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_______________________________________________________

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

_____________________________

FORM 10-Q

[X] Quarterly Report Pursuant to Section 13 or 15(d) of
the Securities Exchange Act of 1934
For the quarterly period ended September 30, 2004
OR
[ ] Transition Report Pursuant to Section 13 or 15(d) of
the Securities and Exchange Act of 1934
For the transition period from
______ to ______


Commission File Number: 0-22392


Prime Medical Services, Inc.
(Exact name of registrant as specified in its charter)


  DELAWARE     74-2652727
  (State or other jurisdiction
of incorporation or organization)
    (IRS Employer
Identification No.)



1301 Capitol of Texas Highway, Suite 200B, Austin, Texas 78746
           (Address of principal executive offices)                (Zip Code)

(512) 328-2892
(Registrant’s telephone number, including area code)

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.

YES   X  NO     


Indicate by check mark whether the registrant is an accelerated filer (as described in Rule 12b-2 of the Exchange Act).

YES   X  NO     

Indicate the number of shares outstanding of each of the issuer's classes of common stock, as of the latest practicable date.


 
Title of Each Class
     Common Stock, $.01 par value
  Number of Shares Outstanding at
November 1, 2004

20,705,335








PART I

ITEM 1 — FINANCIAL INFORMATION












-2-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)

  Three Months Ended
September 30,
Nine Months Ended
September 30,
($ in thousands, except per share data)

2004
2003
2004
2003
Revenue:                    
     Urology   $ 20,003   $ 15,658   $ 55,989   $ 45,756  
     Manufacturing    26,192    23,641    80,462    70,780  
     Other    237    260    712    785  




         Total revenue    46,432    39,559    137,163    117,321  




Cost of services and general and  
     administrative expenses:  
     Urology    9,155    5,963    24,861    18,974  
     Manufacturing    24,076    22,503    73,287    64,923  
     Corporate    700    901    2,724    2,341  
     Depreciation and amortization    1,837    1,759    5,303    5,410  




     35,768    31,126    106,175    91,648  




Operating income    10,664    8,433    30,988    25,673  
 
Other income (expenses):  
     Interest and dividends    58    43    207    264  
     Interest expense    (2,380 )  (2,338 )  (7,033 )  (6,875 )
     Loan fees    --    (257 )  --    (257 )
     Other, net    76    203    44    (55 )




     (2,246 )  (2,349 )  (6,782 )  (6,923 )




Income before provision for income  
     taxes and minority interests    8,418    6,084    24,206    18,750  
 
Minority interest in consolidated income    6,592    4,910    16,856    12,803  
 
Provision for income taxes    584    399    2,605    2,022  




Net income   $ 1,242   $ 775   $ 4,745   $ 3,925  




Basic earnings per share:  
     Net income   $ 0.06   $ 0.05   $ 0.24   $ 0.23  




     Weighted average shares outstanding    20,680    17,145    20,012    17,182  




Diluted earnings per share:  
     Net income   $ 0.06   $ 0.04   $ 0.23   $ 0.23  




     Weighted average shares outstanding    21,013    17,366    20,282    17,387  





See accompanying notes to consolidated financial statements.


-3-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS



($ in thousands)


September 30,
2004
(Unaudited)

December 31,
2003
(Audited)

ASSETS            
 
Current assets:  
     Cash and cash equivalents   $ 6,385   $ 9,780  
     Accounts receivable, less allowance for doubtful  
        accounts of $444 in 2004 and $512 in 2003    24,456    27,245  
     Other receivables    731    795  
     Deferred income taxes    13,021    8,385  
     Prepaid expenses and other current assets    2,328    1,617  
     Inventory    30,506    21,288  


        Total current assets    77,427    69,110  


Property and equipment:  
     Equipment, furniture and fixtures    42,104    40,161  
     Building and leasehold improvements    12,188    11,235  


     54,292    51,396  
     Less accumulated depreciation and amortization    (26,776 )  (27,440 )


        Property and equipment, net    27,516    23,956  


 
Other investments    2,916    3,088  
Goodwill, at cost    185,882    177,974  
Other noncurrent assets    6,841    5,840  


    $ 300,582   $ 279,968  




See accompanying notes to consolidated financial statements.



-4-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS (continued)



($ in thousands, except share data)


September 30,
2004
(Unaudited)

December 31,
2003
(Audited)

LIABILITIES            
 
Current liabilities:  
     Current portion of long-term debt   $ 3,397   $ 3,345  
     Accounts payable    9,362    8,617  
     Accrued distributions to minority interests    --    6,908  
     Accrued expenses    13,728    10,137  
     Customer deposits    6,904    6,259  


         Total current liabilities    33,391    35,266  
 
Long-term debt, net of current portion    107,040    111,728  
Other long term obligations    1,279    1,397  
Deferred income taxes    21,003    17,889  


         Total liabilities    162,713    166,280  
 
Minority interest    9,076    7,077  
 
STOCKHOLDERS' EQUITY  
 
Preferred stock, $.01 par value; 1,000,000 shares authorized; none outstanding    --    --  
Common stock, $0.01 par value; 40,000,000 shares authorized; 21,078,633 shares issued  
      in 2004 and 17,324,585 issued in 2003; and 20,695,667 outstanding in 2004 and    211    173  
     17,081,869 outstanding in 2003  
Capital in excess of par value    88,916    70,813  
Accumulated earnings    41,584    36,839  
Treasury stock, at cost, 382,966 shares in 2004 and 242,716 shares in 2003    (1,918 )  (1,214 )


         Total stockholders' equity    128,793    106,611  


    $ 300,582   $ 279,968  




See accompanying notes to consolidated financial statements.



-5-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)

  Nine Months Ended September 30,
($ in thousands)

2004
2003
CASH FLOWS FROM OPERATING ACTIVITIES:            
     Fee and other revenue collected   $ 143,092   $ 120,355  
     Cash paid to employees, suppliers of goods and others    (114,133 )  (92,421 )
     Interest received    207    264  
     Interest paid    (4,991 )  (3,397 )
     Taxes refunded    794    8  


         Net cash provided by operating activities    24,969    24,809  


CASH FLOWS FROM INVESTING ACTIVITIES:  
     Purchase of entities, net of cash acquired    3,155    (12,513 )
     Escrow deposits    513    (1,742 )
     Purchases of equipment and leasehold improvements    (6,403 )  (5,128 )
     Distributions from investments    232    274  
     Proceeds from sales of equipment    568    243  


         Net cash used in investing activities    (1,935 )  (18,866 )


CASH FLOWS FROM FINANCING ACTIVITIES:  
     Borrowings on notes payable    1,491    19,572  
     Payments on notes payable, exclusive of interest    (5,776 )  (14,148 )
     Distributions to minority interest    (22,509 )  (21,346 )
     Contributions by minority interest, net of buyouts    153    (280 )
     Purchase of treasury stock    --    (1,214 )
     Exercise of stock options    212    --  


         Net cash used in financing activities    (26,429 )  (17,416 )


NET DECREASE IN CASH AND CASH EQUIVALENTS    (3,395 )  (11,473 )
 
Cash and cash equivalents, beginning of period    9,780    20,174  


Cash and cash equivalents, end of period   $ 6,385   $ 8,701  




See accompanying notes to consolidated financial statements.




