings, Inc.
August 3, 2021
Page 3
Form 10-Q for the Quarterly Period Ended March 31, 2021

Item 6 - Exhibits, page 33

7.       We note that your Section 906 certifications refer to RTI Surgical
Holdings, Inc. Please
         amend the filing to provide corrected Section 906 certifications that
refer to the correct
         registrant.
       In closing, we remind you that the company and its management are
responsible for the
accuracy and adequacy of their disclosures, notwithstanding any review,
comments, action or
absence of action by the staff.

      Please contact Eric Atallah at (202) 551-3663 or Mary Mast, Senior
Accountant, at (202)
551-3613 with any questions.



FirstName LastNameJonathon M. Singer                           Sincerely,
Comapany NameSurgalign Holdings, Inc.
                                                               Division of
Corporation Finance
August 3, 2021 Page 3                                          Office of Life
Sciences
FirstName LastName