Boston Scientific (BSX) 10-K 20 Feb 24 2023 FY Annual report Financial data

Cover

Cover - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2023	Jan. 31, 2024	Jun. 30, 2023
Entity Information [Line Items]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Document Transition Report	false
Entity File Number	1-11083
Entity Registrant Name	BOSTON SCIENTIFIC CORPORATION
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-2695240
Entity Address, Address Line One	300 Boston Scientific Way
Entity Address, City or Town	Marlborough
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01752-1234
City Area Code	508
Local Phone Number	683-4000
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 79,000
Entity Listing, Par Value Per Share	$ 0.01
Entity Common Stock, Shares Outstanding		1,467,095,627
Entity Central Index Key	0000885725
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Amendment Flag	false
Documents Incorporated by Reference	Documents Incorporated by Reference Portions of the registrant’s definitive proxy statement to be filed within 120 days of December 31, 2023 with the Securities and Exchange Commission in connection with its 2024 Annual Meeting of Stockholders are incorporated by reference into Part III of this Form 10-K.
Common stock
Entity Information [Line Items]
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	BSX
Security Exchange Name	NYSE
Senior Note due 2027 [Member]
Entity Information [Line Items]
Title of 12(b) Security	0.625% Senior Notes due 2027
Trading Symbol	BSX27
Security Exchange Name	NYSE

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2023
Audit Information [Abstract]
Auditor Name	Ernst & Young LLP
Auditor Firm ID	42
Auditor Location	Boston, Massachusetts

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Net sales	$ 14,240	$ 12,682	$ 11,888
Cost of products sold	4,345	3,956	3,711
Gross profit	9,896	8,727	8,177
Operating expenses:
Selling, general and administrative expenses	5,190	4,520	4,359
Research and development expenses	1,414	1,323	1,204
Royalty expense	46	47	49
Amortization expense	828	803	741
Intangible asset impairment charges	58	132	370
Contingent consideration net expense (benefit)	58	35	(136)
Restructuring net charges (credits)	69	24	40
Litigation-related net charges (credits)	(111)	173	430
Loss (Gain) on Disposal of Businesses and Assets	0	22	(78)
Operating expenses	7,553	7,078	6,978
Operating income (loss)	2,343	1,649	1,199
Other income (expense):
Interest expense	(265)	(470)	(341)
Other, net	(93)	(38)	218
Income (loss) before income taxes	1,985	1,141	1,076
Income tax expense (benefit)	393	443	36
Net income (loss)	1,592	698	1,041
Preferred stock dividends	23	55	55
Net income (loss) attributable to noncontrolling interests	(1)	0	0
Net income (loss) attributable to Boston Scientific common stockholders	$ 1,570	$ 642	$ 985
Net income (loss) per common share — basic	$ 1.08	$ 0.45	$ 0.69
Net income (loss) per common share — diluted	$ 1.07	$ 0.45	$ 0.69
Weighted-average shares outstanding
Basic	1,453,000	1,430,500	1,422,300
Diluted	1,463,500	1,439,700	1,433,800

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 1,592	$ 698	$ 1,041
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustment	(105)	(94)	(125)
Net change in derivative financial instruments	(115)	63	170
Net change in defined benefit pensions and other items	(9)	37	11
Other comprehensive income (loss)	(230)	6	56
Comprehensive income (loss)	1,362	704	1,096
Comprehensive income (loss) attributable to noncontrolling interests	(11)	0	0
Comprehensive income attributable to Boston Scientific common stockholders	$ 1,373	$ 704	$ 1,096

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 865	$ 928
Trade accounts receivable, net	2,228	1,970
Inventories	2,484	1,867
Prepaid income taxes	315	264
Other current assets	621	731
Total current assets	6,514	5,760
Property, plant and equipment, net	2,859	2,446
Goodwill	14,387	12,920
Other intangible assets, net	6,003	5,902
Deferred tax assets	3,841	3,942
Other long-term assets	1,531	1,500
TOTAL ASSETS	35,136	32,469
Current liabilities:
Current debt obligations	531	20
Accounts payable	942	862
Accrued expenses	2,646	2,160
Other current liabilities	814	761
Total current liabilities	4,933	3,803
Long-term debt	8,571	8,915
Deferred tax liabilities	134	144
Other long-term liabilities	1,967	2,035
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value - authorized 50,000,000 shares; 0 shares issued as of December 31, 2023 and 10,062,500 shares issued as of December 31, 2022	0	0
Common stock, $0.01 par value - authorized 2,000,000,000 shares; 1,729,000,224 shares issued as of December 31, 2023 and 1,696,633,993 shares issued as of December 31, 2022	17	17
Treasury stock, at cost - 263,289,848 shares as of December 31, 2023 and 2022	(2,251)	(2,251)
Additional paid-in capital	20,647	20,289
Retained earnings (Accumulated deficit)	819	(750)
Accumulated other comprehensive income (loss), net of tax:	49	269
Equity, Attributable to Parent	19,282	17,573
Noncontrolling interests	248	0
Total stockholders’ equity	19,530	17,573
TOTAL LIABILITIES AND EQUITY	$ 35,136	$ 32,469

Consolidated Balance Sheet Para

Consolidated Balance Sheet Paranthetical - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Consolidated Balance Sheet (Parenthetical) [Abstract]
Preferred Stock, Par or Stated Value Per Share	$ 0.01	$ 0.01
Preferred Stock, Shares Authorized	50,000,000	50,000,000
Preferred Stock, Shares Issued	0	10,062,500
Common Stock, Par or Stated Value Per Share	$ 0.01	$ 0.01
Common Stock, Shares Authorized	2,000,000,000	2,000,000,000
Common Stock, Shares, Issued	1,729,000,224	1,696,633,993
Treasury Stock, Shares	263,289,848	263,289,848

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Millions	Total	Preferred stock	Common stock	Treasury Stock	Additional paid-in capital	Retained earnings (Accumulated deficit)	Accumulated other comprehensive income (loss), net of tax	Noncontrolling interests
Preferred Stock, Shares Issued at Dec. 31, 2020		10,062,500
Balance (Shares) at Dec. 31, 2020			1,679,911,918
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Conversion of mandatory convertible preferred stock to common stock		0	0
Impact of stock-based compensation plans			8,898,134
Preferred Stock, Shares Issued at Dec. 31, 2021		10,062,500
Balance (Shares) at Dec. 31, 2021	1,688,810,052		1,688,810,052
Beginning Stockholders' Equity at Dec. 31, 2020		$ 0	$ 17	$ (2,251)	$ 19,732	$ (2,378)	$ 207	$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Conversion of mandatory convertible preferred stock to common stock	$ 0	0	0
Impact of stock-based compensation plans			0		254
Repurchase of common stock				0
Net income (loss)	1,041					1,041
Preferred stock dividends						(55)
Foreign currency translation adjustment	(125)						(125)
Derivative financial instruments	170						170
Defined benefit pensions and other items	11						11
Changes to noncontrolling ownership interest								0
Net income (loss) attributable to noncontrolling interests	0							0
Changes in other comprehensive income (loss)	56							0
Ending Stockholders' Equity at Dec. 31, 2021	16,622	$ 0	$ 17	(2,251)	19,986	(1,392)	263	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total equity	$ 16,622
Conversion of mandatory convertible preferred stock to common stock		0	0
Impact of stock-based compensation plans			7,823,941
Preferred Stock, Shares Issued at Dec. 31, 2022	10,062,500	10,062,500
Balance (Shares) at Dec. 31, 2022	1,696,633,993		1,696,633,993
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Conversion of mandatory convertible preferred stock to common stock		$ 0	$ 0		0
Impact of stock-based compensation plans			0		303
Repurchase of common stock				0
Net income (loss)	$ 698					698
Preferred stock dividends						(55)
Foreign currency translation adjustment	(94)						(94)
Derivative financial instruments	63						63
Defined benefit pensions and other items	37						37
Changes to noncontrolling ownership interest								0
Net income (loss) attributable to noncontrolling interests	0							0
Changes in other comprehensive income (loss)	6						6	0
Ending Stockholders' Equity at Dec. 31, 2022	17,573	$ 0	$ 17	(2,251)	20,289	(750)	269	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total equity	$ 17,573
Conversion of mandatory convertible preferred stock to common stock		(10,062,500)	23,982,902
Impact of stock-based compensation plans			8,383,329
Preferred Stock, Shares Issued at Dec. 31, 2023	0	0
Balance (Shares) at Dec. 31, 2023	1,729,000,224
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Conversion of mandatory convertible preferred stock to common stock		$ 0	$ 0		0
Impact of stock-based compensation plans			0		359
Repurchase of common stock				0
Net income (loss)	$ 1,592					1,592
Preferred stock dividends						(23)
Foreign currency translation adjustment	(105)						(95)
Derivative financial instruments	(115)						(115)
Defined benefit pensions and other items	(9)						(9)
Changes to noncontrolling ownership interest								259
Net income (loss) attributable to noncontrolling interests	1							(1)
Changes in other comprehensive income (loss)	(230)						(219)	(10)
Ending Stockholders' Equity at Dec. 31, 2023	19,282	$ 0	$ 17	$ (2,251)	$ 20,647	$ 819	$ 49	$ 248
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total equity	$ 19,530

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Cash Flows [Abstract]
Net income (loss)	$ 1,592,000,000	$ 698,000,000	$ 1,041,000,000
Adjustments to reconcile net income (loss) to cash provided by (used for) operating activities
Loss (gain) on disposal of businesses and assets	0	22,000,000	(78,000,000)
Depreciation and amortization	1,196,000,000	1,136,000,000	1,093,000,000
Deferred and prepaid income taxes	(1,000,000)	(63,000,000)	(124,000,000)
Stock-based compensation expense	233,000,000	220,000,000	194,000,000
Goodwill and other intangible asset impairment charges	58,000,000	132,000,000	370,000,000
Net loss (gain) on investments and notes receivable	59,000,000	1,000,000	(250,000,000)
Contingent consideration net expense (benefit)	58,000,000	35,000,000	(136,000,000)
Inventory step-up amortization	6,000,000	32,000,000	34,000,000
Debt extinguishment net charges	0	194,000,000	0
Other, net	73,000,000	125,000,000	78,000,000
Increase (decrease) in operating assets and liabilities, excluding purchase accounting:
Trade accounts receivable	(238,000,000)	(220,000,000)	(279,000,000)
Inventories	(660,000,000)	(321,000,000)	(346,000,000)
Other assets	10,000,000	(209,000,000)	(134,000,000)
Accounts payable, accrued expenses and other liabilities	118,000,000	(255,000,000)	408,000,000
Cash provided by (used for) operating activities	2,503,000,000	1,526,000,000	1,870,000,000
Investing Activities
Purchases of property, plant and equipment and internal use software	(711,000,000)	(588,000,000)	(554,000,000)
Proceeds from sale of property, plant and equipment	4,000,000	12,000,000	14,000,000
Payments for acquisitions of businesses, net of cash acquired	(1,811,000,000)	(1,542,000,000)	(2,258,000,000)
Proceeds from (payments for) investments and acquisitions of certain technologies	(89,000,000)	(24,000,000)	279,000,000
Proceeds from disposal of certain businesses and assets	0	5,000,000	826,000,000
Proceeds from royalty rights	30,000,000	70,000,000	82,000,000
Proceeds from settlements of hedge contracts	2,000,000	56,000,000	15,000,000
Cash provided by (used for) investing activities	(2,574,000,000)	(2,011,000,000)	(1,597,000,000)
Financing Activities
Payment of contingent consideration previously established in purchase accounting	(39,000,000)	(335,000,000)	(15,000,000)
Payments for royalty rights	(50,000,000)	(75,000,000)	(85,000,000)
Payments on short-term borrowings	0	(250,000,000)	0
Net decrease in commercial paper	(4,000,000)	(1,000,000)	0
Payments on long-term borrowings and debt extinguishment costs	0	(3,184,000,000)	0
Proceeds from long-term borrowings, net of debt issuance costs	0	3,270,000,000	0
Cash dividends paid on preferred stock	(28,000,000)	(55,000,000)	(55,000,000)
Cash used to net share settle employee equity awards	(56,000,000)	(53,000,000)	(50,000,000)
Proceeds from issuances of shares of common stock pursuant to employee stock compensation and purchase plans	182,000,000	136,000,000	110,000,000
Cash provided by (used for) financing activities	5,000,000	(548,000,000)	(95,000,000)
Effect of foreign exchange rates on cash	(4,000,000)	(9,000,000)	(6,000,000)
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted cash equivalents	(70,000,000)	(1,042,000,000)	173,000,000
Cash, cash equivalents, restricted cash and restricted cash equivalents at beginning of period	1,126,000,000	2,168,000,000	1,995,000,000
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period	1,055,000,000	1,126,000,000	2,168,000,000
Supplemental Information
Cash paid for income taxes, net	512,000,000	662,000,000	302,000,000
Cash paid for interest	259,000,000	450,000,000	338,000,000
Fair value of contingent consideration recorded in purchase accounting	273,000,000	0	440,000,000
Non-cash impact of transferred royalty rights	(30,000,000)	(70,000,000)	(82,000,000)
Cash and cash equivalents	865,000,000	928,000,000	1,925,000,000
Restricted cash and restricted cash equivalents included in Other current assets	130,000,000	149,000,000	188,000,000
Restricted cash equivalents included in Other long-term assets	60,000,000	48,000,000	55,000,000
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period	$ 1,055,000,000	$ 1,126,000,000	$ 2,168,000,000