-6-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS (continued)
(Unaudited)

  Nine Months Ended September 30,
($ in thousands)

2004
2003
Reconciliation of net income to net cash provided by operating activities:            
     Net income   $ 4,745   $ 3,925  
     Adjustments to reconcile net income to net cash provided by operating activities:  
         Minority interest in consolidated income    16,856    12,803  
         Depreciation and amortization    5,303    5,410  
         Provision for uncollectible accounts    (97 )  218  
         Provision for deferred income taxes    1,741    4,667  
         Stock buyback agreements    (816 )  850  
         Equity in earnings of affiliates    (60 )  (48 )
         Proceeds from termination of interest rate swap    --    1,151  
         Other    (418 )  356  
 
     Changes in operating assets and liabilities, net of effect of purchase transactions:  
         Accounts receivable    5,515    1,946  
         Other receivables    (217 )  2,285  
         Other assets    (6,320 )  (2,961 )
         Accounts payable    (1,630 )  (4,028 )
         Accrued expenses    367    (1,765 )


     Total adjustments    20,224    20,884  


Net cash provided by operating activities   $ 24,969   $ 24,809  




See accompanying notes to consolidated financial statements.




-7-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
SEPTEMBER 30, 2004
(Unaudited)


1. General

The accompanying unaudited consolidated financial statements have been prepared in conformity with the accounting principles for interim financial statements and with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. These consolidated financial statements reflect all adjustments which are, in our opinion, necessary for a fair presentation of the statement of the financial position as of September 30, 2004 and the results of operations and cash flows for the periods presented. These statements have not been audited by our independent registered public accounting firm. The operating results for the interim periods are not necessarily indicative of results for the full fiscal year.


The notes to consolidated financial statements appearing in our Annual Report on Form 10-K for the year ended December 31, 2003 filed with the Securities and Exchange Commission should be read in conjunction with this Quarterly Report on Form 10-Q. There have been no significant changes in the information reported in those notes other than from normal business activities and as discussed herein.


On June 11, 2004, we executed a definitive Agreement and Plan of Merger with HealthTronics Surgical Services, Inc. (HealthTronics) pursuant to which we will, if all closing conditions are met (including approval of the merger by our stockholders and HealthTronics shareholders), merge with and into HealthTronics, with HealthTronics as the surviving corporation. Under the terms of that agreement, as a result of the merger, our stockholders will receive one share of HealthTronics common stock for each share of our common stock. Because our stockholders will own approximately 62% of the shares of HealthTronics common stock after the merger, and because our directors and senior management will represent a majority of the combined company’s directors and senior management, we will be deemed to be the acquiring company for accounting purposes and the merger will be accounted for as a reverse acquisition under the purchase method of accounting for business combinations in accordance with accounting principles generally accepted in the United States. The consideration paid (purchase price) will be allocated to the tangible and intangible net assets of HealthTronics based on their fair values, and the net assets of HealthTronics will be recorded at fair values as of the completion of the merger and added to those of Prime. The assets acquired and liabilities assumed will be deemed to be those of HealthTronics because HealthTronics will be the surviving legal entity.


2. Earnings per share

Basic earnings per share (“EPS”) is based on weighted average shares outstanding without any dilutive effects considered. Diluted EPS reflects dilution from all contingently issuable shares, including options and warrants. A reconciliation of such EPS data is as follows:




-8-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
SEPTEMBER 30, 2004 (continued)
(Unaudited)


2. Earnings per share (continued)



($ in thousands, except per share data)
Basic
earnings
per share
Diluted
earnings
per share
           
Nine Months Ended September 30, 2004            
           
Net income   $ 4,745   $ 4,745  


Weighted average shares outstanding    20,012    20,012  
Effect of dilutive securities    --    270  


     Shares for EPS calculation    20,012    20,282  


Net income per share   $ 0.24   $ 0.23  


           
Nine Months Ended September 30, 2003            
           
Net income   $ 3,925   $ 3,925  


Weighted average shares outstanding    17,182    17,182  
Effect of dilutive securities    --    205  


     Shares for EPS calculation    17,182    17,387  


Net income per share   $ 0.23   $ 0.23  


Three Months Ended September 30, 2004  
           
Net income   $ 1,242 $ 1,242


Weighted average shares outstanding    20,680    20,680  
Effect of dilutive securities    --    333  


     Shares for EPS calculation    20,680    21,013  


Net income per share   $ 0.06 $ 0.06


Three Months Ended September 30, 2003  
           
Net income   $ 775 $ 775


Weighted average shares outstanding    17,145    17,145  
Effect of dilutive securities    --    221  


     Shares for EPS calculation    17,145    17,366  


Net income per share   $ 0.05 $ 0.04




-9-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
SEPTEMBER 30, 2004 (continued)
(Unaudited)


2. Earnings per share (continued)

We did not include in our computation of diluted EPS unexercised stock options and warrants to purchase 1,625,000 and 3,050,000 shares of our common stock as of September 30, 2004 and 2003, respectively, because the effect would be antidilutive.


3. Segment Reporting

We have two reportable segments: urology and manufacturing. The urology segment provides services related to the operation of the lithotripters, including scheduling, staffing, training, quality assurance, maintenance, regulatory compliance and contracting with payors, hospitals and surgery centers. The manufacturing segment provides manufacturing services and installation, upgrade, refurbishment and repair of major medical equipment for mobile medical service providers and the mobile broadcast and communication industry.


We measure performance based on the pretax income or loss from our operating segments, which does not include unallocated corporate general and administrative expenses and corporate interest revenue and expense.




($ in thousands) Urology Manufacturing
               
Nine Months Ended                
    September 30, 2004  
Revenue from  
external customers   $ 55,989   $80,462      
Intersegment revenues    --    --      
Segment profit    10,044    6,308      
               
Nine Months Ended  
    September 30, 2003  
Revenue from  
external customers   $ 45,756   $ 70,780    
Intersegment revenues    --    603      
Segment profit    9,775    5,039      


-10-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
SEPTEMBER 30, 2004 (continued)
(Unaudited)

3. Segment Reporting (continued)


The following is a reconciliation of the measure of segment profit per above to consolidated income before provision for income taxes per the consolidated statements of operations:


($ in thousands) Nine Months Ended September 30,
2004                           2003
       
Total segment profit     $16,352   $ 14,814  
Corporate revenues    712    785  
Unallocated corporate expenses:  
    General and administrative    (2,724 )  (2,341 )
    Net interest expense    (6,574 )  (6,299 )
    Loan Fees    --  (257 )
    Other, net    (416 )  (755 )


Total unallocated corporate expenses    (9,714 )  (9,652 )


Income before income taxes   $ 7,350   $5,947



($ in thousands) Urology Manufacturing
               
Three Months Ended                
    September 30, 2004  
Revenue from  
external customers   $ 20,003   $26,192      
Intersegment revenues    --    --      
Segment profit    2,849    1,842      
               
Three Months Ended  
    September 30, 2003  
Revenue from  
external customers   $15,658   $23,641    
Intersegment revenues    --    --      
Segment profit    3,756    840      


-11-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
SEPTEMBER 30, 2004 (continued)
(Unaudited)

3. Segment Reporting (continued)


The following is a reconciliation of the measure of segment profit per above to consolidated income before provision for income taxes per the consolidated statements of operations:


($ in thousands) Three Months Ended September 30,
2004                           2003
       
Total segment profit     $ 4,691   $ 4,596  
Corporate revenues    237    260  
Unallocated corporate expenses:  
    General and administrative    (700 )  (901 )
    Net interest expense    (2,247 )  (2,165 )
    Loan fees    --  (257 )
    Other, net    (155 )  (359 )


Total unallocated corporate expenses    (3,102 )  (3,682 )


Income before income taxes   $ 1,826   $1,174



4. Stock-Based Compensation

Upon adoption of Statement of Financial Accounting Standards No. 123, Accounting for Stock-Based Compensation (“Statement 123”), in 1996, we have continued to measure compensation expense for our stock-based employee compensation plans using the intrinsic value method prescribed by APB Opinion No. 25, Accounting for Stock Issued to Employees. We have provided proforma disclosures of net income and earnings per share as if the fair value-based method prescribed by Statement 123 had been applied in measuring compensation expense.


