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Revenue Recognition | 12 Months Ended
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Dec. 31, 2024
Revenue Recognition [Abstract] |
Revenue Recognition | REVENUE RECOGNITION We disaggregate our net sales by business 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 2024 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. In the fourth quarter 2024 we reorganized our Spine business to align with certain updates to our internal reporting structure. The spine enabling technologies portfolio (Enabling Technologies) was reclassified to Other Orthopaedics and Spine, the interventional spine portfolio was reclassified to Neuro Cranial and the remaining Spine business was renamed to Spinal Implants. In addition, we changed the name of our “Orthopaedics and Spine” operating segment to “Orthopaedics.” Neuro Cranial includes sales related to interventional spine of $413, $327 and $282 for 2024, 2023 and 2022. Other Orthopaedics includes sales related to Enabling Technologies of $152, $149 and $131 for 2024, 2023 and 2022. In the first quarter of 2024 a product line previously included in Instruments has been reclassified to Endoscopy to align with a change in our internal reporting structure. We have reflected these changes in all historical periods presented.
Segment Net Sales |  |  |  |  |
MedSurg and Neurotechnology: | 2024 |  | 2023 |  | 2022
Instruments | $ | 2,834 |  |  | $ | 2,534 |  |  | $ | 2,245 |
Endoscopy | 3,389 |  |  | 3,068 |  |  | 2,759 |
Medical | 3,852 |  |  | 3,459 |  |  | 3,031 |
Neurovascular | 1,307 |  |  | 1,226 |  |  | 1,200 |
Neuro Cranial | 2,136 |  |  | 1,876 |  |  | 1,658 |
| $ | 13,518 |  |  | $ | 12,163 |  |  | $ | 10,893 |
Orthopaedics: |  |  |  |  |
Knees | $ | 2,447 |  |  | $ | 2,273 |  |  | $ | 1,997 |
Hips | 1,704 |  |  | 1,544 |  |  | 1,413 |
Trauma and Extremities | 3,507 |  |  | 3,147 |  |  | 2,807 |
Spinal Implants | 707 |  |  | 713 |  |  | 733 |
Other | 712 |  |  | 658 |  |  | 606 |
| $ | 9,077 |  |  | $ | 8,335 |  |  | $ | 7,556 |
Total | $ | 22,595 |  |  | $ | 20,498 |  |  | $ | 18,449 |
United States Net Sales |  |  |  |  |
MedSurg and Neurotechnology: | 2024 |  | 2023 |  | 2022
Instruments | $ | 2,267 |  |  | $ | 2,016 |  |  | $ | 1,776 |
Endoscopy | 2,792 |  |  | 2,513 |  |  | 2,245 |
Medical | 3,191 |  |  | 2,785 |  |  | 2,422 |
Neurovascular | 506 |  |  | 483 |  |  | 446 |
Neuro Cranial | 1,761 |  |  | 1,531 |  |  | 1,359 |
| $ | 10,517 |  |  | $ | 9,328 |  |  | $ | 8,248 |
Orthopaedics: |  |  |  |  |
Knees | $ | 1,788 |  |  | $ | 1,676 |  |  | $ | 1,493 |
Hips | 1,059 |  |  | 988 |  |  | 896 |
Trauma and Extremities | 2,586 |  |  | 2,297 |  |  | 2,035 |
Spinal Implants | 489 |  |  | 500 |  |  | 511 |
Other | 504 |  |  | 468 |  |  | 455 |
| $ | 6,426 |  |  | $ | 5,929 |  |  | $ | 5,390 |
Total | $ | 16,943 |  |  | $ | 15,257 |  |  | $ | 13,638 |
International Net Sales |  |  |  |  |
MedSurg and Neurotechnology: | 2024 |  | 2023 |  | 2022
Instruments | $ | 567 |  |  | $ | 518 |  |  | $ | 469 |
Endoscopy | 597 |  |  | 555 |  |  | 514 |
Medical | 661 |  |  | 674 |  |  | 609 |
Neurovascular | 801 |  |  | 743 |  |  | 754 |
Neuro Cranial | 375 |  |  | 345 |  |  | 299 |
| $ | 3,001 |  |  | $ | 2,835 |  |  | $ | 2,645 |
Orthopaedics: |  |  |  |  |
Knees | $ | 659 |  |  | $ | 597 |  |  | $ | 504 |
Hips | 645 |  |  | 556 |  |  | 517 |
Trauma and Extremities | 921 |  |  | 850 |  |  | 772 |
Spinal Implants | 218 |  |  | 213 |  |  | 222 |
Other | 208 |  |  | 190 |  |  | 151 |
| $ | 2,651 |  |  | $ | 2,406 |  |  | $ | 2,166 |
Total | $ | 5,652 |  |  | $ | 5,241 |  |  | $ | 4,811 |
MedSurg and Neurotechnology MedSurg and Neurotechnology products include surgical equipment, patient and caregiver safety technologies (Instruments), endoscopic and communications systems (Endoscopy), and patient handling, emergency medical equipment, intensive care disposable products and clinical communication and artificial intelligence-assisted virtual care platform technology (Medical), minimally invasive products for the treatment of acute ischemic and hemorrhagic stroke (Neurovascular), cranial, maxillofacial and chest wall devices as well as dural substitutes and sealants; 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 Orthopaedics products primarily include implants used in total joint replacements, such as hip, knee and shoulder, and trauma and extremities surgeries, and cervical and thoracolumbar systems that include fixation, minimally invasive and interbody systems used in spinal injury, complex spine 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 Spinal Implants 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. Costs to Obtain or Fulfill a Contract We typically do not incur costs to fulfill a contract before a product or service is provided to a customer due to the nature of our products and services. 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 deferred contract costs. 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, 2024 and 2023 deferred contracts costs recorded in our Consolidated Balance Sheets were not significant. Contract Assets and Liabilities Our contract assets primarily relate to conditional rights to consideration for work completed but not billed at the reporting date. On December 31, 2024 and 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 $978 and $860 on December 31, 2024 and 2023 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:
| 2024
Beginning contract liabilities | $ | 860 |
Revenue recognized from beginning of year contract liabilities | (553) |
Net advance consideration received during the period | 671 |
Ending contract liabilities | $ | 978 |

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