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
SIGNIFICANT ACCOUNTING POLICIES	NOTE A – SIGNIFICANT ACCOUNTING POLICIES Principles of Consolidation Our consolidated financial statements include the accounts of Boston Scientific Corporation's wholly owned subsidiaries and entities for which we have a controlling financial interest. All intercompany balances and transactions have been eliminated in consolidation. When used in this report, the terms "we," "us," "our" and "the Company" mean Boston Scientific Corporation and its divisions and subsidiaries. We assess the terms of our investment interests to determine if any of our investees meet the definition of a variable interest entity (VIE) . For any VIEs, we perform an analysis to determine whether our variable interests give us a controlling financial interest. The analysis identifies the primary beneficiary of a VIE as the enterprise that has both 1) the power to direct activities of a VIE that most significantly impact the entity’s economic performance and 2) the obligation to absorb losses of the entity or the right to receive benefits from the entity. Based on our assessments under the applicable guidance, we did not have controlling financial interests in any VIEs and, therefore, did not consolidate any VIEs during 2023, 2022 or 2021. Basis of Presentation The accompanying consolidated financial statements and notes thereto have been prepared in accordance with accounting principles generally accepted in the United States (GAAP) and with the instructions to Form 10-K and Regulation S-X. Amounts reported in millions within this Annual Report on Form 10-K are computed based on the amounts in thousands. As a result, the sum of the components may not equal the total amount reported in millions due to rounding. Certain columns and rows within tables may not add due to the use of rounded numbers. Percentages presented are calculated from the underlying unrounded numbers. Subsequent Events We evaluate events occurring after the date of our accompanying consolidated balance sheets for potential recognition or disclosure in our consolidated financial statements. Those items requiring recognition in the financial statements have been recorded and disclosed accordingly. Those items requiring disclosure (non-recognized subsequent events) in the financial statements have been disclosed accordingly. Refer to Note B – Acquisitions and Strategic Investments for further details. Accounting Estimates To prepare our consolidated financial statements in accordance with GAAP, management makes estimates and assumptions that may affect the reported amounts of our assets and liabilities, the disclosure of contingent liabilities as of the date of our consolidated financial statements and the reported amounts of our revenues and expenses during the reporting period. Our actual results may differ from these estimates. Refer to Critical Accounting Estimates included in Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations of this Annual Report on Form 10-K for further discussion. Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents Cash and Cash Equivalents We record Cash and cash equivalents in our consolidated balance sheets at cost, which approximates fair value. Our policy is to invest excess cash in short-term marketable securities earning a market rate of interest without assuming undue risk of loss of principal amounts invested and we limit our direct exposure to securities in any one industry or issuer. We consider cash equivalents to be all short-term marketable securities with remaining days to maturity of 90 days or less from the purchase date that can be readily converted to cash. Restricted Cash Amounts included in restricted cash represent cash on hand required to be set aside by a contractual agreement related to receivable factoring arrangements and deferred compensation plans and are included in Other current assets within our consolidated balance sheets. Generally, the restrictions related to the factoring arrangements lapse at the time we remit the customer payments collected by us for servicing previously sold customer receivables to the purchaser. Restrictions for deferred compensation lapse when amounts are paid to the employee. Restricted Cash Equivalents Restricted cash equivalents primarily represent amounts paid into various qualified settlement funds related to our ongoing transvaginal surgical mesh litigation and current amounts related to our non-qualified pension plan and are included in Other current assets within our consolidated balance sheets. The restrictions related to the various qualified settlement funds will lapse as we approve amounts payable to claimants, at which time we no longer have rights to a return of the amounts paid into the various qualified settlement funds. Restricted cash equivalents included in Other long-term assets within our consolidated balance sheets are related to deferred compensation plans. Concentrations of Credit Risk Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, derivative financial instruments and accounts and notes receivable. Our investment policy limits exposure to concentrations of credit risk and changes in market conditions. Counterparties to financial instruments expose us to credit-related losses in the event of nonperformance. We transact our financial instruments with a diversified group of major financial institutions with investment grade credit ratings and actively monitor their credit ratings and our outstanding positions to limit our credit exposure. In the normal course, our payment terms with customers, including distributors, hospitals, health care agencies, clinics, doctors' offices and other private and governmental institutions, are typically 30 days in the U.S. but may be longer in international markets and generally do not require collateral. We record credit loss reserves to Allowance for credit losses when we establish Trade accounts receivable if credit losses are expected over the asset's contractual life. We base our estimates of credit loss reserves on historical experience and adjust, as necessary, to reflect current conditions using reasonable and supportable forecasts not already reflected in the historical loss information. We utilize an accounts receivable aging approach to determine the reserve to record at accounts receivable commencement for certain customers, applying country or region-specific factors. In performing the assessment of outstanding accounts receivable, regardless of country or region, we may consider significant factors relevant to collectability, including those specific to a customer such as bankruptcy, lengthy average payment cycles and type of account. We write-off amounts determined to be uncollectible against this reserve. We are not dependent on any single institution, and no single customer accounted for more than ten percent of our net sales in 2023, 2022 and 2021; however, large group purchasing organizations, hospital networks, international distributors and dealers and other buying groups are important to our business and represent a substantial portion of our net sales. We closely monitor outstanding receivables for potential collection risks, including those that may arise from economic conditions, in both the U.S. and international economies. Our sales to government-owned or supported customers, particularly in southern Europe, are subject to an increased number of days outstanding prior to payment relative to other countries. Further, the ongoing site-of-service trend of shifting procedure volumes in the U.S. toward non-hospital settings, particularly ambulatory surgery centers and office-based labs, continues. Many of these customers are smaller than those we have historically done business with and may have more limited liquidity. We have adjusted our estimates of credit loss reserves for these customers, regions and conditions, as appropriate. We believe our Allowance for credit losses is adequate as of December 31, 2023; however, if significant changes were to occur in the payment practices of government customers, or if there is an increase in bankruptcies among our ambulatory surgery center or office-based customers, we may not be able to collect on receivables due to us from these customers, and our write-offs of uncollectible accounts may increase. Revenue Recognition We sell our products primarily through a direct sales force. In certain international markets, we sell our products through independent distributors or dealers. We consider revenue to be earned when all of the following criteria are met in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 606, Revenue from Contracts with Customers : • We have a contract with a customer that creates enforceable rights and obligations, • Promised products or services are identified, • The transaction price, or the amount we expect to receive, is determinable and • We have transferred control of the promised items to the customer. Transfer of control is evidenced upon passage of title and risk of loss to the customer unless we are required to provide additional services. We treat shipping and handling costs performed after a customer obtains control of the good as a fulfillment cost and record these costs as a component of Selling, general and administrative expenses when incurred. We recognize revenue from consignment arrangements based on product usage, or implant, which indicates that the sale is complete. We recognize a receivable at the point in time we have an unconditional right to payment. Payment terms are typically 30 days in the U.S. but may be longer in international markets. Deferred Revenue We record a contract liability, or deferred revenue, when we have an obligation to provide a product or service to the customer and payment is received or due in advance of our performance. When we sell a device with a future service obligation, we defer revenue on the unfulfilled performance obligation and recognize this revenue over the related service period. Many of our Cardiac Rhythm Management (CRM) product offerings combine the sale of a device with our LATITUDE™ Patient Management System, which represents a future service obligation. Generally, we do not have observable evidence of the standalone selling price related to our future service obligations; therefore, we estimate the selling price using an expected cost plus a margin approach. We allocate the transaction price using the relative standalone selling price method. The use of alternative estimates could result in a different amount of revenue deferral. Contract liabilities are classified within Other current liabilities and Other long-term liabilities on our accompanying consolidated balance sheets. Our contract liabilities are primarily composed of deferred revenue related to the LATITUDE™ Patient Management System. Revenue is recognized over the average service period which is based on device and patient longevity. Our contract liabilities also include deferred revenue related to the LUX-Dx™ Insertable Cardiac Monitor system, also within our CRM business, for which revenue is recognized over the average service period based on device longevity and usage. We have elected not to disclose the transaction price allocated to unsatisfied performance obligations when the original expected contract duration is one year or less. In addition, we have not identified material unfulfilled performance obligations for which revenue is not currently deferred. Variable Consideration We generally allow our customers to return defective, damaged and, in certain cases, expired products for credit. We base our estimate for sales returns upon historical trends and record the amount as a reduction to revenue when we sell the initial product. In addition, we may allow customers to return previously purchased products for next-generation product offerings. For these transactions, we defer recognition of revenue on the sale of the earlier generation product based upon an estimate of the amount of product to be returned when the next-generation products are shipped to the customer. Uncertain timing of next-generation product approvals, variability in product launch strategies, product recalls and variation in product utilization all affect our estimates related to sales returns and could cause actual returns to differ from these estimates. We also offer sales rebates and discounts to certain customers. We treat sales rebates and discounts as a reduction of revenue and classify the corresponding liability as current. We estimate rebates for products where there is sufficient historical information available to predict the volume of expected future rebates. If we are unable to reasonably estimate the expected rebates, we record a liability for the maximum rebate percentage offered. We have entered certain agreements with group purchasing organizations to sell our products to participating hospitals at negotiated prices. We recognize revenue from these agreements following the same revenue recognition criteria discussed above. Post-Implant Services We provide non-contractual services to customers, where necessary, to ensure the safe and effective use of certain implanted devices. Because the revenue related to the immaterial services is recognized before they are delivered, we forward accrue the costs to provide these services at the time the devices are sold. We record these costs to Selling, general and administrative expenses within our consolidated statements of operations. We estimate the amount of time spent by our representatives performing these services and their compensation throughout the device life to determine the service cost. Changes to our business practice or the use of alternative estimates could result in a different amount of accrued cost. Warranty Obligations We offer warranties on certain of our product offerings. The majority of our warranty liability relates to implantable devices offered by our CRM business, which include implantable defibrillator and pacemaker systems. These products come with a standard limited warranty covering the replacement of these devices. We offer a full warranty for a portion of the period post-implant and a partial warranty for a period of time thereafter. We estimate the costs that we may incur under our warranty programs based on the number of units sold, historical and anticipated rates of warranty claims and cost per claim and record a liability equal to these estimated costs as Cost of products sold at the time the product sale occurs. We assess the adequacy of our recorded warranty liabilities on a quarterly basis and adjust these amounts as necessary. Inventories We state inventories at the lower of first-in, first-out cost or net realizable value. We utilize a standard costing system, capitalizing variances between estimated and actual production costs during periods of normal production, and amortize to Cost of products sold over inventory turns. We expense manufacturing variances during periods of abnormal production, or less than 75 percent of manufacturing capacity. We did not record any abnormal production variances during the years ended December 31, 2023, 2022 or 2021. We base our provisions for excess, expired and obsolete inventory primarily on our estimates of forecasted net sales. A significant change in the timing or level of demand for our products as compared to forecasted amounts may result in recording additional provisions for excess, expired and obsolete inventory in the future. Further, the industry in which we participate is characterized by rapid product development and frequent new product introductions. Uncertain timing of next-generation product approvals, variability in product launch strategies, product recalls and variation in product utilization all affect our estimates related to excess, expired and obsolete inventory. Property, Plant and Equipment We state property, plant, equipment and leasehold improvements at historical cost. We charge expenditures for maintenance and repairs to expense and capitalize additions and improvements that extend the life of the underlying asset. We provide for depreciation using the straight-line method at rates that approximate the estimated useful lives of the assets. We depreciate buildings over a maximum life of 40 years; building improvements over the remaining useful life of the building structure; equipment, furniture and fixtures over a three seven Valuation of Business Combinations We allocate the amounts we pay for each acquisition to the assets we acquire and liabilities we assume based on their fair values at the date of acquisition, including identifiable intangible assets and in-process research and development (IPR&D), which either arise from a contractual or legal right or are separable from goodwill. We base the fair value of identifiable intangible assets acquired in a business combination, including IPR&D, on detailed valuations that use information and assumptions provided by management, which consider management’s best estimates of inputs and assumptions that a market participant would use. We allocate to goodwill any excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Transaction costs associated with these acquisitions are expensed as incurred through Selling, general and administrative expenses . In cases where we acquire a company in which we previously held an equity stake, we attribute a portion of the purchase price to the previously-held equity interest, which is implied based on the total purchase consideration allocable to each of the shareholders, including Boston Scientific, according to priority of equity interests. We record a gain or loss in Other, net equal to the difference between the implied fair value of our prior ownership and the book value immediately prior to the acquisition. Where an acquisition involves a contingent consideration arrangement, we recognize a liability equal to the fair value of the contingent payments we expect to make as of the acquisition date. We re-measure this liability each reporting period and record changes in the fair value through Contingent consideration net expense (benefit) on our consolidated statements of operations. Increases or decreases in the fair value of the contingent consideration liability can result from changes in discount rates, periods, timing and amount of projected revenue or timing or likelihood of achieving regulatory, revenue or commercialization-based milestones. Payment of additional consideration is generally contingent on the acquired company reaching certain performance milestones after the acquisition date, including attaining specified revenue levels, achieving product development targets and/or obtaining regulatory approvals for products in development at the date of the acquisition. Indefinite-lived Intangibles and IPR&D Our indefinite-lived intangible assets, which are not subject to amortization, include acquired balloon and other technology, which are foundational to our ongoing operations, as well as IPR&D intangible assets acquired in a business combination. Our IPR&D represents intangible assets that are used in research and development activities but have not yet reached technological feasibility, regardless of whether they have alternative future use. The primary basis for determining the technological feasibility or completion of these projects is obtaining regulatory approval to market the underlying products in an applicable geographic region. We classify IPR&D as an indefinite-lived intangible asset until the completion or abandonment of the associated research and development efforts. Upon completion of the associated research and development efforts, we will determine the useful life of the technology and begin amortizing the assets to reflect their use over their remaining lives. Upon permanent abandonment, we write-off the remaining carrying amount of the associated IPR&D intangible asset. We test our indefinite-lived intangible assets at least annually during the third quarter for impairment and reassess their classification as indefinite-lived assets. In addition, we review our indefinite-lived intangible assets for classification and impairment more frequently if impairment indicators exist. We assess qualitative factors to determine whether the existence of events and circumstances indicate that it is more likely than not that our indefinite-lived intangible assets are impaired. If we conclude that it is more likely than not that the asset is impaired, we then determine the fair value of the intangible asset and perform the quantitative impairment test by comparing the fair value with the carrying value in accordance with FASB ASC Topic 350, Intangibles - Goodwill and Other (FASB ASC Topic 350) . If the carrying value exceeds the fair value of the indefinite-lived intangible asset, we write the carrying value down to the fair value. We use the income approach to determine the fair values of our IPR&D. We base our revenue assumptions on estimates of relevant market sizes, expected market growth rates, expected trends in technology and expected levels of market share. In arriving at the value of the in-process projects, we consider, among other factors, the in-process projects’ stage of completion, the complexity of the work completed as of the acquisition date, the costs already incurred, the projected costs to complete, the contribution of other acquired assets, the expected regulatory path and introduction dates by region and the estimated useful life of the technology. See Note C – Goodwill and Other Intangible Assets for more information related to indefinite-lived intangibles, including IPR&D. For asset purchases outside of business combinations, we expense any purchased research and development assets as of the acquisition date. Amortization and Impairment of Intangible Assets We record definite-lived intangible assets at historical cost and amortize them over their estimated useful lives. We use a straight-line method of amortization, unless a method that better reflects the pattern in which the economic benefits of the intangible asset are consumed or otherwise used up can be reliably determined. The approximate useful lives for amortization of our intangible assets are as follows: patents and licenses, two five one Cost of products sold; Selling, general and administrative expenses and Research and development expenses, as appropriate within our accompanying consolidated statements of operations, and include in Amortization expense only that associated with intangible assets acquired in a business combination or asset acquisition, as well as internally-developed patents. We review intangible assets subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may indicate impairment include, but are not limited to, a significant adverse change in legal factors or business climate that could affect the value of an asset, a product recall or an adverse action or assessment by a regulator. If we determine it is more likely than not that the asset is impaired based on our qualitative assessment of impairment indicators, we test the intangible asset for recoverability. For purposes of the recoverability test, we group our amortizable intangible assets with other assets and liabilities at the lowest level of identifiable cash flows if the intangible asset does not generate cash flows independent of other assets and liabilities. If the carrying value of the intangible asset or asset group exceeds the undiscounted cash flows expected to result from the use and eventual disposition of the intangible asset or asset group, we will write the carrying value down to fair value in the period impairment is identified. We calculate fair value of our intangible assets as the present value of estimated future cash flows we expect to generate from the asset. In determining our estimated future cash flows associated with our intangible assets, we use estimates and assumptions about future revenue contributions, cost structures and remaining useful lives of the asset or asset group. See Note C – Goodwill and Other Intangible Assets for more information related to impairments of intangible assets. For patents developed internally, we capitalize costs incurred to obtain patents, including attorney fees, registration fees, consulting fees and other expenditures directly related to securing the patent. Goodwill Valuation We allocate any excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired in a business combination to goodwill. We test our goodwill balances, utilizing both the qualitative and quantitative approach described in FASB ASC Topic 350, Intangibles - Goodwill and Other , in the second quarter of each year as of April 1 for impairment, or more frequently if impairment indicators are present or changes in circumstances suggest an impairment may exist. We assess goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment, referred to as a component. For our 2023 annual impairment assessment, we identified the following reporting units for purposes of our annual goodwill impairment test: Interventional Cardiology, Rhythm Management, Peripheral Interventions, Endoscopy, Urology and Neuromodulation. Based on the criteria prescribed in FASB ASC Topic 350, we aggregated the Interventional Cardiology Therapies and Watchman components of our Cardiology operating segment into a single Interventional Cardiology reporting unit and aggregated the Cardiac Rhythm Management and Electrophysiology components into a single Rhythm Management reporting unit. In performing annual impairment assessments, the qualitative approach is used for testing reporting units where fair value has historically exceeded carrying value by greater than 100 percent, and all other reporting units are tested using the quantitative approach. When a quantitative test is performed, we typically use the income approach, specifically the Discounted Cash Flow method, to derive the fair value of each of our reporting units in preparing our goodwill impairment assessments. We historically selected this method as being the most meaningful in preparing our goodwill assessments because we believe the income approach most appropriately measures the fair value of our income producing assets. We make assumptions about the amount and timing of future expected cash flows, terminal value growth rates and appropriate discount rates. The amount and timing of future cash flows within our Discounted Cash Flow analysis is based on our most recent operational budgets, long range strategic plans and other estimates. Investments in Publicly Traded and Privately-Held Entities For publicly-held equity securities for which we do not have the ability to exercise significant influence, we measure at fair value with changes in fair value recognized currently in Other, net within our accompanying consolidated statements of operations. For privately-held equity securities for which we do not have the ability to exercise significant influence, we apply the measurement alternative approach and measure these investments at cost minus impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer. We account for investments in entities for which we have the ability to exercise significant influence under the equity method if we hold 50 percent or less of the voting stock and the entity is not a VIE in which we are the primary beneficiary in accordance with FASB ASC Topic 323, Investments - Equity Method and Joint Ventures . We record these investments initially at cost and adjust the carrying amount to reflect our share of the earnings or losses of the investee, including all adjustments similar to those made in preparing consolidated financial statements. Lastly, we have notes receivable from certain companies that we account for in accordance with FASB ASC Topic 320 , Investments - Debt and Equity Securities . Refer to Note B – Acquisitions and Strategic Investments for additional details on our investment balances. Each reporting period, we evaluate our investments to determine if there are any events or circumstances that are likely to have a significant adverse effect on the fair value of the investment. Examples of such impairment indicators include, but are not limited to, a significant deterioration in earnings performance, recent financing rounds at reduced valuations, a significant adverse change in the regulatory, economic or technological environment of an investee or a significant doubt about an investee’s ability to continue as a going concern. If we identify an impairment indicator, we will estimate the fair value of the investment and compare it to its carrying value. Our estimation of fair value considers financial information related to the investee available to us, including valuations based on recent third-party equity investments in the investee. For our investments for which we apply the measurement alternative, if the fair value of the investment is less than its carrying value, the investment is impaired and we recognize an impairment loss equal to the difference between an investment’s carrying value and its fair value. For our equity method investments, if we determine an impairment is other-than-temporary, we recognize an impairment loss equal to the difference between an investment’s carrying value and its fair value. We deem an impairment to be other-than-temporary unless available evidence indicates that the valuation is more likely than not to recover up to the carrying value of the investment in a reasonable period of time, and we have both the ability and intent to hold the investment for at least the period of time needed to recover the value. Net gains and losses and impairments associated with our investment portfolio are included within Other, net in our consolidated statements of operations. Income Taxes We utilize the asset and liability method of accounting for income taxes. Under this method, we determine deferred tax assets and liabilities based on differences between the financial reporting and tax bases of our assets and liabilities. We measure deferred tax assets and liabilities using the enacted tax rates and laws that will be in effect when we expect the differences to reverse. We reduce our deferred tax assets by a valuation allowance if, based upon the weight of available evidence, it is more likely than not that we will not realize some portion or all of the deferred tax assets. We consider relevant evidence, both positive and negative, to determine the need for a valuation allowance. Information evaluated includes our financial condition and results of operations for the current and preceding years, the availability of deferred tax liabilities and tax carrybacks, as well as estimates of the impact of future taxable income and available prudent and feasible tax-planning strategies. We recognize interest and penalties related to income taxes as a component of income tax expense. As part of the Tax Cuts and Jobs Act (TCJA), we are subject to a territorial tax system in which we are required to establish an accounting policy in providing for tax on Global Intangible Low Taxed Income (GILTI) earned by certain foreign subsidiaries. We have elected to treat the impact of GILTI as a period cost and report it as part of continuing operations. See Note H – Income Taxes for further information and discussion of our income tax provision and balances including a discussion of the impacts of the TCJA. Legal and Product Liability Costs We are involved in various legal and regulatory proceedings, including intellectual property, breach of contract, securities and product liability litigation. In some cases, the claimants seek damages, as well as other relief, which, if granted, could require significant expenditures or impact our ability to sell our products. We are also the subject of certain governmental investigations, which could result in substantial fines, penalties and administrative remedies. We maintain an insurance policy providing limit