For purposes of proforma disclosures, the estimated fair value of the options is amortized to expense over the options’ vesting period. Our proforma information follows (in thousands except for earnings per share information):


  Three Months Ended
September 30,
Nine Months Ended
September 30,
2004
2003
2004
2003
Net income, as reported     $ 1,242   $ 775   $ 4,745   $ 3,925  
Stock-based employee compensation  
   expense, net of tax

    282
   275
   866
   1,046
 
Pro forma net income

   $

960
  $

500
  $

3,879
  $

2,879
 
Pro forma earning per share:  
     Basic   $ 0.05   $ 0.03   $ 0.19   $ 0.17  
     Diluted   $ 0.05   $ 0.03   $ 0.19   $ 0.17  


-12-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
SEPTEMBER 30, 2004 (continued)
(Unaudited)



5. Acquisitions

Effective February 20, 2004, we acquired Medstone International, Inc. (“Medstone”). Medstone manufactures, sells, and maintains lithotripters and makes them available for use by health care providers under various fee-for-service arrangements in both fixed and mobile settings. Medstone and its subsidiaries also market fixed and mobile tables for urological treatments and imaging, patient handling tables for use by pain management clinics and other users, and x-ray generators for medical imaging. A pioneer in the manufacture of shockwave lithotripsy, Medstone’s lithotripter was the first FDA approved device to treat both kidney stones and gallstones. With more than 130 lithotripters in operation worldwide, and more than 324 urology and patient handling tables in use, the Medstone devices are well established in the urology office and hospital market. The aggregate purchase price was approximately $19 million of our common stock for all outstanding shares of Medstone. We determined the value of our common stock by using an average closing price for the two trading days prior to and after the public announcement of the merger. Approximately 3.6 million shares were issued. We recognized $6 million of goodwill related to this transaction, none of which is tax deductible. We recognized approximately $1 million of intangibles, which are being amortized over three years. Medstone had total assets with an estimated fair value of $20.5 million and total liabilities with an estimated fair value of $7.2 million as of the purchase date.


6. Condensed Financial Information Regarding Guarantor Subsidiaries

Condensed consolidating financial information for us, our Guarantor Subsidiaries and our Non-guarantor Subsidiaries for September 30, 2004 and 2003 is presented below for purposes of complying with the reporting requirements of the Guarantor Subsidiaries. The Guarantor Subsidiaries are wholly owned subsidiaries of ours that have fully, unconditionally, jointly and severally guaranteed our 8.75% unsecured senior subordinated notes.




-13-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Condensed Consolidating Statement of Operations
Nine Months Ended September 30, 2004
(Unaudited)


($ in thousands)


Prime Medical
Services, Inc.

Guarantor
Subsidiaries

Non-Guarantor
Subsidiaries

Eliminating
Entries

Consolidated
Total

Revenue:                        
     Urology   $ 7,625   $ 19,621   $ 42,617   $ (13,874 ) $55,989  
     Manufacturing    6,181    80,462    --    (6,181 )  80,462  
     Other    --    712    --    --    712  





         Total revenue    13,806    100,795    42,617    (20,055 )  137,163  





Cost of services and general and  
     administrative expenses:  
         Urology    --    8,454    16,407    --    24,861  
         Manufacturing    --    73,287    --    --    73,287  
         Corporate    160    2,564    --    --    2,724  
         Depreciation and amortization    --    2,466    2,837    --    5,303  





     160    86,771    19,244    --    106,175  





Operating income    13,646    14,024    23,373    (20,055 )  30,988  





Other income (expenses):  
     Interest and dividends    66    119    22    --    207  
     Interest expense    (6,525 )  (279 )  (229 )  --    (7,033 )
     Other, net    22    68    (46 )  --    44  





         Total other income (expenses)    (6,437 )  (92 )  (253 )  --    (6,782 )





Income before provision for income  
     taxes and minority interest    7,209    13,932    23,120    (20,055 )  24,206  
Minority interest in consolidated income    --    --    --    16,856    16,856  
Provision for income taxes    2,464    126    15    --    2,605  





Net income   $ 4,745   $ 13,806   $ 23,105   $ (36,911 ) $ 4,745  








-14-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Condensed Consolidating Statement of Operations
Nine Months Ended September 30, 2003
(Unaudited)


($ in thousands)


Prime Medical
Services, Inc.

Guarantor
Subsidiaries

Non-Guarantor
Subsidiaries

Eliminating
Entries

Consolidated
Total

Revenue:                        
     Urology   $ 7,200   $ 11,893   $ 38,756   $ (12,093 ) $45,756  
     Manufacturing    5,039    70,780    --    (5,039 )  70,780  
     Other    --    785    --    --    785  





         Total revenue    12,239    83,458    38,756    (17,132 )  117,321  





Cost of services and general and  
     administrative expenses:  
         Urology    --    1,740    17,234    --    18,974  
         Manufacturing    --    64,923    --    --    64,923  
         Corporate    73    2,268    --    --    2,341  
         Depreciation and amortization    --    2,153    3,257    --    5,410  





     73    71,084    20,491    --    91,648  





Operating income    12,166    12,374    18,265    (17,132 )  25,673  





Other income (expenses):  
     Interest and dividends    53    189    22    --    264  
     Interest expense    (6,285 )  (353 )  (237 )  --    (6,875 )
     Loan fees    (257 )  --    --    --    (257 )
     Other, net    --    299    (354 )  --    (55 )





         Total other income (expenses)    (6,489 )  135    (569 )  --    (6,923 )





Income before provision for income  
     taxes and minority interest    5,677    12,509    17,696    (17,132 )  18,750  
Minority interest in consolidated income    --    --    --    12,803    12,803  
Provision for income taxes    1,752    270    --    --    2,022  





Net income   $ 3,925   $ 12,239   $ 17,696   $ (29,935 ) $ 3,925  







-15-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Condensed Consolidating Statement of Operations
Three Months Ended September 30, 2004
(Unaudited)


($ in thousands)


Prime Medical
Services, Inc.

Guarantor
Subsidiaries

Non-Guarantor
Subsidiaries

Eliminating
Entries

Consolidated
Total

Revenue:                        
     Urology   $ 2,283   $ 6,854   $ 15,218   $ (4,352 ) $20,003  
     Manufacturing    1,842    26,192    --    (1,842 )  26,192  
     Other    --    237    --    --    237  





         Total revenue    4,125    33,283    15,218    (6,194 )  46,432  





Cost of services and general and  
     administrative expenses:  
         Urology    --    3,615    5,540    --    9,155  
         Manufacturing    --    24,076    --    --    24,076  
         Corporate    118    582    --    --    700  
         Depreciation and amortization    --    899    938    --    1,837  





     118    29,172    6,478    --    35,768  





Operating income    4,007    4,111    8,740    (6,194 )  10,664  





Other income (expenses):  
     Interest and dividends    10    40    8    --    58  
     Interest expense    (2,206 )  (97 )  (77 )  --    (2,380 )
     Other, net    1    70    5    --    76  





         Total other income (expenses)    (2,195 )  13    (64 )  --    (2,246 )





Income before provision for income  
     taxes and minority interest    1,812    4,124    8,676    (6,194 )  8,418  
Minority interest in consolidated income    --    --    --    6,592    6,592  
Provision for income taxes    570    (1 )  15    --    584  





Net income   $ 1,242   $ 4,125   $ 8,661   $ (12,786 ) $ 1,242  







-16-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Condensed Consolidating Statement of Operations
Three Months Ended September 30, 2003
(Unaudited)


($ in thousands)


Prime Medical
Services, Inc.

