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Revenue Recognition | 12 Months Ended
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Dec. 31, 2023
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 2023 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. Beginning in the first quarter 2023 we consolidated Other MedSurg and Neurotechnology into Endoscopy as Other MedSurg and Neurotechnology (primarily Sustainability Solutions) has been fully integrated into our Endoscopy business. Endoscopy includes sales related to Other of $343, $302 and $277 for 2023, 2022 and 2021. We have reflected these changes in all historical periods presented.
Segment Net Sales |  |  |  |  |
MedSurg and Neurotechnology: | 2023 |  | 2022 |  | 2021
Instruments | $ | 2,569 |  |  | $ | 2,279 |  |  | $ | 2,111 |
Endoscopy | 3,033 |  |  | 2,725 |  |  | 2,418 |
Medical | 3,459 |  |  | 3,031 |  |  | 2,607 |
Neurovascular | 1,226 |  |  | 1,200 |  |  | 1,188 |
Neuro Cranial | 1,549 |  |  | 1,376 |  |  | 1,214 |
| $ | 11,836 |  |  | $ | 10,611 |  |  | $ | 9,538 |
Orthopaedics and Spine: |  |  |  |  |
Knees | $ | 2,273 |  |  | $ | 1,997 |  |  | $ | 1,848 |
Hips | 1,544 |  |  | 1,413 |  |  | 1,342 |
Trauma and Extremities | 3,147 |  |  | 2,807 |  |  | 2,664 |
Spine | 1,189 |  |  | 1,146 |  |  | 1,167 |
Other | 509 |  |  | 475 |  |  | 549 |
| $ | 8,662 |  |  | $ | 7,838 |  |  | $ | 7,570 |
Total | $ | 20,498 |  |  | $ | 18,449 |  |  | $ | 17,108 |
United States Net Sales |  |  |  |  |
MedSurg and Neurotechnology: | 2023 |  | 2022 |  | 2021
Instruments | $ | 2,051 |  |  | $ | 1,810 |  |  | $ | 1,637 |
Endoscopy | 2,478 |  |  | 2,211 |  |  | 1,943 |
Medical | 2,785 |  |  | 2,422 |  |  | 2,007 |
Neurovascular | 483 |  |  | 446 |  |  | 451 |
Neuro Cranial | 1,270 |  |  | 1,135 |  |  | 988 |
| $ | 9,067 |  |  | $ | 8,024 |  |  | $ | 7,026 |
Orthopaedics and Spine: |  |  |  |  |
Knees | $ | 1,676 |  |  | $ | 1,493 |  |  | $ | 1,351 |
Hips | 988 |  |  | 896 |  |  | 822 |
Trauma and Extremities | 2,297 |  |  | 2,035 |  |  | 1,866 |
Spine | 883 |  |  | 836 |  |  | 831 |
Other | 346 |  |  | 354 |  |  | 425 |
| $ | 6,190 |  |  | $ | 5,614 |  |  | $ | 5,295 |
Total | $ | 15,257 |  |  | $ | 13,638 |  |  | $ | 12,321 |
International Net Sales |  |  |  |  |
MedSurg and Neurotechnology: | 2023 |  | 2022 |  | 2021
Instruments | $ | 518 |  |  | $ | 469 |  |  | $ | 474 |
Endoscopy | 555 |  |  | 514 |  |  | 475 |
Medical | 674 |  |  | 609 |  |  | 600 |
Neurovascular | 743 |  |  | 754 |  |  | 737 |
Neuro Cranial | 279 |  |  | 241 |  |  | 226 |
| $ | 2,769 |  |  | $ | 2,587 |  |  | $ | 2,512 |
Orthopaedics and Spine: |  |  |  |  |
Knees | $ | 597 |  |  | $ | 504 |  |  | $ | 497 |
Hips | 556 |  |  | 517 |  |  | 520 |
Trauma and Extremities | 850 |  |  | 772 |  |  | 798 |
Spine | 306 |  |  | 310 |  |  | 336 |
Other | 163 |  |  | 121 |  |  | 124 |
| $ | 2,472 |  |  | $ | 2,224 |  |  | $ | 2,275 |
Total | $ | 5,241 |  |  | $ | 4,811 |  |  | $ | 4,787 |
MedSurg and Neurotechnology MedSurg and Neurotechnology products include surgical equipment and navigation systems (Instruments), endoscopic and communications systems (Endoscopy), patient handling, emergency medical equipment, intensive care disposable products and clinical communication and workflow solutions (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). 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, 2023 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. This occurs primarily when payment is received upfront for certain multi-period extended warranty service contracts. Our contract liabilities of $860 and $741 on December 31, 2023 and 2022 are classified within accrued expenses and other liabilities and other noncurrent liabilities within our Consolidated Balance Sheets based on the timing of when we expect to complete our performance obligations. Changes in contract liabilities during the year were as follows:
| 2023
Beginning contract liabilities | $ | 741 |
Revenue recognized from beginning of year contract liabilities | (379) |
Net advance consideration received during the period | 498 |
Ending contract liabilities | $ | 860 |

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- Definition The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 9 -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-9 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 10 -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-10 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 15 -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-15 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (a) -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-12 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (b) -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-12 Reference 6: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (c) -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-12 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (d) -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-12 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 12 -Subparagraph (e) -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-12 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 13 -Subparagraph (b)(2) -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-13 Reference 10: http://www.xbrl.org/2003/role/disclosureRef -Name Accounting Standards Codification -Topic 606 -Publisher FASB -URI https://asc.fasb.org//606/tableOfContent + Details
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