Acquisitions and Strategic Inve

Acquisitions and Strategic Investments	12 Months Ended
	Dec. 31, 2023
Business Combinations [Abstract]
ACQUISITIONS AND STRATEGIC INVESTMENTS	NOTE B – ACQUISITIONS AND STRATEGIC INVESTMENTS Our consolidated financial statements include the operating results for acquired entities from the respective dates of acquisition. We have not presented supplemental pro forma financial information for completed acquisitions or divestitures given their results are not material to our consolidated financial statements. Further, transaction costs were immaterial to our consolidated financial statements and were expensed as incurred. On January 8, 2024, we announced our entry into a definitive agreement to acquire 100 percent of Axonics, Inc. (Axonics), a publicly traded medical technology company primarily focused on the development and commercialization of devices to treat urinary and bowel dysfunction. The purchase price is $71.00 in cash per share, or approximately $3.670 billion. The transaction is expected to close in the first half of 2024, subject to customary closing conditions. The Axonics business will be integrated into our Urology division. 2023 Acquisitions On February 20, 2023, we completed the acquisition of a majority stake investment in Acotec, a publicly traded Chinese manufacturer of drug-coated balloons and other products used in the treatment of vascular and other diseases. We consolidated this majority stake investment in Acotec based on the conclusion we control the entity, and recorded a noncontrolling interest for the portion we do not own. We acquired approximately 65 percent of the outstanding shares of Acotec, for an upfront cash payment of HK$20.00 per share, or $519 million at foreign currency exchange rates at closing. The Acotec portfolio complements our existing Peripheral Interventions portfolio. On April 4, 2023, we completed our acquisition of 100 percent of the outstanding equity of Apollo Endosurgery, Inc. (Apollo), a public company which offers a portfolio of devices used during endoluminal procedures to close gastrointestinal defects, manage gastrointestinal complications and aid in weight loss for patients suffering from obesity. The transaction consisted of an upfront cash payment of $636 million, net of cash acquired. The Apollo business is being integrated into our Endoscopy division. On November 17, 2023, we completed our acquisition of 100 percent of the outstanding equity of Relievant Medsystems, Inc. (Relievant), a privately held medical technology company that developed and commercialized the Intracept® Intraosseous Nerve Ablation System to treat vertebrogenic pain, a form of chronic low back pain. The transaction consisted of an upfront cash payment of $794 million, net of cash acquired, and additional sales-based milestones over the 3 years following the transaction close. These milestones, certain of which are uncapped, are estimated to have a fair value of $273 million. The Relievant business is being integrated into our Neuromodulation division. Purchase Price Allocation We accounted for these transactions as business combinations in accordance with FASB ASC Topic 805 , Business Combinations (FASB ASC Topic 805). The preliminary purchase prices were comprised of the amounts presented below: (in millions) Acotec (1) Apollo Relievant Payment for acquisition, net of cash acquired (2) $ 381 $ 636 $ 794 Fair value of contingent consideration — — 273 $ 381 $ 636 $ 1,067 (1) Excludes approximately $140 million of cash on hand at the closing of the transaction (2) Related to Acotec, represents our majority stake investment We recorded the assets acquired, liabilities assumed and specific to Acotec, the noncontrolling interest, at their respective fair values as of the closing date of the transaction. The preliminary purchase price allocations were comprised of the components presented below, which represent the preliminary determination of the fair value of identifiable assets acquired and liabilities assumed, as well as goodwill. The final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with FASB ASC Topic 805: (in millions) Acotec Apollo Relievant Goodwill $ 337 $ 378 $ 731 Amortizable intangible assets 334 248 325 Other assets acquired 93 50 24 Liabilities assumed (48) (33) (15) Net deferred tax liabilities (76) (5) 1 Fair value of noncontrolling interest (259) — — $ 381 $ 636 $ 1,067 The fair value of Acotec's noncontrolling interest was based on the publicly traded market value of the remaining 35 percent of the outstanding shares we did not acquire as of the transaction date and is presented within Stockholders' equity within our accompanying consolidated balance sheets. Goodwill was primarily established for Acotec due to opportunities for collaboration in research and development, manufacturing and commercial strategies, and for Apollo and Relievant, due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies, none of which is deductible for tax purposes. We allocated a portion of the purchase price to the specific intangible asset categories as follows: Amount Assigned (in millions) Weighted Average Amortization Period (in years) Risk-Adjusted Discount Acotec: Amortizable intangible assets: Technology-related $ 308 11 14% Customer relationships 15 11 14% Other intangible assets 11 13 14% $ 334 Apollo: Amortizable intangible assets: Technology-related $ 222 11 12% Customer relationships 26 11 12% $ 248 Relievant Amortizable intangible assets: Technology-related $ 287 12 12% Customer relationships 38 12 12% $ 325 2022 Acquisition On February 14, 2022, we completed our acquisition of Baylis Medical Company Inc. (Baylis Medical), a privately-held company which developed the radiofrequency (RF) NRG™ and VersaCross™ Transseptal Platforms as well as a family of guidewires, sheaths and dilators used to support left heart access, which expanded our electrophysiology and structural heart product portfolios. The transaction consisted of an upfront cash payment of $1.463 billion, net of cash acquired, subject to closing adjustments. We are integrating Baylis Medical into our Cardiology division. Purchase Price Allocation We accounted for the acquisition of Baylis Medical as a business combination in accordance with FASB ASC Topic 805. The final purchase price was comprised of the amount presented below: (in millions) Payment for acquisition, net of cash acquired $ 1,463 $ 1,463 We recorded the assets acquired and liabilities assumed at their respective fair values as of the acquisition date. The final purchase price allocation was comprised of the following components: (in millions) Goodwill $ 988 Amortizable intangible assets 657 Other assets acquired 112 Liabilities assumed (287) Net deferred tax liabilities (7) $ 1,463 Goodwill was primarily established due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies, and was deductible for tax purposes. We allocated a portion of the purchase price to the specific intangible asset categories as follows: Amount Assigned (in millions) Weighted Average Amortization Period (in years) Risk-Adjusted Discount Amortizable intangible assets: Technology-related 622 11 11% Other intangible assets 36 11 11% $ 657 Our technology-related intangible assets consist of technical processes, intellectual property and institutional understanding with respect to products and processes that we intend to leverage in future products or processes and will carry forward from one product generation to the next. We used the multi-period excess earnings method, a form of the income approach, to derive the fair value of the technology-related intangible assets and are amortizing them on a straight-line basis over their assigned estimated useful lives. Contingent Consideration Changes in the fair value of our contingent consideration liability during 2023 and 2022 associated with current and prior period acquisitions were as follows: (in millions) Balance as of December 31, 2021 $ 486 Contingent consideration net expense (benefit) 35 Contingent consideration payments (371) Balance as of December 31, 2022 $ 149 Amount recorded related to current year acquisitions 273 Contingent consideration net expense (benefit) 58 Contingent consideration payments (76) Balance as of December 31, 2023 $ 404 In 2023, payments were primarily related to our acquisition of Farapulse, Inc. (Farapulse) following the achievement of revenue milestones. In 2022, payments were primarily related to our acquisition of Farapulse and Preventice Solutions, Inc., following the achievement of revenue and/or regulatory milestones. The net expense of $58 million and $35 million recorded in 2023 and 2022, respectively, related primarily to an increase in expected revenue-based payments as a result of over-achievement of net sales performance, primarily related to our acquisition of Farapulse. In both periods, this increase was partially offset by a reduction in the contingent consideration liability for certain acquisitions for which we reduced the probability of achievement of associated regulatory and commercialization-based milestones upon which payment is conditioned. The maximum amount for certain contingent consideration is not determinable as it is uncapped and based on a percent of certain sales. As of December 31, 2023, the fair value of such uncapped contingent consideration is estimated at $177 million. As of December 31, 2023, the maximum amount that we could be required to pay under our other contingent consideration arrangements (undiscounted) is approximately $398 million. The recurring Level 3 fair value measurements of our contingent consideration liability that we expect to be required to settle include the following significant unobservable inputs: Contingent Consideration Liability Fair Value as of December 31, 2023 Valuation Technique Unobservable Input Range Weighted Average (1) Revenue-based Payments and Milestones $404 million Discounted Cash Flow Discount Rate 6 % - 12% 10% Probability of Payment 90% - 100% 98% Projected Year of Payment 2024 - 2027 2025 (1) Unobservable inputs were weighted by the relative fair value of the contingent consideration liability. For projected year of payment, the amount represents the median of the inputs and is not a weighted average. Projected contingent payment amounts related to our revenue-based payments and milestones are discounted back to the current period, primarily using a discounted cash flow model. Significant increases or decreases in projected revenues, probabilities of payment, discount rates or the time until payment is made would have resulted in a significantly lower or higher fair value measurement as of December 31, 2023. Strategic Investments The aggregate carrying amount of our strategic investments was comprised of the following: As of December 31, (in millions) 2023 2022 Equity method investments $ 219 $ 188 Measurement alternative investments (1, 2) 194 219 $ 413 $ 407 (1) Measurement alternative investments are privately-held equity securities without readily determinable fair values that are measured at cost less impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer, recognized in Other, net within our accompanying consolidated statements of operations. (2) Includes publicly-held equity securities and convertible notes measured at fair value with changes in fair value recognized in Other, net within our consolidated statements of operations. These investments are classified as Other long-term assets within our consolidated balance sheets, in accordance with GAAP and our accounting policies.

