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REVENUE AND CONTRACT ACQUISITION COSTS
 6 Months Ended
Jun. 30, 2021
Revenue from Contract with Customer [Abstract]  
REVENUE AND CONTRACT ACQUISITION COSTS REVENUE AND CONTRACT ACQUISITION COSTS
The following table presents revenue disaggregated by types and geography (in millions):
Three Months Ended June 30,Six Months Ended June 30,
U.S.2021202020212020
Instruments and accessories$577.5 $315.6 $1,078.3 $760.0 
Systems277.6 139.3 480.3 338.1 
Services150.7 80.6 294.7 219.0 
Total U.S. revenue
$1,005.8 $535.5 $1,853.3 $1,317.1 
Outside of U.S. (“OUS”)
Instruments and accessories$218.9 $145.2 $424.0 $318.3 
Systems162.0 121.7 328.0 206.2 
Services77.3 49.7 150.8 110.0 
Total OUS revenue
$458.2 $316.6 $902.8 $634.5 
Total
Instruments and accessories$796.4 $460.8 $1,502.3 $1,078.3 
Systems439.6 261.0 808.3 544.3 
Services228.0 130.3 445.5 329.0 
Total revenue
$1,464.0 $852.1 $2,756.1 $1,951.6 
Remaining Performance Obligations
The transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which revenue has not yet been recognized. A significant portion of this amount relates to performance obligations in the Company’s service contracts that will be satisfied and recognized as revenue in future periods. In addition, non-lease elements associated with the Company’s lease arrangements are primarily comprised of service contracts that will be satisfied and recognized as revenue in future periods. The transaction price allocated to the remaining performance obligations and the non-lease elements associated with lease arrangements was $1,700 million as of June 30, 2021. The remaining performance obligations are expected to be satisfied over the term of the individual sales arrangements, which generally are 5 years. Service revenue associated with the lease arrangements will generally be recognized over the service period, which generally coincides with the lease term.
Contract Assets and Liabilities
The following information summarizes the Company’s contract assets and liabilities (in millions):
As of
 June 30, 2021December 31, 2020
Contract assets$43.4 $34.6 
Deferred revenue$392.0 $382.3 
The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 days from date of invoice. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative standalone selling price of the related performance obligations satisfied and the contractual billing terms in the arrangements. Deferred revenue for the periods presented primarily relates to service contracts where the service fees are billed up-front, generally quarterly or annually, prior to those services having been performed. The associated deferred revenue is generally recognized over the term of the service period. The Company did not have any significant impairment losses on its contract assets for the periods presented.
During the three and six months ended June 30, 2021, the Company recognized $99.3 million and $250.2 million of revenue, respectively, that was included in the deferred revenue balance as of December 31, 2020. During the three and six months ended June 30, 2020, the Company recognized $54.6 million and $191.6 million of revenue, respectively, net of the impact of the Customer Relief Program, that was included in the deferred revenue balance as of December 31, 2019.
Intuitive System Leasing
The following table presents revenue from Intuitive System Leasing arrangements (in millions):
Three Months Ended June 30,Six Months Ended June 30,
2021202020212020
Sales-type lease revenue$84.0 $16.8 $101.3 $71.8 
Operating lease revenue $67.3 $42.2 $126.3 $81.3 
For the three and six months ended June 30, 2021, and 2020, variable lease revenue relating to usage-based arrangements was not material.
Trade Accounts Receivable
The allowance for doubtful accounts is based on the Company’s assessment of the collectibility of customer accounts. The Company regularly reviews the allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. For the three and six months ended June 30, 2021, and 2020, bad debt expense was not significant.
The Company’s exposure to credit losses may increase if its customers are adversely affected by changes in healthcare laws, coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with the current COVID-19 pandemic, or other customer-specific factors. Although the Company has historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of lease and trade receivables as hospital cash flows are impacted by their response to the COVID-19 pandemic and deferral of elective surgical procedures.