Guarantor
Subsidiaries

Non-Guarantor
Subsidiaries

Eliminating
Entries

Consolidated
Total

Revenue:                        
     Urology   $ 2,686   $ 4,126   $ 13,603   $ (4,757 ) $15,658  
     Manufacturing    840    23,641    --    (840 )  23,641  
     Other    --    260    --    --    260  





         Total revenue    3,526    28,027    13,603    (5,597 )  39,559  





Cost of services and general and  
     administrative expenses:  
         Urology    --    562    5,401    --    5,963  
         Manufacturing    --    22,503    --    --    22,503  
         Corporate    20    881    --    --    901  
         Depreciation and amortization    --    732    1,027    --    1,759  





     20    24,678    6,428    --    31,126  





Operating income    3,506    3,349    7,175    (5,597 )  8,433  





Other income (expenses):  
     Interest and dividends    --    35    8    --    43  
     Interest expense    (2,155 )  (92 )  (91 )  --    (2,338 )
     Loan fees    (257 )  --    --    --    (257 )
     Other, net    --    314    (111 )  --    203  





         Total other income (expenses)    (2,412 )  257    (194 )  --    (2,349 )





Income before provision for income  
     taxes and minority interest    1,094    3,606    6,981    (5,597 )  6,084  
Minority interest in consolidated income    --    --    --    4,910    4,910  
Provision for income taxes    319    80    --    --    399  





Net income   $ 775   $ 3,526   $ 6,981   $ (10,507 ) $ 775  







-17-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Condensed Consolidating Balance Sheet
September 30, 2004
(Unaudited)


($ in thousands)


Prime Medical
Services, Inc.

Guarantor
Subsidiaries

Non-Guarantor
Subsidiaries

Eliminating
Entries

Consolidated
Total

ASSETS                        
Current assets:  
     Cash and cash equivalents   $ 30   $ 3,582   $ 2,773   $ --   $ 6,385  
     Accounts receivable, net    --    15,845    8,611    --    24,456  
     Other receivables    --    2,783    (2,052 )  --    731  
     Deferred income taxes    2,061    10,960    --    --    13,021  
     Prepaid expenses and other current assets    15    2,190    123    --    2,328  
     Inventory    --    30,506    --    --    30,506  





         Total current assets    2,106    65,866    9,455    --    77,427  





Property and equipment:  
     Equipment, furniture and fixtures    --    13,891    28,213    --    42,104  
     Building and leasehold improvements    --    12,176    12    --    12,188  





     --    26,067    28,225    --    54,292  
     Less accumulated depreciation  
         and amortization    --    (8,966 )  (17,810 )  --    (26,776 )





         Property and equipment, net    --    17,101    10,415    --    27,516  





Investment in subsidiaries  
     and other investments    251,223    7,439    --    (255,746 )  2,916  
Goodwill, net of accumulated amortization    --    185,882    --    --    185,882  
Other noncurrent assets    1,648    4,689    504    --    6,841  





    $ 254,977   $ 280,977   $ 20,374   $ (255,746 ) $ 300,582  





LIABILITIES  
Current liabilities:  
     Current portion of long-term debt   $ 188   $ 311   $ 2,898   $ --   $ 3,397  
     Accounts payable    --    9,146    216    --    9,362  
     Accrued expenses    5,748    7,278    702    --    13,728  
     Customer deposits    --    6,904    --    --    6,904  





         Total current liabilities    5,936    23,639    3,816    --    33,391  
Long-term debt, net of current portion    100,470    3,611    2,959    --    107,040  
Other long term obligations    --    1,279    --    --    1,279  
Deferred income taxes    19,778    1,225    --    --    21,003  





         Total liabilities    126,184    29,754    6,775    --    162,713  





Minority interest    --    --    --    9,076    9,076  
STOCKHOLDERS' EQUITY  
Common stock    211    --    --    --    211  
Capital in excess of par value    88,916    --    --    --    88,916  
Accumulated earnings    41,584    --    --    --    41,584  
Treasury stock    (1,918 )  --    --    --    (1,918 )
Subsidiary net equity    --    251,223    13,599    (264,822 )  --  





         Total stockholders' equity    128,793    251,223    13,599    (264,822 )  128,793  





    $ 254,977   $ 280,977   $ 20,374   $ (255,746 ) $ 300,582  








-18-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Condensed Consolidating Statement of Cash Flow
Nine Months Ended September 30, 2004
(Unaudited)



($ in thousands)


Prime Medical
Services, Inc.

Guarantor
Subsidiaries

Non-Guarantor
Subsidiaries

Eliminating
Entries

Consolidated
Total

CASH FLOWS FROM OPERATING                        
     ACTIVITIES:  
         Net cash provided by (used in)  
              operating activities   $ (8,977 ) $ 4,745   $ 29,201   $ --   $ 24,969  





CASH FLOWS FROM INVESTING  
     ACTIVITIES:  
     Purchase of equity investments and entities    --    3,155    --    --    3,155  
     Purchases of property and equipment    --    (3,733 )  (2,670 )  --    (6,403 )
     Proceeds from sales of equipment    --    514    54    --    568  
     Distributions from subsidiaries    11,232    7,760    --    (18,992 )  --  
     Distributions from investments    --    232    --    --    232  
     Escrow deposits    513    --    --    --    513  





         Net cash provided by (used in)  
              investing activities    11,745    7,928    (2,616 )  (18,992 )  (1,935 )





CASH FLOWS FROM FINANCING  
     ACTIVITIES:  
     Borrowings on notes payable    --    --    1,491    --    1,491  
     Payments on notes payable exclusive of  
         interest    (3,000 )  --    (2,776 )  --    (5,776 )
     Contributions by minority interest,  
         net of buyouts    --    --    153    --    153  
     Distributions to minority interest    --    --    --    (22,509 )  (22,509 )
     Exercise of stock options    212    --    --    --    212  
     Distributions to equity owners    --    (11,232 )  (30,269 )  41,501    --  





         Net cash provided by (used in)  
                financing activities    (2,788 )  (11,232 )  (31,401 )  18,992    (26,429 )





NET INCREASE (DECREASE) IN CASH AND  
     CASH EQUIVALENTS    (20 )  1,441    (4,816 )  --    (3,395 )
Cash and cash equivalents, beginning of period    50    2,141    7,589    --    9,780  





Cash and cash equivalents, end of period   $ 30   $ 3,582   $ 2,773   $ --   $ 6,385  







-19-



PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Condensed Consolidating Statement of Cash Flows
Nine Months Ended September 30, 2003
(Unaudited)



($ in thousands)


Prime Medical
Services, Inc.

Guarantor
Subsidiaries

Non-Guarantor
Subsidiaries

Eliminating
Entries

Consolidated
Total

CASH FLOWS FROM OPERATING                        
     ACTIVITIES:  
         Net cash provided by (used in)  
              operating activities   $ (6,997 ) $ 9,384   $ 22,422   $ --   $ 24,809  





CASH FLOWS FROM INVESTING  
     ACTIVITIES:  
     Purchase of equity investments and entities    --    (12,513 )  --    --    (12,513 )
     Purchases of property and equipment    --    (2,017 )  (3,111 )  --    (5,128 )
     Proceeds from sales of equipment    --    186    57    --    243  
     Distributions from subsidiaries    18,371    8,569    --    (26,940 )  --  
     Investments    (12,000 )  --    --    12,000    --  
     Distributions from investments    --    274    --    --    274  
     Escrow deposits    (1,742 )  --    --    --    (1,742 )





         Net cash provided by (used in)  
              investing activities    4,629    (5,501 )  (3,054 )  (14,940 )  (18,866 )





CASH FLOWS FROM FINANCING  
     ACTIVITIES:  
     Borrowings on notes payable    16,000    --    3,572    --    19,572  
     Payments on notes payable exclusive of  
         interest    (12,500 )  --    (1,648 )  --    (14,148 )
     Contributions by minority interest,  
         net of buyouts    --    --    (280 )  --    (280 )
     Distributions to minority interest    --    --    --    (21,346 )  (21,346 )
     Purchase of treasury stock    (1,214 )  --    --    --    (1,214 )
     Contributions from parent    --    12,000    --    (12,000 )  --  
     Distributions to equity owners    --    (18,371 )  (29,915 )  48,286    --  