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	12 Months Ended
	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 Gross Carrying Amount Accumulated 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.

Hedging Activities and Fair Val

Hedging Activities and Fair Value Measurements	12 Months Ended
	Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
HEDGING ACTIVITIES AND FAIR VALUE MEASUREMENTS	NOTE D – HEDGING ACTIVITIES AND FAIR VALUE MEASUREMENTS Derivative Instruments and Hedging Activities We address market risk from changes in foreign currency exchange rates and interest rates through risk management programs which include the use of derivative and nonderivative financial instruments. We operate these programs pursuant to documented corporate risk management policies and do not enter into derivative transactions for speculative purposes. Our derivative instruments do not subject our earnings to material risk, as the gains or losses on these derivatives generally offset losses or gains recognized on the hedged item. We manage concentration of counterparty credit risk by limiting acceptable counterparties to major financial institutions with investment grade credit ratings, limiting the amount of credit exposure to individual counterparties and by actively monitoring counterparty credit ratings and the amount of individual credit exposure. We also employ master netting arrangements that limit the risk of counterparty non-payment on a particular settlement date to the net gain that would have otherwise been received from the counterparty. Although not completely eliminated, we do not consider the risk of counterparty default to be significant as a result of these protections. Further, none of our derivative instruments are subject to collateral or other security arrangements, nor do they contain provisions that are dependent on our credit ratings from any credit rating agency. Currency Hedging Instruments Risk Management Strategy Our risk from changes in currency exchange rates consists primarily of monetary assets and liabilities; forecasted intercompany and third-party transactions; and net investments in certain subsidiaries. We manage currency exchange rate risk at a consolidated level to reduce the cost of hedging by taking advantage of offsetting transactions. We employ derivative and nonderivative instruments, primarily forward currency contracts, to reduce the risk to our earnings and cash flows associated with changes in currency exchange rates. The success of our currency risk management program depends, in part, on forecast transactions denominated primarily in euro, Chinese renminbi, Japanese yen, British pound sterling, Australian dollar, Swiss franc and South Korean won. We may experience unanticipated currency exchange gains or losses to the extent the actual activity is different than forecasted. In addition, changes in currency exchange rates related to any unhedged transactions may impact our earnings and cash flows. Hedge Designations and Relationships Certain of our currency derivative instruments are designated as cash flow hedges under FASB ASC Topic 815, and are intended to protect the U.S. dollar value of forecasted transactions. The gain or loss on a derivative instrument designated as a cash flow hedge is recorded in the Net change in derivative financial instruments component of Other comprehensive income (loss), net of tax (OCI) within our consolidated statements of comprehensive income (loss) until the underlying third-party transaction occurs. When the underlying third-party transaction occurs, we recognize the gain or loss in earnings within Cost of products sold in our consolidated statements of operations. In the event the hedging relationship is no longer effective, or if the occurrence of the hedged forecast transaction becomes no longer probable, we reclassify the gains or losses within Accumulated other comprehensive income (loss), net of tax (AOCI) to earnings at that time. The cash flows related to the derivative instruments designated as cash flow hedges are reported as operating activities in our consolidated statements of cash flows. We also designate certain forward currency contracts as net investment hedges to hedge a portion of our net investments in certain of our entities with functional currencies denominated in the Japanese yen and Taiwan dollar. For these derivative instruments, we elected to use the spot method to assess hedge effectiveness. We also elected to exclude the spot-forward difference, referred to as the excluded component, from the assessment of hedge effectiveness and are amortizing this amount separately, as calculated at the date of designation, on a straight-line basis over the term of the currency forward contracts. As such, we defer recognition of foreign currency gains and losses within the Foreign currency translation adjustment (CTA) component of OCI, and we reclassify amortization of the excluded component from AOCI to current period earnings within Interest expense in our consolidated statements of operations. We designate certain euro-denominated debt as net investment hedges to hedge a portion of our net investments in certain of our entities with functional currencies denominated in the Euro. As of December 31, 2023 and 2022, we designated as a net investment hedge our €900 million in aggregate principal amount of 0.625% senior notes issued in November 2019 and due in 2027 (2027 Notes). For these nonderivative instruments, we defer recognition of the foreign currency remeasurement gains and losses within the CTA component of OCI. We reclassify these gains and losses to current period earnings within Other, net in our consolidated statements of operations only when the hedged item affects earnings, which would occur upon disposal or substantial liquidation of the underlying foreign subsidiary. We also use forward currency contracts that are not part of designated hedging relationships as a part of our strategy to manage our exposure to currency exchange rate risk related to monetary assets and liabilities and related forecast transactions. These non-designated currency forward contracts have an original time to maturity consistent with the hedged currency transaction exposures, generally less than one year, and are marked-to-market with changes in fair value recorded to earnings within Other, net in our consolidated statements of operations. Interest Rate Hedging Instruments Risk Management Strategy Our interest rate risk relates primarily to U.S. dollar and euro-denominated borrowings partially offset by U.S. dollar cash investments. We use interest rate derivative instruments to mitigate the risk to our earnings and cash flows associated with exposure to changes in interest rates. Under these agreements, we and the counterparty, at specified intervals, exchange the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional principal amount. We designate these derivative instruments either as fair value or cash flow hedges in accordance with FASB ASC Topic 815. Hedge Designations and Relationships We had no interest rate derivative instruments designated as cash flow hedges outstanding as of December 31, 2023 and December 31, 2022. In the event that we designate outstanding interest rate derivative instruments as cash flow hedges, we record the changes in the fair value of the derivatives within OCI until the underlying hedged transaction occurs. We had no interest rate derivative instruments designated as fair value hedges outstanding as of December 31, 2023 and December 31, 2022. In the event that we designate outstanding interest rate derivative instruments as fair value hedges, we record the changes in the fair values of interest rate derivatives designated as fair value hedges and of the underlying hedged debt instruments in Interest expense , which generally offset. The following table presents the contractual amounts of our hedging instruments outstanding: (in millions) FASB ASC Topic 815 Designation As of December 31, 2023 2022 Forward currency contracts Cash flow hedge $ 2,284 $ 2,725 Forward currency contracts Net investment hedge 333 365 Foreign currency-denominated debt (1) Net investment hedge 997 997 Forward currency contracts Non-designated 3,282 4,235 Total Notional Outstanding $ 6,896 $ 8,321 (1) Foreign currency-denominated debt is the €900 million debt principal designated as a net investment hedge. The remaining time to maturity as of December 31, 2023 is within 36 months for all forward currency contracts designated as cash flow hedges and generally less than one year for all non-designated forward currency contracts. The forward currency contracts designated as net investment hedges generally mature between one and two years. The euro-denominated debt principal designated as a net investment hedge has a contractual maturity of December 1, 2027. The following presents the effect of our derivative and nonderivative instruments designated as cash flow and net investment hedges under FASB ASC Topic 815 in our accompanying consolidated statements of operations. Refer to Note O – Changes in Other Comprehensive Income for the total amounts relating to derivative and nonderivative instruments presented within our consolidated statements of comprehensive income (loss). Effect of Hedging Relationships on Accumulated Other Comprehensive Income Amount Recognized in OCI on Hedges Consolidated Statements of Operations (1) Amount Reclassified from AOCI into Earnings (in millions) Pre-Tax Gain (Loss) Tax Benefit (Expense) Gain (Loss) Net of Tax Location of Amount Reclassified and Total Amount of Line Item Pre-Tax (Gain) Loss Tax (Benefit) Expense (Gain) Loss Net of Tax Year Ended December 31, 2023 Forward currency contracts Cash flow hedges $ 81 $ (18) $ 63 Cost of products sold $ 4,345 $ (235) $ 53 $ (182) Net investment hedges (2) 32 (7) 25 Interest expense 265 (10) 2 (8) Foreign currency-denominated debt Net investment hedges (3) (34) 8 (27) Other, net 93 — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 265 3 (1) 2 Year Ended December 31, 2022 Forward currency contracts Cash flow hedges $ 276 $ (62) $ 214 Cost of products sold $ 3,956 $ (209) $ 47 $ (162) Net investment hedges (2) 41 (10) 32 Interest expense 470 (10) 2 (8) Foreign currency-denominated debt Net investment hedges (3) 61 (14) 47 Other, net 38 — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 470 16 (4) 13 Year Ended December 31, 2021 Forward currency contracts Cash flow hedges $ 268 $ (60) $ 208 Cost of products sold $ 3,711 $ (54) $ 12 $ (42) Net investment hedges (2) 56 (13) 43 Interest expense 341 (13) 3 (10) Foreign currency-denominated debt Net investment hedges (3) 82 (19) 64 Other, net (218) — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 341 5 (1) 4 (1) In all periods presented in the table above, the pre-tax (gain) loss amounts reclassified from AOCI to earnings represent the effect of the hedging relationships on earnings. (2) For our outstanding forward currency contracts designated as net investment hedges, the net gain or loss reclassified from AOCI to earnings as a reduction of Interest expense represents the straight-line amortization of the excluded component as calculated at the date of designation. This initial value of the excluded component has been excluded from the assessment of effectiveness in accordance with FASB ASC Topic 815. In the current and prior periods, we did not recognize any gains or losses on the components included in the assessment of hedge effectiveness in earnings. (3) For our outstanding euro-denominated debt principal designated as a net investment hedge, the change in fair value attributable to changes in the spot rate is recorded in the CTA component of OCI. No amounts were reclassified from AOCI to current period earnings. As of December 31, 2023, pre-tax net gains or losses for our derivative instruments designated, or previously designated, as cash flow and net investment hedges under FASB ASC Topic 815 that may be reclassified from AOCI to earnings within the next twelve months are presented below (in millions): Designated Hedging Instrument FASB ASC Topic 815 Designation Location on Consolidated Statements of Operations Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings Forward currency contracts Cash flow hedge Cost of products sold $ 152 Forward currency contracts Net investment hedge Interest expense 9 Interest rate derivative contracts Cash flow hedge Interest expense (1) Net gains and losses on currency hedge contracts not designated as hedging instruments offset by net gains and losses from currency transaction exposures are presented below: (in millions) Location on Consolidated Statements of Operations Year Ended December 31, 2023 2022 2021 Net gain (loss) on currency hedge contracts Other, net $ 3 $ (53) $ (16) Net gain (loss) on currency transaction exposures Other, net (44) 21 (12) Net currency exchange gain (loss) $ (41) $ (31) $ (27) Fair Value Measurements FASB ASC Topic 815 requires all derivative and nonderivative instruments to be recognized at their fair values as either assets or liabilities on the balance sheet. We determine the fair value of our derivative and nonderivative instruments using the framework prescribed by FASB ASC Topic 820, Fair Value Measurements and Disclosures ( FASB ASC Topic 820), and considering the estimated amount we would receive or pay to transfer these instruments at the reporting date with respect to current currency exchange rates, interest rates, the creditworthiness of the counterparty for unrealized gain positions and our own creditworthiness for unrealized loss positions. In certain instances, we may utilize financial models to measure fair value of our derivative and nonderivative instruments. In doing so, we use inputs that include quoted prices for similar assets or liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, other observable inputs for the asset or liability and inputs derived principally from, or corroborated by, observable market data by correlation or other means. The following are the balances of our derivative and nonderivative assets and liabilities: (in millions) Location on Consolidated Balance Sheets (1) As of December 31, 2023 2022 Derivative and Nonderivative Assets: Designated Hedging Instruments Forward currency contracts Other current assets $ 140 $ 196 Forward currency contracts Other long-term assets 107 149 246 345 Non-Designated Hedging Instruments Forward currency contracts Other current assets 20 36 Total Derivative and Nonderivative Assets $ 266 $ 381 Derivative and Nonderivative Liabilities: Designated Hedging Instruments Forward currency contracts Other current liabilities $ 15 $ — Forward currency contracts Other long-term liabilities 9 1 Foreign currency-denominated debt (2) Long-term debt 988 952 1,012 953 Non-Designated Hedging Instruments Forward currency contracts Other current liabilities 38 52 Total Derivative and Nonderivative Liabilities $ 1,050 $ 1,005 (1) We classify derivative and nonderivative assets and liabilities as current when the settlement date of the contract is one year or less. (2) Foreign currency-denominated debt is the €900 million debt principal designated as a net investment hedge. A portion of this notional is subject to de-designation and re-designation based on changes in the underlying hedged item. Recurring Fair Value Measurements On a recurring basis, we measure certain financial assets and financial liabilities at fair value based upon quoted market prices. Where quoted market prices or other observable inputs are not available, we apply valuation techniques to estimate fair value. FASB ASC Topic 820 establishes a three-level valuation hierarchy for disclosure of fair value measurements. The category of a financial asset or a financial liability within the valuation hierarchy is based upon the lowest level of input that is significant to the measurement of fair value. The three levels of the hierarchy are defined as follows: • Level 1 – Inputs to the valuation methodology are quoted market prices for identical assets or liabilities. • Level 2 – Inputs to the valuation methodology are other observable inputs, including quoted market prices for similar assets or liabilities and market-corroborated inputs. • Level 3 – Inputs to the valuation methodology are unobservable inputs based on management’s best estimate of inputs market participants would use in pricing the asset or liability at the measurement date, including assumptions about risk. Assets and liabilities measured at fair value on a recurring basis consist of the following: As of December 31, 2023 December 31, 2022 (in millions) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Assets Money market funds and time deposits $ 454 $ — $ — $ 454 $ 673 $ — $ — $ 673 Publicly-held securities 18 — — 18 2 — — 2 Hedging instruments — 266 — 266 — 381 — 381 Licensing arrangements — — 77 77 — — 127 127 $ 472 $ 266 $ 77 $ 816 $ 674 $ 381 $ 127 $ 1,182 Liabilities Hedging instruments $ — $ 1,050 $ — $ 1,050 $ — $ 1,005 $ — $ 1,005 Contingent consideration liability — — 404 404 — — 149 149 Licensing arrangements — — 90 90 — — 159 159 $ — $ 1,050 $ 494 $ 1,545 $ — $ 1,005 $ 308 $ 1,313 Our investments in money market funds and time deposits are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices. These investments are classified as Cash and cash equivalents within our accompanying consolidated balance sheets, in accordance with GAAP and our accounting policies. In addition to $454 million invested in money market funds and time deposits as of December 31, 2023 and $673 million as of December 31, 2022, we held $411 million in interest-bearing and non-interest-bearing bank accounts as of December 31, 2023 and $256 million as of December 31, 2022. Our recurring fair value measurements using Level 3 inputs include those related to our contingent consideration liability. Refer to Note B – Acquisitions and Strategic Investments for a discussion of the changes in the fair value of our contingent consideration liability. In addition, our recurring fair value measurements using Level 3 inputs related to our licensing arrangements, including the contractual right to receive future royalty payments related to the Zytiga™ Drug. We own the contractual right to receive 50 percent of the future Zytiga Drug royalty payments from the licensee and remit such payments to the inventors associated with the intellectual property. We recognized a financial asset and associated liability for our licensing arrangements at fair value in our consolidated balance sheets using the fair value option in accordance with FASB ASC Topic 825, Financial Instruments. We elected the fair value option to measure the financial asset and associated liability as it provides for consistency and comparability of these financial instruments with others. Royalty payments we receive reduce the fair value of the financial asset and are presented within Proceeds from royalty rights, and payments we remit to inventors reduce the fair value of the financial liability and are presented within Payments for royalty rights within our consolidated statements of cash flows. We sold our right to receive and retain the other 50 percent of the future royalty payments in 2019 for an upfront cash payment, which we accounted for as a secured borrowing in accordance with FASB ASC Topic 860, Transfers and Servicing (FASB ASC Topic 860). Although we sold these rights, we continue to recognize at fair value the future royalty payments as a financial asset and associated liability. Royalty payments associated with the rights we sold no longer impact our cash flows, and we present this activity as Non-cash impact of transferred royalty rights in the supplemental information to our consolidated statements of cash flows. We reduce the fair value of the financial asset and associated liability when such non-cash activity occurs. We record the fair value of the financial asset and associated liability using a discounted cash flow approach considering the probability-weighted expected future cash flows to be generated by the royalty stream. The fair value of the financial liability also considers the related contractual provisions that govern our payment obligations. Significant increases or decreases in projected cash flows of the royalty stream and the related contractual provisions that govern our payment obligations, discount rates or the time until payment is made would have resulted in a significantly lower or higher fair value measurement of the licensing arrangements' financial asset and liability as of December 31, 2023. However, increases or decreases in the financial asset would be offset by increases or decreases in the financial liability, other than for timing of receipt and remittance; as such our earnings are not subject to material gains and losses from the licensing arrangement. The recurring Level 3 fair value measurements of our licensing arrangements recognized in our consolidated balance sheets as of December 31, 2023 include the following significant unobservable inputs: Licensing Arrangements Fair Value as of December 31, 2023 Valuation Technique Unobservable Input Range Weighted Average (1) Financial Asset $77 million Discounted Cash Flow Discount Rate 15% 15% Projected Year of Payment 2024 - 2025 2024 Financial Liability $90 million Discounted Cash Flow Discount Rate 12% - 15% 13% Projected Year of Payment 2024 - 2026 2025 (1) Unobservable inputs relate to a single financial asset and liability. As such, unobservable inputs were not weighted by the relative fair value of the instruments. For projected year of payment, the amount represents the median of the inputs and is not a weighted average. Changes in the fair value of our licensing arrangements' financial asset were as follows: (in millions) Balance as of December 31, 2021 $ 246 Proceeds from royalty rights (141) Fair value adjustment (expense) benefit 22 Balance as of December 31, 2022 $ 127 Proceeds from royalty rights (61) Fair value adjustment (expense) benefit 11 Balance as of December 31, 2023 $ 77 Changes in the fair value of our licensing arrangements' financial liability were as follows: (in millions) Balance as of December 31, 2021 $ 281 Payments for royalty rights (145) Fair value adjustment expense (benefit) 23 Balance as of December 31, 2022 $ 159 Payments for royalty rights (80) Fair value adjustment expense (benefit) 12 Balance as of December 31, 2023 $ 90 Non-Recurring Fair Value Measurements We hold certain assets and liabilities that are measured at fair value on a non-recurring basis in periods after initial recognition. The fair value of a measurement alternative investment is not estimated if there are no identified events or changes in circumstances that may have a significant adverse effect on the fair value of the investment. Refer to Note B – Acquisitions and Strategic Investments for a discussion of our strategic investments and Note C – Goodwill and Other Intangible Assets for a discussion of the fair values of our intangible assets including goodwill. The fair value of our outstanding debt obligations, excluding finance leases, was $8.735 billion as of December 31, 2023 and $8.203 billion as of December 31, 2022. We determined fair value by using quoted market prices for our publicly registered senior notes, classified as Level 1 within the fair value hierarchy, and face value for commercial paper, term loans and credit facility borrowings outstanding. Refer to Note E – Contractual Obligations and Commitments for a discussion of our debt obligations.

