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Revenue Recognition
 12 Months Ended
Dec. 31, 2021
Revenue Recognition [Abstract]  
Revenue Recognition REVENUE RECOGNITION
We disaggregate our net sales by product line and geographic location for each of our segments as we believe it best depicts how the nature, amount, timing and certainty of our net sales and cash flows are affected by economic factors.
Products and services are primarily transferred to customers at a point in time, with some transfers of services taking place over time. In 2021 less than 10% of our sales were recognized as services transferred over time. Refer to Note 1 for further discussion on our revenue recognition policies.
Segment Net Sales
MedSurg and Neurotechnology:202120202019
Instruments$2,111 $1,863 $1,959 
Endoscopy2,141 1,763 1,983 
Medical2,607 2,524 2,264 
Neurovascular1,188 973 924 
Neuro Cranial1,214 972 1,059 
Other277 250 286 
$9,538 $8,345 $8,475 
Orthopaedics and Spine:
Knees$1,848 $1,567 $1,815 
Hips1,342 1,206 1,383 
Trauma and Extremities2,664 1,722 1,639 
Spine1,167 1,047 1,157 
Other549 464 415 
$7,570 $6,006 $6,409 
Total$17,108 $14,351 $14,884 
United States Net Sales
MedSurg and Neurotechnology:202120202019
Instruments$1,637 $1,471 $1,542 
Endoscopy1,670 1,408 1,577 
Medical2,007 1,910 1,787 
Neurovascular451 381 391 
Neuro Cranial988 801 890 
Other273 247 283 
$7,026 $6,218 $6,470 
Orthopaedics and Spine:
Knees$1,351 $1,170 $1,347 
Hips822 777 882 
Trauma and Extremities1,866 1,139 1,051 
Spine831 764 873 
Other425 387 334 
$5,295 $4,237 $4,487 
Total$12,321 $10,455 $10,957 
International Net Sales
MedSurg and Neurotechnology:202120202019
Instruments$474 $392 $417 
Endoscopy471 355 406 
Medical600 614 477 
Neurovascular737 592 533 
Neuro Cranial226 171 169 
Other4 3 3 
$2,512 $2,127 $2,005 
Orthopaedics and Spine:
Knees$497 $397 $468 
Hips520 429 501 
Trauma and Extremities798 583 588 
Spine336 283 284 
Other124 77 81 
$2,275 $1,769 $1,922 
Total$4,787 $3,896 $3,927 
MedSurg and Neurotechnology
MedSurg and Neurotechnology products include surgical equipment and navigation systems (Instruments), endoscopic and communications systems (Endoscopy), patient handling, emergency medical equipment and intensive care disposable products (Medical), minimally invasive products for the treatment of acute ischemic and hemorrhagic stroke (Neurovascular), a comprehensive line of products for traditional brain and open skull based surgical procedures; orthobiologic and biosurgery products, including synthetic bone grafts and vertebral
augmentation products (Neuro Cranial) and other medical device products used in a variety of medical specialties. Substantially all MedSurg and Neurotechnology sales are recognized when a purchase order has been received and control has transferred. For certain Endoscopy, Instruments and Medical services, we may recognize sales over time as we satisfy performance obligations that may include an obligation to complete installation, provide training and perform ongoing services, generally performed within one year.
Orthopaedics and Spine
Orthopaedics and Spine products consist primarily of implants used in hip and knee joint replacements and trauma and extremity surgeries, and cervical, thoracolumbar and interbody systems used in spinal injury, deformity and degenerative therapies. Substantially all Orthopaedics sales are recognized when we have received a purchase order and appropriate notification the product has been used or implanted. Substantially all Spine sales are recognized when a purchase order has been received and control has transferred. For certain Orthopaedic products in the "other" category, we recognize sales at a point in time, as well as over time for performance obligations that may include an obligation to complete installation and provide training and ongoing services. Performance obligations are generally satisfied within one year.
Contract Assets and Liabilities
The nature of our products and services do not generally give rise to contract assets as we typically do not incur costs to fulfill a contract before a product or service is provided to a customer. Our costs to obtain contracts are typically in the form of sales commissions paid to employees or third-party agents. Certain sales commissions paid to employees prior to recognition of sales are recorded as contract assets. We expense sales commissions associated with obtaining a contract at the time of the sale or as incurred as the amortization period is generally less than one year. These costs have been presented within selling, general and administrative expenses. On December 31, 2021 contract assets recorded in our Consolidated Balance Sheets were not significant.
Our contract liabilities arise as a result of consideration received from customers at inception of contracts for certain businesses or where the timing of billing for services precedes satisfaction of our performance obligations. We generally satisfy performance obligations within one year from the contract inception date. Our contract liabilities were $529 and $416 on December 31, 2021 and December 31, 2020.