         Net cash provided by (used in)  
                financing activities    2,286    (6,371 )  (28,271 )  14,940    (17,416 )





NET INCREASE (DECREASE) IN CASH AND  
     CASH EQUIVALENTS    (82 )  (2,488 )  (8,903 )  --    (11,473 )
Cash and cash equivalents, beginning of period    66    7,897    12,211    --    20,174  





Cash and cash equivalents, end of period   $ (16 ) $ 5,409   $ 3,308   $ --   $ 8,701  







-20-



Item 2 — Management’s Discussion and Analysis
of Financial Condition and
Results of Operations


Forward-Looking Statements

The statements contained in this report that are not purely historical are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934, including statements regarding our expectations, hopes, intentions or strategies regarding the future. You should not place undue reliance on forward-looking statements. All forward-looking statements included in this report are based on information available to us on the date hereof, and we assume no obligation to update any such forward-looking statements. It is important to note that our actual results could differ materially from those in the forward-looking statements. In addition to any risks and uncertainties specifically identified below and in the text surrounding forward-looking statements in this report, you should consult our reports on Form 10-K and other filings with the Securities and Exchange Commission for factors that could cause our actual results to differ materially from those presented.


Statements that are predictive in nature, that depend upon or refer to future events or conditions, or that include words such as “will”, “would”, “should”, “plans”, “likely”, “expects”, “anticipates”, “intends”, “believes”, “estimates”, “thinks”, “may”, and similar expressions, are forward-looking statements. The following important factors, in addition to those referred to above, could affect the future results of our industries in general, and us in particular, and could cause those results to differ materially from those expressed in such forward-looking statements:


  the effects of our indebtedness, which could adversely restrict our ability to operate, could make us vulnerable to general adverse economic and industry conditions, could place us at a competitive disadvantage compared to our competitors that have less debt, and could have other adverse consequences;
  
  uncertainties in our establishing or maintaining relationships with physicians and hospitals;
  
  the impact of current and future laws and governmental regulations;
  
  uncertainties inherent in third party payors’ attempts to limit health care coverages and levels of reimbursement;
  
  uncertainties in our establishing or maintaining relationships with our manufacturing suppliers;
  
  the effects of competition and technological changes;
  
  the availability (or lack thereof) of acquisition or combination opportunities; and
  
  general economic, market or business conditions.



-21-



General

We provide urology services and design and manufacture trailers and coaches that transport high technology medical devices and equipment for mobile command and control centers and the media and broadcast industry.


Urology Services. According to the American Foundation for Urologic Disease, nearly 10% of Americans are afflicted with kidney stones during their lifetime. Most kidney stones occur within the 40-60 year old age group. The two primary forms of treatment of kidney stones are lithotripsy and endoscopy, a form of invasive surgery that sometimes utilizes laser. Of the approximately 600,000 kidney stone cases each year, approximately 225,000 to 250,000 are treated with lithotripsy. Lithotripsy uses extracorporeal shock waves to break up kidney stones into small pieces, which can pass naturally through the body’s urinary tract. This procedure is a non-invasive procedure for treating kidney stones, typically performed on an outpatient basis, that eliminates the need for lengthy hospital stays and extensive recovery periods associated with surgery.


Our services are provided principally through limited partnerships or other entities that we manage, which use lithotripsy devices. As of September 30, 2004, we owned 86 lithotripters, 68 of which are mobile and 18 of which are fixed site. We do not render any medical services. Rather, the physicians do.


We have two types of contracts, retail and wholesale. Retail contracts are contracts where we contract with the hospital and private insurance payors. Wholesale contracts are contracts where we contract only with the hospital. The two approaches functionally differ in that, under a retail contract, we generally bill for the entire non-physician fee for all patients other than governmental pay patients, for which the hospital bills the non-physician fee. Under a wholesale contract, the hospital generally bills for the entire non-physician fee for all patients. In both cases, the billing party contractually bears the costs associated with the billing service, including pre-certification, as well as non-collection. The non-billing party is generally entitled to its fees regardless of whether the billing party actually collects the non-physician fee. Accordingly, under the wholesale contracts where we are the non-billing party, the hospital generally receives a greater proportion of the total non-physician fee to compensate for its billing costs and collection risk. Conversely, under the retail contracts where we generally provide the billing services and bear the collection risk, we receive a greater proportion of the total non-physician fee.


Although the non-physician fee under both retail and wholesale contracts varies widely based on geographical markets and the identity of the third party payor, we estimate that nationally, on average, our share of the non-physician fee is roughly $3,400 and $1,600 under the retail and wholesale arrangements, respectively for 2004 and 2003. At this time, we do not anticipate a material shift between our retail and wholesale arrangements.


We also, through our Medstone subsidiary, manufacture, sell and maintain lithotripters, and market fixed and mobile tables for urological treatments and imaging, as well as patient handling tables for use by pain management clinics. See “Recent Developments” for a description of our Medstone subsidiary.


As the general partner of the limited partnerships, we also provide services relating to operating our lithotripters, including scheduling, staffing, training, quality assurance, maintenance, regulatory compliance, and contracting with payors, hospitals and surgery centers. We do not directly bill, nor do we collect for services rendered to, Medicare or Medicaid.




-22-



Although, for the three and nine months ended September 30, 2004 and 2003, manufacturing revenue was higher than urology revenue, the operating margins on urology revenue have been, historically, much higher than on manufacturing revenue. We recognize urology revenue primarily from the following sources:


 

Fees for urology services. A substantial majority of our urology revenue is derived from fees related to lithotripsy treatments performed using our lithotripters. We, through our partnerships or other entities, facilitate the use of our equipment and provide other support services in connection with these treatments at hospitals and other health care facilities. The professional fee payable to the physician performing the procedure is generally billed and collected by the physician.


 

Fees for operating our lithotripters. Through our partnerships and otherwise directly by us, we provide services related to operating our lithotripters and receive a management fee for performing these services. In addition, we provide equipment maintenance services to our partnerships and supply them with other consumables.


 

Fees for equipment sales and licensing applications. We manufacture, sell and maintain lithotripters and certain medical tables. In addition to the original sales price we receive for lithotripter sales, we receive a licensing fee for each patient treated from the owner of the lithotripter. In exchange for this licensing fee, we also provide the owner of the lithotripter with certain consumables.


Manufacturing.     We design, construct and engineer mobile trailers, coaches, and special purpose mobile units that transport high technology medical devices such as magnetic resonance imaging, or MRI machines, cardiac catheterization labs for testing blood pressure, CT scanware, or CAT scan machines, lithotripters, postitron emission tomography devices, or machines for PET scans, and equipment designed for mobile command and control centers, and broadcasting and communications applications.


A significant portion of our revenue has been derived from our manufacturing operations. Manufacturing revenue is recognized at the time we fulfill the terms of the contract under which we have sold the equipment.


Recent Developments

In February 2004, we acquired Medstone International, Inc., or Medstone, for approximately $19 million of our common stock. Medstone manufactures, sells, and maintains lithotripters and makes them available for use by health care providers under various fee-for-service arrangements in both fixed and mobile settings. Medstone and its subsidiaries also market fixed and mobile tables for urological treatments and imaging, patient handling tables for use by pain management clinics and other users, and x-ray generators for medical imaging. A pioneer in the manufacture of shockwave lithotripsy, Medstone’s lithotripter was the first FDA approved device to treat both kidney stones and gallstones. With more than 130 lithotripters in operation worldwide, and more than 324 urology and patient handling tables in use, the Medstone devices are well established in the urology office and hospital market.


In April 2004, we announced our plans to reorganize our manufacturing segment in the last half of 2004. This reorganization will rationalize plant capacity accumulated through acquisitions, streamline production, and optimize synergies available through labor redundancies and purchasing and materials management.