Contractual Obligations and Com

Contractual Obligations and Commitments	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
CONTRACTUAL OBLIGATIONS AND COMMITMENTS	NOTE E – CONTRACTUAL OBLIGATIONS AND COMMITMENTS Borrowings and Credit Arrangements We had total debt outstanding of $9.102 billion as of December 31, 2023 and $8.935 billion as of December 31, 2022, with current maturities of $531 million as of December 31, 2023 and $20 million as of December 31, 2022. The debt maturity schedule for our long-term debt obligations is presented below: Issuance Date Maturity Date As of December 31, Coupon Rate (1) (in millions, except interest rates) 2023 2022 March 2024 Notes February 2019 March 2024 — 504 3.450% March 2025 Senior Notes (3) March 2022 March 2025 1,105 1,067 0.750% June 2025 Senior Notes May 2020 June 2025 500 500 1.900% March 2026 Senior Notes February 2019 March 2026 255 255 3.750% December 2027 Senior Notes (3) November 2019 December 2027 995 960 0.625% March 2028 Senior Notes (3) March 2022 March 2028 829 800 1.375% March 2028 Senior Notes February 2018 March 2028 344 344 4.000% March 2029 Senior Notes February 2019 March 2029 272 272 4.000% June 2030 Senior Notes May 2020 June 2030 1,200 1,200 2.650% March 2031 Senior Notes (3) March 2022 March 2031 829 800 1.625% March 2034 Senior Notes (3) March 2022 March 2034 553 534 1.875% November 2035 Senior Notes (2) November 2005 November 2035 350 350 6.500% March 2039 Senior Notes February 2019 March 2039 450 450 4.550% January 2040 Senior Notes December 2009 January 2040 300 300 7.375% March 2049 Senior Notes February 2019 March 2049 650 650 4.700% Unamortized Debt Issuance Discount and Deferred Financing Costs 2024 - 2049 (65) (76) Finance Lease Obligation Various 5 5 Long-term debt $ 8,571 $ 8,915 (1) Coupon rates are semi-annual, except for the euro-denominated notes, which bear an annual coupon. (2) Corporate credit rating improvements may result in a decrease in the adjusted interest rate on our November 2035 Notes to the extent that our lowest credit rating is above BBB- or Baa3. The interest rates on our November 2035 Notes will be permanently reinstated to the issuance rate of 6.25% if the lowest credit ratings assigned to these senior notes is either A- or A3 or higher. (3) These notes are euro-denominated and presented in U.S. dollars based on the exchange rate in effect as of December 31, 2023 and 2022, respectively. Contractual maturities of our long-term debt outstanding as of December 31, 2023 are as follows ( in millions ): Fiscal Year 2025 1,605 2026 255 2027 995 2028 1,173 Thereafter 4,604 Revolving Credit Facility On May 10, 2021, we entered into a $2.750 billion revolving credit facility (2021 Revolving Credit Facility) with a global syndicate of commercial banks, initially scheduled to mature on May 10, 2026, with one-year extension options, subject to certain conditions. On March 1, 2023, we entered into an amendment of the 2021 Revolving Credit Facility credit agreement, which provided for an extension of the scheduled maturity date to May 10, 2027 and replaced the London Interbank Offered Rate (LIBOR) with the Secured Overnight Financing Rate (SOFR) as the Eurocurrency Rate for Dollars, including applicable credit spread adjustments and relevant SOFR benchmark provisions, among other things described under Financial Covenant below. This facility provides backing for our commercial paper program, and outstanding commercial paper directly reduces borrowing capacity under the 2021 Revolving Credit Facility. We had no amounts outstanding under the 2021 Revolving Credit Facility as of December 31, 2023 or December 31, 2022. Financial Covenant As of December 31, 2023, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility. Covenant Requirement Actual Maximum permitted leverage ratio (1) 3.75 times 2.33 times (1) Ratio of total debt to deemed consolidated Earnings Before Interest, Taxes, Depreciation and Amortization (EBITDA), as defined by the 2021 Revolving Credit Facility credit agreement, as amended. The 2021 Revolving Credit Facility includes the financial covenant requirement for all of our credit arrangements that we maintain the maximum permitted leverage ratio of 3.75 times for the remaining term. The agreement provides for higher leverage ratios, at our election, for the period following a qualified acquisition, for which consideration exceeds $1.000 billion. In the event of such an acquisition, for the four succeeding quarters immediately following, including the quarter in which the acquisition occurs, the maximum permitted leverage ratio is 4.75 times. It steps down for the fifth, sixth and seventh succeeding quarters to 4.50 times, 4.25 times and 4.00 times, respectively. Thereafter, a maximum leverage ratio of 3.75 times is required through the remaining term of the 2021 Revolving Credit Facility. We have not elected to increase the maximum permitted leverage ratio for qualified acquisitions to date, due to our funding of these acquisitions using cash on hand or commercial paper. The financial covenant requirement, as amended on March 1, 2023, provides for an exclusion from the calculation of consolidated EBITDA, as defined by the credit agreement, through maturity, of certain charges and expenses. The credit agreement amendment reset the starting date for purposes of calculating such permitted exclusions in each case from March 31, 2021 to December 31, 2022. Permitted exclusions include any non-cash charges and up to $500 million in restructuring charges and restructuring-related expenses related to our current or future restructuring plans. As of December 31, 2023, we had $317 million of the restructuring charge exclusion remaining. In addition, any cash litigation payments (net of any cash litigation receipts), as defined by the agreement, are excluded from the calculation of consolidated EBITDA, as defined by the agreement, provided that the sum of any excluded net cash litigation payments do not exceed $1.000 billion plus all accrued legal liabilities as of December 31, 2022. As of December 31, 2023, we had $1.484 billion of the litigation exclusion remaining. Any inability to maintain compliance with this covenant could require us to seek to further renegotiate the terms of our credit arrangements or seek waivers from compliance with this covenant, both of which could result in additional borrowing costs. Further, there can be no assurance that our lenders would agree to such new terms or grant such waivers on terms acceptable to us. In this case, all 2021 Revolving Credit Facility commitments would terminate, and any amounts borrowed under the facility would become immediately due and payable. Furthermore, any termination of our 2021 Revolving Credit Facility may negatively impact the credit ratings assigned to our commercial paper program, which may impact our ability to refinance any then outstanding commercial paper as it becomes due and payable . Commercial Paper Our commercial paper program is backed by the 2021 Revolving Credit Facility. We did not have any commercial paper outstanding as of December 31, 2023 and 2022. Senior Notes We had senior notes outstanding of $9.136 billion as of December 31, 2023 and $8.986 billion as of December 31, 2022. Our senior notes were issued in public offerings, are redeemable prior to maturity and are not subject to sinking fund requirements. Our senior notes are unsecured, unsubordinated obligations and rank on parity with each other. These notes are effectively junior to liabilities of our subsidiaries (see Other Arrangements below). In March 2022, American Medical Systems Europe B.V. (AMS Europe), an indirect, wholly owned subsidiary of Boston Scientific, completed a registered public offering (the Offering) of €3.000 billion in aggregate principal amount of euro-dominated senior notes comprised of €1.000 billion of 0.750% Senior Notes due 2025, €750 million of 1.375% Senior Notes due 2028, €750 million of 1.625% Senior Notes due 2031 and €500 million of 1.875% Senior Notes due 2034 (collectively, the Eurobonds). Boston Scientific has fully and unconditionally guaranteed all of AMS Europe's obligations under the Eurobonds, and no other subsidiary of Boston Scientific will guarantee these obligations. AMS Europe is a “finance subsidiary” as defined in Rule 13-01(a)(4)(vi) of Regulation S-X. The financial condition, results of operations and cash flows of AMS Europe are consolidated in the financial statements of Boston Scientific. The Offering resulted in cash proceeds of $3.270 billion, net of investor discounts and issuance costs. We used the net proceeds from the Offering to fund the tender offer and early redemption of combined aggregate principal amount of $3.275 billion of certain of our outstanding senior notes, as well as to pay accrued interest, tender premiums, fees and expenses. We recorded associated debt extinguishment net charges of $194 million during the first quarter of 2022 presented in Interest expense within our consolidated statements of operations. Other Arrangements We have accounts receivable factoring programs in certain European countries and with commercial banks in China and Japan which include promissory notes discounting programs. We account for our factoring programs as sales under FASB ASC Topic 860. We have no retained interest in the transferred receivables, other than collection and administration, and once sold, the accounts receivable are no longer available to satisfy creditors in the event of bankruptcy. Amounts de-recognized for accounts and notes receivable, which are excluded from Trade accounts receivable, net in our accompanying consolidated balance sheets, are aggregated by contract denominated currency below (in millions): As of December 31, 2023 As of December 31, 2022 Factoring Arrangements Amount Weighted Average Interest Rate Amount Weighted Average Interest Rate Euro denominated $ 206 5.1 % $ 161 2.4 % Yen denominated 214 0.6 % 194 0.6 % Renminbi denominated 14 2.9 % 13 3.1 % Other Contractual Obligations and Commitments We had outstanding letters of credit of $174 million as of December 31, 2023 and $135 million as of December 31, 2022, which consisted primarily of bank guarantees and collateral for workers' compensation insurance arrangements. As of December 31, 2023 and December 31, 2022, we had not recognized a related liability for our outstanding letters of credit in our consolidated balance sheets. As of December 31, 2023, future minimum purchase obligations, relating primarily to non-cancellable inventory commitments and capital expenditures entered in the normal course of business, were (in millions): Fiscal Year Unrecorded Purchase Obligations 2024 $ 951 2025 283 2026 155 2027 45 2028 31 Thereafter 150 $ 1,615 We have a supplier financing program offered primarily in the U.S. that enables our suppliers to opt to receive early payment at a nominal discount, while allowing us to lengthen our payment terms and optimize working capital. Our standard payment term in the U.S. is 90 days. All outstanding payables related to the supplier finance program are classified within Accounts Payable within our unaudited consolidated balance sheets and were $152 million as of December 31, 2023 and $129 million as of December 31, 2022.

Leases

Leases	12 Months Ended
	Dec. 31, 2023
Leases [Abstract]
LEASES	NOTE F – LEASES We have operating and finance leases for real estate including corporate offices, land, warehouse space, and vehicles and certain equipment. Leases with an initial term of 12 months or less are generally not recorded on the balance sheet, unless the arrangement includes an option to purchase the underlying asset, or an option to renew the arrangement, that we are reasonably certain to exercise (short-term leases). We recognize lease expense on a straight-line basis over the lease term for short-term leases that we do not record on our balance sheet. If there is a change in our assessment of the lease term and, as a result, the remaining lease term extends more than 12 months from the end of the previously determined lease term, or we subsequently become reasonably certain that we will exercise an option to purchase the underlying asset, the lease no longer meets the definition of a short-term lease and is accounted for as either an operating or finance lease and recognized on the balance sheet. In accordance with FASB ASC Topic 842, we account for the lease components and the non-lease components as a single lease component, with the exception of our warehouse leases. Our leases have remaining lease terms of less than 1 year to approximately 53 years, some of which may include options to extend the leases for up to 10 years. If we are reasonably certain we will exercise an option to extend the lease, the time period covered by the extension option is included in the lease term. We determine whether an arrangement is or contains a lease based on the unique facts and circumstances present at the inception of the arrangement. Operating lease liabilities and their corresponding right-of-use assets are recorded based on the present value of lease payments over the expected lease term. The interest rate implicit in lease contracts is typically not readily determinable. As such, we utilize the appropriate incremental borrowing rate, which is the rate incurred to borrow on a collateralized basis over a similar term at an amount equal to the lease payments in a similar economic environment. Certain adjustments to the right-of-use asset may be required for items such as initial direct costs paid or incentives received. Our operating lease right-of-use assets are presented within Other long-term assets and corresponding liabilities are presented within Other current liabilities and Other long-term liabilities on our consolidated balance sheets. Refer to Note E – Contractual Obligations and Commitments for information regarding our finance leases. As of December 31, 2023, we have entered into two leases for additional office, warehouse and lab space which have not yet commenced. These facilities are currently under construction. We do not control the building during construction and are thus not deemed to be the owner during construction. Total estimated undiscounted future lease payments are approximately $500 million, which includes a buyout option exercisable once construction is complete which we are reasonably certain to exercise with respect to one of the leases. These leases will commence at the end of 2024 and second half of 2025 with noncancellable lease terms ranging from 20 to 25 years. The following table presents supplemental balance sheet information related to our operating leases: As of December 31, (in millions) 2023 2022 Assets Operating lease right-of-use assets in Other long-term assets $ 439 $ 386 Liabilities Operating lease liabilities in Other current liabilities 76 61 Operating lease liabilities in Other long-term liabilities 390 347 The following table presents the weighted average remaining lease term and discount rate information related to our operating leases: As of December 31, 2023 2022 Weighted average remaining lease term 9 years 10 years Weighted average discount rate 4.5% 3.3% Our operating lease cost under FASB ASC Topic 842 was $96 million in 2023, $91 million in 2022 and $90 million in 2021. The following table presents supplemental cash flow information related to our operating leases: Year Ended December 31, (in millions) 2023 2022 Cash paid for amounts included in the measurement of operating lease liabilities Operating cash flows from operating leases $ 93 $ 91 Right-of-use assets obtained in exchange for operating lease obligations were $123 million and $43 million for the years ended December 31, 2023 and 2022, respectively. The following table presents the maturities of our operating lease liabilities as of December 31, 2023 (in millions): Fiscal year Operating Leases (1) 2024 $ 89 2025 78 2026 65 2027 49 2028 41 Thereafter 217 Total future minimum operating lease payments 539 Less: imputed interest (74) Present value of operating lease liabilities $ 466 (1) Excludes expected lease payments for lease terms that have not yet commenced.

Supplemental Balance Sheet Info

Supplemental Balance Sheet Information	12 Months Ended
	Dec. 31, 2023
Supplemental Balance Sheet Information [Abstract]
SUPPLEMENTAL BALANCE SHEET INFORMATION	NOTE G – SUPPLEMENTAL BALANCE SHEET INFORMATION Components of selected captions in our accompanying consolidated balance sheets are as follows: Trade accounts receivable, net As of December 31, (in millions) 2023 2022 Trade accounts receivable $ 2,338 $ 2,079 Allowance for credit losses (110) (109) $ 2,228 $ 1,970 The following is a rollforward of our Allowance for credit losses : Year Ended December 31, (in millions) 2023 2022 2021 Beginning balance $ 109 $ 108 $ 105 Credit loss expense 50 35 28 Write-offs (48) (35) (25) Ending balance $ 110 $ 109 $ 108 Inventories As of December 31, (in millions) 2023 2022 Finished goods $ 1,537 $ 1,171 Work-in-process 174 147 Raw materials 773 548 $ 2,484 $ 1,867 Approximately 22 percent of our finished goods inventory as of December 31, 2023 and approximately 27 percent as of December 31, 2022 was at customer locations pursuant to consignment arrangements or held by sales representatives. Other current assets As of December 31, (in millions) 2023 2022 Restricted cash and restricted cash equivalents $ 130 $ 149 Derivative assets 159 232 Licensing arrangements 47 60 Other 285 290 $ 621 $ 731 Property, plant and equipment, net As of December 31, (in millions) 2023 2022 Land $ 140 $ 137 Buildings and improvements 1,843 1,695 Equipment, furniture and fixtures 3,503 3,297 Capital in progress 857 598 6,343 5,728 Less: accumulated depreciation 3,484 3,282 $ 2,859 $ 2,446 Depreciation expense was $367 million in 2023, $333 million in 2022 and $352 million in 2021. Other long-term assets As of December 31, (in millions) 2023 2022 Restricted cash equivalents $ 60 $ 48 Operating lease right-of-use assets 439 386 Derivative assets 107 149 Investments 413 407 Licensing arrangements 30 67 Indemnification asset 176 172 Other 306 271 $ 1,531 $ 1,500 Accrued expenses As of December 31, (in millions) 2023 2022 Legal reserves $ 206 $ 231 Payroll and related liabilities 1,051 830 Rebates 389 352 Contingent consideration 304 74 Other 696 674 $ 2,646 $ 2,160 Other current liabilities As of December 31, (in millions) 2023 2022 Deferred revenue $ 266 $ 220 Licensing arrangements 49 79 Taxes payable 220 232 Other 278 230 $ 814 $ 761 Other long-term liabilities As of December 31, (in millions) 2023 2022 Accrued income taxes $ 470 $ 597 Legal reserves 172 212 Contingent consideration 100 75 Licensing arrangements 41 80 Operating lease liabilities 390 347 Deferred revenue 311 289 Other 484 434 $ 1,967 $ 2,035

