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Goodwill and Other Intangible Assets | 12 Months Ended
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Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract] |
GOODWILL AND OTHER INTANGIBLE ASSETS | NOTE C – GOODWILL AND OTHER INTANGIBLE ASSETS The gross carrying amount of goodwill and other intangible assets and the related accumulated amortization for intangible assets subject to amortization and accumulated goodwill impairment charges are as follows:
| As of December 31, 2023 |  | As of December 31, 2022
(in millions) | Gross Carrying Amount |  | Accumulated Amortization/ Write-offs |  | Gross Carrying Amount |  | Accumulated Amortization/ Write-offs
Technology-related | $ | 13,207 |  |  | $ | (8,101) |  |  | $ | 12,397 |  |  | $ | (7,378) |
Patents | 480 |  |  | (387) |  |  | 486 |  |  | (394) |
Other intangible assets | 2,130 |  |  | (1,500) |  |  | 1,960 |  |  | (1,400) |
Amortizable intangible assets | $ | 15,817 |  |  | $ | (9,988) |  |  | $ | 14,843 |  |  | $ | (9,173) |
Goodwill | $ | 24,287 |  |  | $ | (9,900) |  |  | $ | 22,820 |  |  | $ | (9,900) |
IPR&D | 54 |  |  |  |  | 112 |  |  |
Technology-related | 120 |  |  |  |  | 120 |  |  |
Indefinite-lived intangible assets | $ | 174 |  |  |  |  | $ | 232 |  |  |
The increase in our balance of goodwill and amortizable intangible assets is related primarily to our majority stake investment in Acotec completed in the first quarter of 2023 and our acquisitions of Apollo and Relievant completed during the second and fourth quarters of 2023, respectively. Intangible asset impairment charges were $58 million in 2023, $132 million in 2022 and $370 million in 2021. The impairment charges recorded in 2023 were primarily associated with the cancellation of an IPR&D program due to the incremental time and cost to complete the program and bring the technology to market. The impairment charges recorded in 2022 were primarily associated with amortizable technology-related intangible assets that were initially established following our acquisition of Vertiflex, Inc., which is now part of our Neuromodulation business, resulting from lower revenue projections due to reimbursement challenges. The following represents a rollforward of our goodwill balance by reportable segment:
(in millions) | MedSurg |  | Cardiovascular |  |  |  | Total
Balance as of December 31, 2021 | $ | 4,246 |  |  | $ | 7,741 |  |  |  |  | $ | 11,988 |
Goodwill acquired | — |  |  | 1,030 |  |  |  |  | 1,030 |
Foreign currency fluctuations and other changes | (10) |  |  | (88) |  |  |  |  | (98) |
Balance as of December 31, 2022 | $ | 4,237 |  |  | $ | 8,684 |  |  |  |  | $ | 12,920 |
Goodwill acquired | 1,110 |  |  | 337 |  |  |  |  | 1,447 |
Foreign currency fluctuations and other changes | — |  |  | 20 |  |  |  |  | 20 |
Balance as of December 31, 2023 | $ | 5,347 |  |  | $ | 9,041 |  |  |  |  | $ | 14,387 |
In the second quarter of 2023, we performed our annual goodwill impairment test utilizing both the qualitative and quantitative approach described in FASB ASC Topic 350. The qualitative approach was used for testing reporting units where fair value has historically exceeded carrying value by greater than 100 percent, and all other reporting units were tested using the quantitative approach. We determined that the fair value of each reporting unit exceeded its carrying value and concluded that goodwill was not impaired or at risk of impairment. Refer to Note A – Significant Accounting Policies for further discussion of our goodwill and intangible asset impairment testing. Estimated Amortization expense for each of the five succeeding fiscal years based upon our amortizable intangible asset portfolio, consisting of intangible assets acquired in a business combination or asset acquisition, as well as internally developed patents, as of December 31, 2023 is as follows:
Fiscal Year | (in millions)
2024 | $ | 828 |
2025 | 757 |
2026 | 737 |
2027 | 714 |
2028 | 690 |
These estimates do not include amortization expense associated with future acquisitions that have been announced but not yet completed as of December 31, 2023.

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- Definition The entire disclosure for goodwill and intangible assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Topic 350 -Name Accounting Standards Codification -Publisher FASB -URI https://asc.fasb.org//350/tableOfContent + Details
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