-23-



On June 11, 2004, we executed a definitive Agreement and Plan of Merger with HealthTronics Surgical Services, Inc., or HealthTronics, pursuant to which we will, if all closing conditions are met (including approval of the merger by our stockholders and HealthTronics shareholders), merge with and into HealthTronics, with HealthTronics as the surviving corporation. Under the terms of that agreement, as a result of the merger, our stockholders will receive one share of HealthTronics common stock for each share of our common stock. Because our stockholders will own approximately 62% of the shares of HealthTronics common stock after the merger, and because our directors and senior management will represent a majority of the combined company’s directors and senior management, we will be deemed to be the acquiring company for accounting purposes and the merger will be accounted for as a reverse acquisition under the purchase method of accounting for business combinations in accordance with accounting principles generally accepted in the United States. The consideration paid (purchase price) will be allocated to the tangible and intangible net assets of HealthTronics based on their fair values, and the net assets of HealthTronics will be recorded at fair values as of the completion of the merger and added to those of Prime. The assets acquired and liabilities assumed will be deemed to be those of HealthTronics because HealthTronics will be the surviving legal entity.


Critical Accounting Policies and Estimates.

Management has identified the following critical accounting policies and estimates:

Impairments of goodwill and other intangible assets are both a critical accounting policy and estimate that requires judgment and is based on assumptions of future operations. We are required to test for impairments at least annually or if circumstances change that would reduce the fair value of a reporting unit below its carrying value. We test for impairment of goodwill during the fourth quarter. We have two reporting units, urology and manufacturing. The fair value of each reporting unit is calculated using estimated discounted future cash flow projections. As of September 30, 2004, we had goodwill of $186 million.


A second critical accounting policy and estimate which requires judgment of management is the estimated allowance for doubtful accounts and contractual adjustments. We have based our estimates on historical collection amounts, current contracts with payors, current changes of the facts and circumstances relating to these matters and certain negotiations with related payors.


A third critical accounting policy is consolidation of our investment in partnerships where we, as the general partner, exercise effective control, even though our ownership is less than 50%. The consolidated financial statements include our accounts, our wholly-owned subsidiaries, and entities more than 50% owned and limited partnerships where we, as the general partner, exercise effective control, even though our ownership is less than 50%. The related partnership agreements provide for broad powers by the general partner. The limited partners do not participate in the management of the partnership and do not have the substantial ability to remove the general partner. Investment in entities in which our investment is less than 50% ownership and we do not have significant control are accounted for by the equity method if ownership is between 20% - 50%, or by the cost method if ownership is less than 20%. We have reviewed each of the underlying agreements and determined we have effective control; however, if it was determined this control did not exist, these investments would be reflected on the equity method of accounting. Although this would change individual line items within our consolidated financial statements, it would have no effect on our net income and/or total stockholders’ equity.


Nine months ended September 30, 2004 compared to the nine months ended September 30, 2003


Our total revenues for the nine months ended September 30, 2004 increased $19,842,000 (17%) as compared to the same period in 2003. Revenues from our urology operations increased by $10,233,000 (22%) due primarily to the acquisition of Medstone during February 2004. The actual numbers of procedures performed in the nine months ended September 30, 2004 increased by 3,235 (15%) compared to the same period in 2003 due primarily to the Medstone acquisition. Average revenue per procedures decreased by 8% because procedures from our Medstone acquisition have a lower average rate. For the nine months ended September 30, 2004, actual Medstone revenues from the acquisition date forward totaled $7.8 million on 3,983 procedures and 13,283 procedures generating per use license fees from the lithotripter sales. We also had $3 million in Medstone equipment sales. Revenues from our organic operations were down approximately $600,000 or 1% as compared to same period in 2003. Our manufacturing revenues increased $9,682,000 (14%) due to a significant increase in the average price per unit. The increase in price per unit is the result of an increase in the sale of command and control units, which usually have a significantly higher sales price. The total number of units actually shipped decreased from 285 during the nine months ended September 30, 2003 to 274 in the same period in 2004.




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Our costs of services and general and administrative expenses for the nine months ended September 30, 2004 decreased from 78% to 77% of revenues. Our costs of services associated with our urology operations increased $5,887,000 (31%) in absolute terms and increased from 41% to 44% of our urology revenues. All of these increases relate to costs associated with our newly acquired Medstone operations, which totaled $7.8 million. Our costs related to organic operations actually decreased $1.3 million primarily due to reduced personnel costs, including a partial reversal of our discretionary bonus accrual, and a decrease in legal costs due to the hiring of an internal legal department in early 2004. Our cost of services associated with our manufacturing operations increased $8,364,000 (13%) in absolute terms and decreased from 92% to 91% of our manufacturing revenues. Our corporate expenses remained constant at 2% of revenues, increasing $383,000 (16%) in absolute terms, as we continue to successfully grow without proportionately adding corporate expenses.


Depreciation and amortization expense decreased $107,000 for the nine months ended September 30, 2004 compared to the same period in 2003. This decrease relates to several lithotripsy units becoming fully depreciated in late 2003 and early 2004 as well as certain computer equipment installed in our central business office in late 2000, partially offset by an increase from our newly acquired Medstone equipment.


Minority interest in consolidated income for the nine months ended September 30, 2004 increased $4,053,000 compared to the same period in 2003. This increase is consistent with the percentage increase in income from our urology segment.


Provision for income taxes for the nine months ended September 30, 2004 increased $583,000 compared to the same period in 2003 and is consistent with the percentage increase in taxable income.


Three months ended September 30, 2004 compared to the three months ended September 30, 2003


Our total revenues for the three months ended September 30, 2004 increased $6,873,000 (17%) as compared to the same period in 2003. Revenues from our urology operations increased by $4,345,000 (28%) due primarily to the acquisition of Medstone in February 2004. The actual number of procedures performed in the three months ended September 30, 2004 increased by 1,449 (20%) compared to the same period in 2003 due primarily to the Medstone acquisition. Average revenue per procedures decreased by 8% because procedures from our Medstone acquisition have a lower average rate. Actual revenues from Medstone in the quarter totaled $2.7 million on 1,585 procedures and 5,338 procedures generating per use license fees from the lithotripter sales. We also had $1 million in Medstone equipment sales. Revenues from our organic operations increased $633,000 for the three months ended September 30, 2004 compared to the same period in 2003. This increase is a result of an increase in lithotripsy procedures and the startup of our greenlight laser operations. Greenlight lasers are a devise used as a treatment for benign prostatic hyperplasia. Our manufacturing revenues increased $2,551,000 (11%) due to an increase in average price per unit. The total number of units shipped decreased from 96 during the three months ended September 30, 2003 to 95 during the same period in 2004. The price per unit increased as a result of an increase in the sale of larger command and control units, which usually have a significantly higher sales price.




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Our costs of services and general and administrative expenses for the three months ended September 30, 2004 decreased from 79% to 77% of revenues. Our costs of services associated with our urology operations increased $3,192,000 (54%) in absolute terms and increased from 38% to 46% of our urology revenues. Costs associated with Medstone revenues discussed above totaled $2.9 million. Our costs related to organic operations remained relatively constant as increased costs from our new greenlight laser operations were offset by a partial reversal of our discretionary bonus plan accrual. Our cost of services associated with our manufacturing operations increased $1,573,000 (7%) in absolute terms and decreased from 95% to 92% of our manufacturing revenues. Our corporate expenses remained constant at 2% of revenues, decreasing $201,000 (22%) in absolute terms, as we continue to successfully grow without proportionately adding corporate expenses.


Depreciation and amortization expense increased $78,000 for the three months ended September 30, 2004 compared to the same period in 2003. This increase relates to several lithotripsy units being fully depreciated in late 2003 and early 2004, as well as certain computer equipment installed in our central business office late 2000, offset by an increase from our newly-acquired Medstone equipment.