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
INCOME TAXES	NOTE H – INCOME TAXES Our Income (loss) before income taxes consisted of the following: Year Ended December 31, (in millions) 2023 2022 2021 Domestic $ (394) $ (1,119) $ (648) Foreign 2,379 2,260 1,724 $ 1,985 $ 1,141 $ 1,076 The related expense (benefit) for income taxes consisted of the following: Year Ended December 31, (in millions) 2023 2022 2021 Current Federal $ 189 $ 51 $ 18 State 15 19 33 Foreign 116 381 127 320 451 178 Deferred Federal (82) (92) (256) State (22) (32) (3) Foreign 176 117 117 73 (7) (142) $ 393 $ 443 $ 36 The reconciliation of income taxes at the federal statutory rate to the actual expense (benefit) for income taxes is as follows: Year Ended December 31, 2023 2022 2021 U.S. federal statutory income tax rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 0.7 % 0.7 % 2.5 % Domestic taxes on foreign earnings 6.9 % 15.3 % 6.8 % Effect of foreign taxes (15.3) % (3.8) % (14.3) % Acquisition-related 2.2 % 4.4 % (8.1) % Research credit (2.9) % (4.5) % (3.0) % Valuation allowance 7.5 % (1.3) % 0.8 % Compensation-related 0.5 % 0.6 % (0.6) % Non-deductible expenses 0.4 % 0.4 % 0.4 % Uncertain tax positions (0.5) % 7.7 % 1.2 % Return to provision (0.1) % (2.1) % (5.7) % Change in tax rates (0.6) % (0.2) % 1.9 % Other, net — % 0.7 % 0.4 % 19.8 % 38.9 % 3.3 % Significant components of our deferred tax assets and liabilities are as follows: As of December 31, (in millions) 2023 2022 Deferred Tax Assets: Inventory costs and related reserves $ 30 $ 19 Tax benefit of net operating losses and credits 744 511 Reserves and accruals 305 304 Restructuring-related charges 14 6 Litigation and product liability reserves 88 103 Investment write-down 58 38 Compensation related 154 136 Federal benefit of uncertain tax positions 11 9 Intangible assets 3,394 3,668 Capitalized R&D 232 160 Property, plant and equipment — 2 5,029 4,954 Less: valuation allowance (1,220) (1,004) 3,809 3,950 Deferred Tax Liabilities: Property, plant and equipment 24 — Unrealized gains and losses on derivative financial instruments 66 117 Other 12 34 102 151 Net Deferred Tax Assets 3,707 3,799 Prepaid on intercompany profit 315 264 Net Deferred Tax Assets and Prepaid on Intercompany Profit $ 4,022 $ 4,062 Our deferred tax assets, deferred tax liabilities and prepaid on intercompany profit are included in the following locations within our accompanying consolidated balance sheets (in millions): Location on Consolidated Balance Sheets As of December 31, Component 2023 2022 Prepaid on intercompany profit Prepaid income taxes $ 315 $ 264 Non-current deferred tax asset Deferred tax assets 3,841 3,942 Deferred Tax Assets and Prepaid on Intercompany Profit 4,157 4,206 Non-current deferred tax liability Deferred tax liabilities 134 144 Deferred Tax Liabilities 134 144 Net Deferred Tax Assets and Prepaid on Intercompany Profit $ 4,022 $ 4,062 As of December 31, 2023 and 2022, we had U.S. federal and state tax net operating loss carryforwards and tax credits, the tax effect of which was $540 million and $464 million, respectively. In addition, we had foreign tax net operating loss carryforwards and tax credits, the tax effect of which was $203 million as of December 31, 2023, and $47 million as of December 31, 2022. These tax attributes expire periodically beginning in 2024. After consideration of all positive and negative evidence, we believe that it is more likely than not that a portion of our deferred tax assets will not be realized. As a result, we recorded a valuation allowance of $1.220 billion as of December 31, 2023, and $1.004 billion as of December 31, 2022. The increase in the valuation allowance as of December 31, 2023, compared to December 31, 2022, is primarily due to establishing valuation allowances on certain foreign deferred tax assets, mainly a capital loss carryforward in the UK. The income tax impact of the unrealized gain or loss component of other comprehensive income and stockholders' equity was a benefit of $39 million in 2023, a charge of $56 million in 2022 and a charge of $81 million in 2021. We obtain tax incentives through Free Trade Zone Regime offered in Costa Rica which allows 100 percent exemption from income tax in the first eight years of operations and 50 percent exemption in the following four years. This tax incentive resulted in income tax savings of $212 million in 2023, $162 million in 2022 and $149 million in 2021. The tax incentive for 100 percent exemption from income tax is expected to expire in 2027, with the 50 percent exemption to expire in 2031. The impact on Net income (loss) per common share - diluted was $0.15 for 2023, $0.11 for 2022 and $0.10 for 2021. We also benefit from tax incentives in Puerto Rico through a Grant of Industrial Tax Exemption (Grant) which applies a reduced tax rate to our taxable profits, resulting in income tax savings of $16 million in 2023, $21 million in 2022 and $27 million in 2021. This Grant expires in 2034, with an option to extend for an additional 15 years. The impact on Net income (loss) per common share - diluted was $0.01 in 2023 and $0.02 in the years 2022 and 2021. Additionally, we benefit from tax incentives in Malaysia which allow a full tax exemption on manufacturing of specific medical device products, which will expire in 2029, with an option to renew for an additional five-year term. This incentive has resulted in income tax savings of $20 million in 2023, $17 million in 2022 and $0 in 2021. The impact on Net income (loss) per common share - diluted was $0.01 in the years 2023 and 2022 and de minimis in 2021. As of December 31, 2023, we had $467 million of gross unrecognized tax benefits, of which a net $395 million, if recognized, would affect our effective tax rate. As of December 31, 2022, we had $492 million of gross unrecognized tax benefits, of which a net $410 million, if recognized, would affect our effective tax rate. As of December 31, 2021, we had $255 million of gross unrecognized tax benefits, of which a net $177 million, if recognized, would affect our effective tax rate. A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows: Year Ended December 31, (in millions) 2023 2022 2021 Beginning Balance $ 492 $ 255 $ 261 Additions based on positions related to the current year 65 88 8 Additions based on positions related to prior years 67 177 41 Reductions for tax positions of prior years (114) (20) (36) Settlements with taxing authorities (14) (1) (2) Statute of limitation expirations (29) (8) (17) Ending Balance $ 467 $ 492 $ 255 We are subject to U.S. federal income tax as well as income tax of multiple state and foreign jurisdictions. We have concluded all U.S. federal income tax matters through 2018 and substantially all material state and local income tax matters through 2016. We have concluded substantially all foreign income tax matters through 2015. In 2023, we received notification from the IRS that the examination of our 2017 and 2018 tax years was resolved. Due to the resolution of these tax years, we recorded a net tax benefit of $44 million to release the reserves related to these years. We paid tax of $16 million to the IRS reflecting the net balance of amounts due for the tax period including an increase to past transition tax installment payments for periods prior to 2023 and interest. The subsequent transition tax payments in 2024 and 2025 will be increased to reflect the final audit settlement. We recognize interest and penalties related to income taxes as a component of income tax expense. We had $70 million accrued for gross interest and penalties as of December 31, 2023, $77 million as of December 31, 2022, and $43 million as of December 31, 2021. Net tax expense related to interest and penalties was immaterial in 2023, 2022 and 2021. It is reasonably possible that within the next 12 months we will resolve multiple issues with foreign, federal and state taxing authorities, resulting in a reduction in our balance of unrecognized tax benefits of up to $24 million. For the year ended December 31, 2017, we were required under the TCJA to calculate a one-time transition tax based on our total post-1986 foreign subsidiaries' earnings and profits (E&P) that we previously deferred from U.S. income taxes. The amount of transition tax remains unchanged at approximately $937 million for both December 31, 2023 and 2022. We anticipate offsetting this liability against existing tax attributes, reducing the required payment to approximately $586 million, which will be remitted over an eight-year period. We have begun remitting the required installment payments, with a balance remaining of $264 million as of December 31, 2023. In addition, we have provided for U.S. state income taxes of $8 million on all U.S. dollar-denominated E&P accumulated through December 31, 2017, which constitutes the preponderance of our foreign subsidiaries' accumulated E&P through December 31, 2017. We intend to indefinitely reinvest the unremitted foreign earnings of all other subsidiaries as of December 31, 2017, as well as all subsequent earnings generated by all of our foreign subsidiaries. Determining the amount of unrecognized deferred tax liability related to any remaining undistributed foreign earnings and additional outside basis difference in these entities is not practicable.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	NOTE I – COMMITMENTS AND CONTINGENCIES The medical device market in which we participate is largely technology driven. As a result, intellectual property rights, particularly patents and trade secrets, play a significant role in product development and differentiation. Over the years, there has been litigation initiated against us by others, including our competitors, claiming that our current or former product offerings infringe patents owned or licensed by them. Intellectual property litigation is inherently complex and unpredictable. In addition, competing parties frequently file multiple suits to leverage patent portfolios across product lines, technologies and geographies and to balance risk and exposure between the parties. In some cases, several competitors are parties in the same proceeding, or in a series of related proceedings, or litigate multiple features of a single class of devices. These dynamics frequently drive settlement not only for individual cases, but also for a series of pending and potentially related and unrelated cases. Although monetary and injunctive relief is typically sought, remedies and restitution are generally not determined until the conclusion of the trial court proceedings and can be modified on appeal. Accordingly, the outcomes of individual cases are difficult to time, predict or quantify and are often dependent upon the outcomes of other cases in other geographies. During recent years, we successfully negotiated closure of several long-standing legal matters and have received favorable rulings in several other matters; however, there continues to be outstanding litigation. Adverse outcomes in one or more of these matters could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity. In addition, product liability, securities and commercial claims have been asserted against us and similar claims may be asserted against us in the future related to events not known to management at the present time. We maintain an insurance policy providing limited coverage against securities claims and we are substantially self-insured with respect to product liability claims and fully self-insured with respect to intellectual property infringement claims. The absence of significant third-party insurance coverage increases our potential exposure to unanticipated claims or adverse decisions. Product liability claims, securities and commercial litigation and other legal proceedings in the future, regardless of their outcome, could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity. In addition, like other companies in the medical device industry, we are subject to extensive regulation by national, state and local government agencies in the U.S. and other countries in which we operate. From time to time we are the subject of qui tam actions and governmental investigations often involving regulatory, marketing and other business practices. These qui tam actions and governmental investigations could result in the commencement of civil and criminal proceedings, substantial fines, penalties and administrative remedies and have a material adverse effect on our financial position, results of operations and/or liquidity. In accordance with FASB ASC Topic 450, Contingencies , we accrue anticipated costs of settlement, damages, losses for product liability claims and, under certain conditions, costs of defense, based on historical experience or to the extent specific losses are probable and estimable. Otherwise, we expense these costs as incurred. If the estimate of a probable loss is a range and no amount within the range is more likely, we accrue the minimum amount of the range. We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related net charges (credits) within our accompanying consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses within our accompanying consolidated statements of operations. Our accrual for legal matters that are probable and estimable was $377 million as of December 31, 2023, and $443 million as of December 31, 2022, and includes certain estimated costs of settlement, damages and defense primarily related to product liability cases or claims related to our transvaginal surgical mesh products. A portion of this accrual is already funded through our qualified settlement fund, which is included in restricted cash and restricted cash equivalents in Other current assets of $130 million as of December 31, 2023, and $149 million as of December 31, 2022. Refer to Note A – Significant Accounting Policies and Note G – Supplemental Balance Sheet Information for additional information. We recorded litigation-related net credits of $111 million in 2023, primarily related to the settlement of offensive patent litigation, and net charges of $173 million in 2022 and $430 million in 2021, primarily related to litigation associated with our transvaginal surgical mesh products, and other legal matters. We continue to assess certain litigation and claims to determine the amounts, if any, that management believes will be paid as a result of such claims and litigation and, therefore, additional losses may be accrued and paid in the future, which could materially adversely impact our operating results, cash flows and/or our ability to comply with our financial covenant. In management's opinion, we are not currently involved in any legal proceedings other than those specifically identified below, which, individually or in the aggregate, could have a material adverse effect on our financial condition, operations and/or cash flows. Unless included in our legal accrual or otherwise indicated below, a range of loss associated with any individual material legal proceeding