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Income Taxes (Tables) | 12 Months Ended
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Dec. 31, 2024
Income Tax Disclosure [Abstract] |
Schedule of Reconciliation of U.S. Statutory Income Tax Rate to Company's Effective Income Tax Rate from Continuing Operations |
Effective Income Tax Rate Reconciliation
| 2024 |  | 2023 |  | 2022
United States federal statutory rate | 21.0 | % |  | 21.0 | % |  | 21.0 | %
United States state and local income taxes, less federal deduction | 1.1 |  |  | 1.1 |  |  | 2.0 |
Foreign income tax at rates other than 21% | (4.1) |  |  | (6.8) |  |  | (4.1) |
Tax related to repatriation of foreign earnings | 0.3 |  |  | 1.2 |  |  | (2.4) |
United States research and development credits | (1.4) |  |  | (1.2) |  |  | (1.5) |
Intellectual property transfers | — |  |  | (3.3) |  |  | 0.1 |
United States federal audit settlement | — |  |  | — |  |  | (6.1) |
Goodwill impairment | 2.8 |  |  | — |  |  | 1.7 |
Outside basis difference related to the anticipated sale of the Spinal Implants business | (4.9) |  |  | — |  |  | — |
Other | (0.5) |  |  | 1.8 |  |  | 1.4 |
Effective income tax rate | 14.3 | % | 0 | 13.8 | % |  | 12.1 | %
Schedule of Provision for Income Taxes |
Earnings Before Income Taxes
| 2024 |  | 2023 |  | 2022
United States | $ | 523 |  |  | $ | 701 |  |  | $ | 407 |
International | 2,969 |  |  | 2,972 |  |  | 2,276 |
Total | $ | 3,492 |  |  | $ | 3,673 |  |  | $ | 2,683 |
Components of Income Tax Expense (Benefit)
Current income tax expense (benefit): | 2024 |  | 2023 |  | 2022
United States federal | $ | 490 |  |  | $ | 236 |  |  | $ | (76) |
United States state and local | 90 |  |  | 48 |  |  | 64 |
International | 289 |  |  | 430 |  |  | 279 |
Total current income tax expense | $ | 869 |  |  | $ | 714 |  |  | $ | 267 |
Deferred income tax expense (benefit): |  |  |  |  |
United States federal | $ | (462) |  |  | $ | (212) |  |  | $ | (179) |
United States state and local | (76) |  |  | (20) |  |  | (30) |
International | 168 |  |  | 26 |  |  | 267 |
Total deferred income tax expense (benefit) | $ | (370) |  |  | $ | (206) |  |  | $ | 58 |
Total income tax expense | $ | 499 |  |  | $ | 508 |  |  | $ | 325 |
Schedule of Difference in Income Tax Effects Comprising Company's Deferred Income Tax Assets and Liabilities |
Deferred Income Tax Assets and Liabilities
Deferred income tax assets: | 2024 |  | 2023
Inventories | $ | 551 |  |  | $ | 521 |
Other accrued expenses | 207 |  |  | 253 |
Depreciation and amortization | 715 |  |  | 918 |
State income taxes | 167 |  |  | 150 |
Share-based compensation | 100 |  |  | 86 |
Research and development capitalization | 408 |  |  | 295 |
International interest expense carryforwards | 52 |  |  | 46 |
Net operating loss and credit carryforwards | 410 |  |  | 385 |
Outside basis difference related to the anticipated sale of the Spinal Implants business | 170 |  |  | — |
Other | 310 |  |  | 235 |
Total deferred income tax assets | $ | 3,090 |  |  | $ | 2,889 |
Less valuation allowances | (228) |  |  | (223) |
Net deferred income tax assets | $ | 2,862 |  |  | $ | 2,666 |
Deferred income tax liabilities: |  |  |
Depreciation and amortization | $ | (1,141) |  |  | $ | (1,012) |
Undistributed earnings | (61) |  |  | (47) |
Total deferred income tax liabilities | $ | (1,202) |  |  | $ | (1,059) |
Net deferred income tax assets | $ | 1,660 |  |  | $ | 1,607 |
Reported as: |  |  |
Noncurrent deferred income tax assets | $ | 1,742 |  |  | $ | 1,670 |
Noncurrent liabilities—Other liabilities | (82) |  |  | (63) |
Total | $ | 1,660 |  |  | $ | 1,607 |
Schedule of Unrecognized Tax Benefits Roll Forward |
Uncertain Income Tax Positions
| 2024 |  | 2023
Beginning uncertain tax positions | $ | 371 |  |  | $ | 286 |
Increases related to current year income tax positions | 18 |  |  | 102 |
Increases related to prior year income tax positions | — |  |  | 10 |
Decreases related to prior year income tax positions | (4) |  |  | (33) |
Settlements of income tax audits | (21) |  |  | (1) |
Statute of limitations expirations and other | (3) |  |  | — |
Foreign currency translation | (12) |  |  | 7 |
Ending uncertain tax positions | $ | 349 |  |  | $ | 371 |
Reported as: |  |  |
Noncurrent liabilities—Income taxes | $ | 349 |  |  | $ | 371 |

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