Minority interest in consolidated income for the three months ended September 30, 2004 increased $1,682,000 compared to the same period in 2003, which was consistent with the increase in income from our urology segment


Provision for income taxes for the three months ended September 30, 2004 increased $185,000 compared to the same period in 2003 due to an increase in taxable income.


Liquidity and Capital Resources

Cash and cash equivalents were $6,385,000 and $9,780,000 at September 30, 2004 and December 31, 2003, respectively. Our subsidiaries generally distribute all of their available cash quarterly, after establishing reserves for estimated capital expenditures and working capital. For the nine months ended September 30, 2004 and 2003, our subsidiaries distributed approximately $22,509,000 and $21,346,000, respectively, to minority interest holders.


Cash provided by operations, after minority interest, was $24,969,000 for the nine months ended September 30, 2004 and was $24,809,000 for the nine months ended September 30, 2003. Fee and other revenue collected increased by $22,737,000 while cash paid to employees, suppliers of goods and others increased by $21,712,000. These fluctuations are attributable to increased operations in our manufacturing segment and from our acquisition of Medstone as well as the timing of accounts payable and accrued expense payments. An increase in interest payments of $1,594,000 was due primarily to proceeds received for the termination of our interest rate swap in May 2003.




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Cash used in investing activities for the nine months ended September 30, 2004 was $1,935,000 primarily due to purchases of equipment and leasehold improvements totaling $6,403,000 partially offset by net cash received from our Medstone acquisition. Cash used in our investing activities for the nine months ended September 30, 2003 was $18,866,000 primarily due to $12,513,000 used in our acquisitions of Winemiller Communications and Aluminum Body Corporation, or ABC. We purchased equipment and leasehold improvements totaling $5,128,000 in 2003. We also had $1,742,000 remaining in an escrow account at September 30, 2003 related to certain contingent consideration for the ABC acquisition.


Cash used in our financing activities for the nine months ended September 30, 2004 was $26,429,000, primarily due to the distributions to minority interest of $22,509,000 and net payments on notes payable of $4,285,000. Cash used in our financing activities for the nine months ended September 30, 2003 was $17,416,000, primarily due to the distributions to minority interests of $21,346,000, partially offset by net borrowings on notes payable of $5,424,000.


Accounts receivable as of September 30, 2004 has decreased $2,789,000 from December 31, 2003. This decrease is primarily related to our manufacturing segment which normally has more unit sales at the end of the fourth quarter than the third quarter, partially offset by an increase in receivables in urology from our newly acquired Medstone operations. Bad debt expense was less than $100,000 for the nine months ended September 30, 2004 compared to approximately $200,000 for the same period in 2003.


Inventory as of September 30, 2004 totaled $30,506,000 and increased $9,218,000 from December 31, 2003. This increase relates primarily to work in process in our manufacturing segment and newly acquired inventory from our Medstone acquisition. Total backlog for the manufacturing segment was $33,720,000 and $30,372,000 as of September 30, 2004 and 2003, respectively.


Senior Credit Facility

Our senior credit facility is a revolving line of credit, and it expires on July 25, 2005. The revolving line of credit has a borrowing limit of $50 million, none of which was drawn at September 30, 2004 and $5 million of which was drawn as of November 1, 2004. Our senior credit facility contains covenants that, among other things, limit the payment of cash dividends on our common stock, limit repurchases of our common stock, restrict the amount of our consolidated debt, restrict our ability to make certain loans and investments, and provide that we must maintain certain financial ratios. As of September 30, 2004, we were not in compliance with one financial ratio, “Total Net Funded Debt to Adjusted EBITDA”. The maximum permitted ratio is 3.75 to 1 and our ratio as of September 30, 2004 was 3.9 to 1. We received a waiver of this noncompliance from the lenders under our credit facility and, as a result, there was no material impact on us.


8.75% Notes

In addition, we have $100 million of unsecured senior subordinated notes. The notes bear interest at 8.75% and interest is payable semi-annually on April 1st and October 1st. Principal is due April 2008.


The indenture governing our 8.75% notes contains covenants that, among other things: (1) limit the incurrence of additional indebtedness; (2) limit certain investments; (3) limit restricted payments; (4) limit the disposition of assets; (5) limit the payment of dividends and other payment restrictions affecting subsidiaries; (6) limit transactions with affiliates; (7) limit the creation of liens; and (8) restrict mergers, consolidations and transfers of assets. In the event of a change of control under the indenture, we will be required to make an offer to repurchase the 8.75% notes at 101% of the principal amount thereof, plus accrued and unpaid interest to the date of the repurchase. Our merger with HealthTronics described above will not be a change of control under the indenture.




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The 8.75% notes are unsecured general obligations and are subordinated in right of payment to all our existing and future senior indebtedness and are guaranteed by certain of our subsidiaries on a full, unconditional, joint and several basis.


Other

Interest Rate Swap .. In August 2002, we entered into an interest rate swap which was designated as a fair value hedge pursuant to the provisions of FAS No. 133, Accounting for Derivative Instruments and Hedging Activities, and FAS No. 138, Accounting for Certain Derivative Instruments and Certain Hedging Activities, An Amendment of FASB Statement No. 133. This swap was executed to convert $50 million of the 8.75% notes from a fixed to floating rate instrument. The floating rate was based on LIBOR plus 4.56%. In March 2003, we amended our interest rate swap agreement to add an additional $25 million with a floating rate based on LIBOR plus 5.11%. We terminated the swaps in May 2003. In August 2003, we entered into two new interest rate swaps for $25 million each which were also designated as fair value hedges. The floating rates of these two interest rate swap agreements were based on LIBOR plus 4.72% and 4.97%, respectively. In January 2004, we terminated these swaps. As of September 30, 2004, approximately $658,000 in proceeds from these swaps was capitalized and is being amortized as a reduction to future interest expense over the remaining life of the 8.75% notes.


Other long term debt. At September 30, 2004, we had approximately $3.9 million of debt related to our building in Austin, Texas, which bears interest at prime plus 1% and is due in monthly installments until November 2006. We also had notes totaling $5.9 million related to equipment purchased by our limited partnerships. These notes are paid from the cash flows of the related partnerships. They bear interest at LIBOR or prime plus a certain premium and are due over the next three years.


Other long term obligations. At September 30, 2004, we had an obligation totaling $1,125,000 related to payments to the previous owner of ABC for $75,000 per quarter until March 31, 2008 as consideration for a noncompetition agreement. Also at September 30, 2004, as part of our Medstone acquisition, we had an obligation totaling $704,000 related to payments to an employee for $20,833 a month until February 28, 2007 and $4,167 a month beginning March 1, 2007 and continuing until February 28, 2009 as consideration for a noncompetition agreement. We also had an obligation for $33,000 related to the estimated fair values of “puts” on our common stock held by two previous minority interest owners of one of our subsidiaries, AK Specialty Vehicles, each of which may be exercised for approximately 121,360 shares in June 2005 at a per share purchase price of $7.19.


Stock Repurchases. During 1998, we announced a stock repurchase program of up to $25.0 million of our common stock. In February 2000, we announced an increase in the authorized repurchase amount from $25.0 million to $35.0 million and in January 2001 we increased this amount to $45.0 million. We have not repurchased any of our common stock since 2001. From time to time, we may purchase additional shares of our common stock where, in our judgment, market valuations of our stock do not accurately reflect our past and projected results of operations. We intend to fund any additional stock purchases using cash flows from operations and borrowings under our senior credit facility. Under our repurchase program, we had purchased 3,820,200 shares of our stock for a total cost of $32,524,000. These shares were retired in August 2002 and no additional shares have been purchased under this program.