cannot be reasonably estimated. Patent Litigation On November 20, 2017, The Board of Regents, University of Texas System and TissueGen. Inc. (collectively, UT), served a lawsuit against us in the Western District of Texas. The complaint against the Company alleges patent infringement of two U.S. patents owned by UT, relating to “Drug Releasing Biodegradable Fiber Implant” and “Drug Releasing Biodegradable Fiber for Delivery of Therapeutics,” and affects the manufacture, use and sale of our Synergy™ Stent System. UT primarily seeks a reasonable royalty. On March 12, 2018, the District Court for the Western District of Texas dismissed the action and transferred it to the United States District Court for the District of Delaware. On September 5, 2019, the Court of Appeals for the Federal Circuit affirmed the dismissal of the District Court for the Western District of Texas. In April 2020, the United States Supreme Court denied the UT’s Petition for Certiorari. UT proceeded with its case against the Company in Delaware. In January 2023, a jury trial was held on the issue of whether the one UT patent still asserted in the case was valid and whether it was infringed by the Company. On January 31, 2023, a jury concluded that UT’s patent was valid and willfully infringed by the Company, and awarded UT $42 million in damages. Following the trial, UT has filed a motion seeking prejudgment interest and enhanced damages. The Company has filed a motion seeking judgment as a matter of law in its favor or alternatively a new trial. Product Liability Litigation Multiple product liability cases or claims related to transvaginal surgical mesh products designed to treat stress urinary incontinence and pelvic organ prolapse have been asserted against us, predominantly in the United States, Canada, the United Kingdom, Scotland, Ireland, and Australia. Plaintiffs generally seek monetary damages based on allegations of personal injury associated with the use of our transvaginal surgical mesh products, including design and manufacturing claims, failure to warn, breach of warranty, fraud, violations of state consumer protection laws and loss of consortium claims. We have entered into individual and master settlement agreements in principle or are in the final stages of entering agreements with certain plaintiffs' counsel, to resolve the majority of these cases and claims. All settlement agreements were entered into solely by way of compromise and without any admission or concession by us of any liability or wrongdoing. In addition, in April 2021 the Company's Board of Directors received a shareholder demand under section 220 of the Delaware General Corporation Law, for inspection of books and records related to mesh settlements. The Company has notified our insurer and retained counsel to respond to the demand. We have established a product liability accrual for remaining claims asserted against us associated with our transvaginal surgical mesh products and the costs of defense thereof. We continue to engage in discussions with plaintiffs’ counsel regarding potential resolution of pending cases and claims, which we continue to vigorously contest. The final resolution of the cases and claims is uncertain and could have a material impact on our results of operations, financial condition and/or liquidity. Trials involving our transvaginal surgical mesh products have resulted in both favorable and unfavorable judgments for us. We do not believe that the judgment in any one trial is representative of potential outcomes of all cases or claims related to our transvaginal surgical mesh products. Governmental Investigations and Qui Tam Matters On December 1, 2015, the Brazilian governmental entity known as CADE (the Administrative Council of Economic Defense), served a search warrant on the offices of our Brazilian subsidiary, as well as on the Brazilian offices of several other major medical device makers who do business in Brazil, in furtherance of an investigation into alleged anti-competitive activity with respect to certain tender offers for government contracts. On June 20, 2017, CADE, through the publication of a “technical note,” announced that it was launching a formal administrative proceeding against Boston Scientific’s Brazilian subsidiary, Boston Scientific do Brasil Ltda. (BSB), as well as against the Brazilian operations of Medtronic, Biotronik and St. Jude Medical, two Brazilian associations, ABIMED and AMBIMO and 29 individuals for alleged anti-competitive behavior. Under applicable guidance, BSB could be fined a percentage of BSB’s 2016 gross revenues. In August 2021, the investigating commissioner issued a preliminary recommendation of liability against all of the involved companies, and also recommended that CADE impose fines and penalties. However, on October 25, 2021, the CADE Attorney General's office recommended dismissal of the charges and allegations against BSB and the individual BSB employees who were still individual defendants. Subsequently, on March 30, 2022, the Federal Prosecutor’s office issued a non-binding recommendation that is contrary to the Attorney General’s recommendation. The full Commission is considering both of these recommendations but has not yet issued its decision. We continue to deny the allegations, intend to defend ourselves vigorously and will appeal any decision of liability by the full Commission to the Brazilian courts. During such an appeal, the decision would have no force and effect, and the Court would consider the case without being bound by CADE’s decision. In March 2022, the Company received a whistleblower letter alleging Foreign Corrupt Practices Act violations in Vietnam. The Company has received related subpoenas for documents from the Office of the U.S. Attorney for the District of Massachusetts and the Securities and Exchange Commission. The Company is cooperating with government agencies while investigating these allegations. On April 5, 2023, the Company received a subpoena from the U.S. Department of Justice (DOJ) that seeks documents and information relating to its ambulatory electrocardiography monitoring (AECG) business. The Company is cooperating with the DOJ in responding to this subpoena. On December 18, 2023, the Company received a Civil Investigative Demand from the DOJ that relates to the provision of peripheral intervention services through office-based labs. The Company is cooperating with the DOJ in responding to the subpoena. Other Proceedings On December 4, 2020, Enrique Jevons, individually and on behalf of all others similarly situated, filed a class action complaint against the Company, Michael F. Mahoney and Daniel J. Brennan, stemming from the recall and retirement of the LOTUS Edge™ Aortic Valve System (LOTUS System) in United States District Court for the Eastern District of New York. On December 14, 2020, the parties agreed to transfer the case to the United States District Court for the District of Massachusetts. On December 16, 2020, Mariano Errichiello, individually and on behalf of all others similarly situated, filed a second, materially similar class action complaint against the Company, Michael F. Mahoney, Joseph M. Fitzgerald, and Daniel J. Brennan in the United States District Court for the District of Massachusetts. Subsequently, on March 30, 2021, the Court consolidated the two actions, and appointed Union Asset Management Holding AG as the lead plaintiff. The plaintiffs filed an Amended Complaint in June 2021 that seeks unspecified compensatory damages in favor of the alleged class as well as unspecified equitable relief. The Company filed a Motion to Dismiss in July 2021, which, in December 2022, the Court granted in part and denied in part. On October 23, 2023, the Company reached an agreement in principle with the lead plaintiff to settle the case. The settlement in principle is subject to approval of the Court. The Court granted the motion for preliminary approval of the proposed settlement on December 27, 2023, and scheduled a final approval hearing for April 23, 2024. On December 15, 2020, the Securities and Exchange Commission’s Boston Regional Office (Boston SEC) notified the Company that it was conducting an investigation related to the Company’s decision to retire the LOTUS System and issued a voluntary request for documents and information related to that decision. On February 10, 2021, the Boston SEC issued a second voluntary request for additional documents and information. The Company cooperated fully with the requests, and on January 3, 2022, the SEC informed us that it was concluding its investigation and that it did not intend to recommend an enforcement action. On February 8, 2021, the Company received a letter from The Vladimir Gusinsky Revocable Trust, a shareholder, demanding that the Company’s Board of Directors conduct an investigation into actions by the Company’s directors and executive officers regarding statements made about the effectiveness and commercial viability of the LOTUS System. The Trust subsequently agreed to stay its demand, pending the outcome of any dispositive motion against the Amended Complaint in the class action complaint described above. The Company received letters on behalf of the Union Excavators Local 731 Pension Fund, Diane Nachbaur, and Frank Tripson, three stockholders of the Company, on July 26, 2021, July 29, 2021, and February 13, 2023, respectively, each demanding access to certain books and records of the Company, pursuant to Section 220 of the Delaware General Corporation Law, regarding the business, operations, effectiveness and commercial viability of the LOTUS system, and related items. On April 7, 2023, Diane Nachbaur filed a shareholder derivative complaint in the United States District Court for the District of Massachusetts against the Company, Michael F. Mahoney, Nelda J. Connors, Charles J. Dockendorff, Yoshiaki Fujimori, Donna A. James, Edward J. Ludwig, David Roux, John E. Sununu, Ellen M. Zane, Joseph M. Fitzgerald, Daniel J. Brennan, Shawn McCarthy, Ian Meredith, Kevin Ballinger, and Susan Vissers Lisa. On May 8, 2023, the Court stayed the case until the conclusion of the consolidated class action case. On October 18, 2023, Frank Tripson filed a shareholder derivative complaint in the Court of Chancery of the State of Delaware against the Company, Michael F. Mahoney, Daniel J. Brennan, Joseph M. Fitzgerald, Shawn McCarthy, Kevin Ballinger, Ian Meredith, Susan Vissers Lisa, Nelda J. Connors, Charles J. Dockendorff, Yoshiaki Fujimori, Donna A. James, Edward J. Ludwig, Stephen P. MacMillan, David Roux, John E. Sununu, and Ellen M. Zane. On December 15, 2023, the Court stayed that case until March 31, 2024. Matters Concluded Since December 31, 2022 On October 28, 2015, the Company filed suit against Cook Group Limited and Cook Medical LLC (collectively, Cook) in the United States District Court for the District of Delaware (1:15-cv-00980) alleging infringement of certain Company patents regarding Cook’s Instinct™ Endoscopic Hemoclip. The Company was seeking lost profits, a reasonable royalty and a permanent injunction. The case was transferred to the District Court for the Southern District of Indiana. Cook filed Inter Partes Review (IPR) requests with the U.S. Patent and Trademark Office (USPTO) against four then-asserted patents, which resulted in the court staying the case until 2020. All IPRs concluded and confirmed the validity of certain claims of each challenged patent. In February 2023, the District Court issued summary judgment rulings dismissing certain claims and defenses. Trial on the remaining two asserted patents took place in May and June 2023 and the jury found that the Company’s patents were both valid and infringed and awarded the Company $158 million as lost profits. On August 4, 2023, the parties entered into a settlement to resolve all claims, and the case was dismissed on August 22, 2023.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2023
Stockholders' Equity Note [Abstract]
STOCKHOLDER'S EQUITY	NOTE J – STOCKHOLDERS' EQUITY Preferred Stock We are authorized to issue 50 million shares of preferred stock in one or more series and to fix the powers, designations, preferences and relative participating, option or other rights thereof, including dividend rights, conversion rights, voting rights, redemption terms, liquidation preferences and the number of shares constituting any series, without any further vote or action by our stockholders. On May 27, 2020, we completed an offering of 10,062,500 shares of 5.50% Mandatory Convertible Preferred Stock, Series A (MCPS) at a price to the public and liquidation preference of $100 per share. The net proceeds from the MCPS offering were approximately $975 million after deducting underwriting discounts and commissions and offering expenses. On June 1, 2023 (the Mandatory Conversion Date), all outstanding shares of MCPS automatically converted into shares of common stock. The conversion rate for each share of MCPS was 2.3834 shares of common stock. No action by the holders of the MCPS was required in connection with the mandatory conversion. Cash was paid in lieu of fractional shares in accordance with the terms of the MCPS. An aggregate of approximately 24 million shares of common stock, including shares of common stock issued to holders of MCPS that elected to convert prior to the Mandatory Conversion Date, were issued upon conversion of the MCPS. Following the mandatory conversion of the MCPS, there were no outstanding shares of MCPS. Prior to the Mandatory Conversion Date during 2023, the Audit Committee of our Board of Directors (the Committee), pursuant to authority delegated to such committee by our Board of Directors, declared, and we paid, cash dividends of $28 million, or $1.3750 per MCPS share to holders representing dividend periods through May 2023. Common Stock We are authorized to issue 2.000 billion shares of common stock, $0.01 par value per share. Holders of common stock are entitled to one vote per share. Holders of common stock are entitled to receive dividends, if and when declared by our Board of Directors, and to share ratably in our assets legally available for distribution to our stockholders in the event of liquidation. Holders of common stock have no preemptive, subscription, redemption, or conversion rights. The holders of common stock do not have cumulative voting rights. The holders of a majority of the shares of common stock can elect all of the directors and can control our management and affairs. Prior to the Mandatory Conversion Date, holders of common stock were junior to holders of MCPS in terms of liquidation preference. On December 14, 2020, our Board of Directors approved a stock repurchase program authorizing the repurchase of up to $1.000 billion of our common stock. We did not repurchase any shares of our common stock during 2023 and had the full amount available under the authorization as of December 31, 2023. There were approximately 263 million shares in treasury as of December 31, 2023 and 2022.