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General

The following table presents our contractual obligations as of September 30, 2004 (in thousands):

 Payments due by period
Contractual Obligations
Total
Less than
1 year

1-3 years
3-5 years
More than 5 years
Long Term Debt (1)     $ 110,437   $ 3,397   $ 6,921   $ 100,119   $ --  
Operating Leases (2)       4,617     1,299     2,198     768   352  
Non-compete contracts (3)       1,829     550     983     296     --  
Stock repurchase agreements (4)      33     33     --     --     --  





Total     $ 116,916   $ 5,279   $ 10,102   $ 101,183 $ 352  





  (1) Represents long term debt as discussed above under “Senior Credit Facility”, “8.75% Notes” and “Other-Other Long Term Debt.”

 (2) Represents operating leases in the ordinary course of our business.

 (3) Represents an obligation of approximately $1,125 due to the previous owner of ABC, at a rate of $75 per quarter and an obligation of $704 due to an employee, at a rate of $21 per month until February 28, 2007 and $4 beginning March 1, 2007 and continuing until February 28, 2009.

  (4) Represents the estimated liability, in accordance with SFAS No. 150, of certain “put” rights on our common stock discussed above under “Other long term obligations.”

Our primary sources of cash are cash flows from operations and borrowings under our senior credit facility. Our cash flows from operations and therefore our ability to make scheduled payments of principal, or to pay the interest on, or to refinance, our indebtedness, or to fund planned capital expenditures, will depend on our future performance, which is subject to general economic, financial, competitive, legislative, regulatory and other factors. Likewise, our ability to borrow under our senior credit facility will depend on these factors, which will affect our ability to comply with the covenants in our facility and our ability to obtain waivers for, or otherwise address, any noncompliance with the terms of our facility with our lenders.


We intend to increase our urology operations primarily through forming new operating subsidiaries in new markets as well as by acquisitions. We seek opportunities to grow our manufacturing operations through acquisitions, expanding our product lines and by selling to a broader customer base. We intend to fund the purchase price for future acquisitions and developments using borrowings under our senior credit facility and cash flows from our operations. In addition, we may use shares of our common stock in such acquisitions where appropriate.


Based upon the current level of our operations and anticipated cost savings and revenue growth, we believe that cash flows from our operations and available cash, together with available borrowings under our senior credit facility, will be adequate to meet our future liquidity needs both for the short term and for at least the next several years. However, there can be no assurance that our business will generate sufficient cash flows from operations, that we will realize our anticipated revenue growth and operating improvements or that future borrowings will be available under our senior credit facility in an amount sufficient to enable us to service our indebtedness or to fund our other liquidity needs.




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Inflation

Our operations are not significantly affected by inflation because we are not required to make large investments in fixed assets. However, the rate of inflation will affect certain of our expenses, such as employee compensation and benefits.


Adoption of Accounting Pronouncements

In January 2003, the FASB issued Interpretation No. 46, Consolidation of Variable Interest Entities, an interpretation of ARB No. 51, or FIN 46. This Interpretation addresses the consolidation by business enterprises of variable interest entities as defined in the Interpretation. The Interpretation applies immediately to variable interests in variable interest entities created after January 31, 2003, and July 1, 2003 for variable interests in variable interest entities that existed at January 31, 2003 and remain in existence at July 1, 2003. In October 2003, the FASB delayed the implementation date for variable interests in variable interest entities that existed at January 31, 2003 and remain in existence at July 1, 2003 until fiscal years beginning after December 31, 2003. FIN 46 was subsequently revised and reissued in December 2003. The reissued guidance required implementation by March 31, 2004. The application of this Interpretation did not have a material effect on our consolidated financial statements.


Item 3 — Quantitative and Qualitative Disclosures
About Market Risk


Interest Rate Risk

As of September 30, 2004, we had long-term debt (including current portion) totaling $110,437,000, of which $100 million has a fixed rate of interest of 8.75%, $37,000 has fixed rates of 5% to 11%, $3,885,000 bears interest at a variable rate equal to a specified prime rate and $5,857,000 bears interest at a variable rate equal to LIBOR + 1% to 3.75%. The remaining $658,000 relates to our interest rate swaps, which are discussed below. We are exposed to some market risk due to the floating interest rate debt totaling $9,742,000 on which we make monthly or quarterly payments of principal and interest. An increase in interest rates of 1% would result in a $97,000 annual increase in interest expense on this existing principal balance.


Additionally, in August 2002, we entered into an interest rate swap, which was designated as a fair value hedge pursuant to the provisions of FAS No. 133, Accounting for Derivative Instruments and Hedging Activities, and FAS No. 138, Accounting for Certain Derivative Instruments and Certain Hedging Activities, an Amendment of FASB Statement No. 133. This swap had the effect of converting $50 million of our 8.75% notes from a fixed to floating rate instrument with a rate of LIBOR plus 4.57%. In March 2003, we amended our interest rate swap agreement to add an additional $25 million with a floating rate based on LIBOR plus 5.11%. We terminated the swap in May 2003. In August 2003, we entered into two new interest rate swaps for $25 million each, which were also designated as fair value hedges. The floating rates of these two interest rate swap agreements were based on LIBOR plus 4.72% and 4.97%, respectively. In January 2004, we terminated these swaps for approximately $150,000. At September 30, 2004, approximately $658,000 in net proceeds from these swaps was capitalized and is being amortized as a reduction to future interest expense over the remaining life of the 8.75% notes.




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Item 4 – Controls and Procedures


At September 30, 2004, under the supervision and with the participation of our management, including our Chief Executive Officer (our principal executive officer) and our Chief Financial Officer (our principal financial officer), we evaluated the effectiveness of our disclosure controls and procedures (as defined under Rule 13a-15(e) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”)). Based on this evaluation, our Chief Executive Officer and our Chief Financial Officer concluded that, as of September 30, 2004, our disclosure controls and procedures are effective.


Except as discussed below, there have been no changes in our internal control over financial reporting that occurred during the period covered by this report that have materially affected, or are reasonably likely to materially affect, such internal control over financial reporting.


During the three months ended September 30, 2004, in response to an internal investigation related to a business transaction involving our manufacturing division, which is more fully described in a Form 8-K we filed on September 28, 2004, we implemented certain improvements to (1) strengthen our internal controls, including heightened authorization and documentation requirements for commissions, (2) establish clear guidelines and training protocol for the solicitation of and entering into government contracts, and (3) ensure that our personnel fully understand and appropriately execute internal control procedures.




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PART II

OTHER INFORMATION









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Item 2. Unregistered Sales of Equity Securities and Use of Proceeds.

Unregistered Sales of Equity Securities.


During the third quarter of 2004, warrants were exercised at an average price of $4.87 resulting in the issuance of 32,990 shares of our common stock. These share were issued under an exception from registration pursuant to Section 4(2) of the Securities Act of 1933.

Item 6. Exhibits and Reports on Form 8-K.

(a)

         
         
         
         
         
         

(b)

         
         

         
         
Exhibits

12.  Computation of ratio of earnings to fixed charges.
31.1 Certification of Chief Executive Officer
31.2 Certification of Chief Financial Officer
32.1 Certification of Chief Executive Officer
32.2 Certification of Chief Financial Officer
99.1 Waiver of Certain Provisions of the Fifth Amended and Restated Loan Agreement dated November, 2004.

Current Reports on Form 8-K

On July 22, 2004, we filed a report on Form 8-K disclosing our second quarter 2004 earnings release.

On September 28, 2004, we filed a report on Form 8-K announcing the conclusion of an internal investigation of a business transaction involving our manufacturing division.


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SIGNATURES


Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.


                                                     



Date: November 5, 2004



                                                     
                                                     
                                                     
PRIME MEDICAL SERVICES, INC.







By: /s/ John Q. Barnidge                                
     John Q. Barnidge, Senior Vice President
         and Chief Financial Officer







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