Stock Inventive and Purchase Pl

Stock Inventive and Purchase Plans	12 Months Ended
	Dec. 31, 2023
Stock Incentive and Purchase Plans [Abstract]
STOCK INCENTIVE AND PURCHASE PLANS	NOTE K – STOCK INCENTIVE AND PURCHASE PLANS Employee and Director Stock Incentive Plans In 2020, our Board of Directors and stockholders approved amendments to our 2011 Long-Term Incentive Plan effective October 1, 2020 (Amended and Restated 2011 LTIP), authorizing for issuance up to 171 million shares of our common stock. The Amended and Restated 2011 LTIP covers officers, directors, employees and consultants and provides for the grant of restricted or unrestricted common stock, restricted stock units (RSUs), options to acquire our common stock, stock appreciation rights, performance awards (market-based and performance-based RSUs) and other stock and non-stock awards. Shares reserved under our current and former stock incentive plans totaled approximately 145 million as of December 31, 2023. The Executive Compensation and Human Resources Committee (the Committee) of the Board of Directors, consisting of independent, non-employee directors may authorize the issuance of common stock and cash awards under the Amended and Restated 2011 LTIP in recognition of the achievement of long-term performance objectives established by the Committee. Non-qualified options issued to employees are generally granted with an exercise price equal to the market price of our stock on the grant date, vest over a three or four-year service period and have a ten-year contractual life. In the case of qualified options, if the recipient owns more than ten percent of the voting power of all classes of stock, the option granted will be at an exercise price of 110 percent of the fair market value of our common stock on the date of grant and will expire over a period not to exceed five years. Non-vested stock awards, including restricted stock awards (RSAs) and RSUs issued to employees are generally granted with an exercise price of zero and typically vest in four equal annual installments. These awards represent our commitment to issue shares to recipients after the vesting period. Upon each vesting date, such awards are no longer subject to risk of forfeiture and we issue shares of our common stock to the recipient. The following presents the impact of stock-based compensation on our consolidated statements of operations: Year Ended December 31, (in millions, except per share data) 2023 2022 2021 Cost of products sold $ 12 $ 12 $ 11 Selling, general and administrative expenses 179 167 147 Research and development expenses 42 41 36 233 220 194 Income tax (benefit) expense (35) (32) (29) $ 198 $ 188 $ 165 Net impact per common share - basic $ 0.14 $ 0.13 $ 0.12 Net impact per common share - assuming dilution $ 0.14 $ 0.13 $ 0.12 Stock Options We use the Black-Scholes option-pricing model to calculate the grant-date fair value of stock options granted to employees under our stock incentive plans. We calculated the fair value for options granted using the following estimated weighted-average assumptions: Year Ended December 31, 2023 2022 2021 Options granted (in thousands) 2,934 3,287 3,822 Weighted-average exercise price $ 47.43 $ 44.02 $ 37.69 Weighted-average grant-date fair value $ 16.83 $ 13.64 $ 10.77 Black-Scholes Assumptions Expected volatility 26 % 28 % 29 % Expected term (in years, weighted) 6.3 6.1 5.9 Risk-free interest rate 3.62% - 4.75% 1.42% - 3.87% 0.66% - 1.20% Expected Volatility We use our historical volatility and implied volatility as a basis to estimate expected volatility in our valuation of stock options. Expected Term We estimate the expected term of options using historical exercise and forfeiture data. We believe that this historical data provides the best estimate of the expected term of new option grants. Risk-Free Interest Rate We use yield rates on U.S. Treasury securities for a period approximating the expected term of the award to estimate the risk-free interest rate in our grant-date fair value assessment. Expected Dividend Yield We have not historically paid cash dividends on our common stock and currently we do not intend to pay cash dividends on our common stock. Therefore, we have assumed an expected dividend yield of zero in our grant-date fair value assessment. Information related to stock options under stock incentive plans are as follows: Stock Options (in thousands) Weighted Weighted Average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in millions) Outstanding as of December 31, 2020 23,122 $ 24 Granted 3,822 38 Exercised (4,796) 13 Cancelled/forfeited (699) 26 Outstanding as of December 31, 2021 21,448 $ 29 Granted 3,287 44 Exercised (2,745) 17 Cancelled/forfeited (502) 34 Outstanding as of December 31, 2022 21,489 $ 32 Granted 2,934 47 Exercised (3,325) 25 Cancelled/forfeited (249) 44 Outstanding as of December 31, 2023 20,850 $ 36 5.8 462 Exercisable as of December 31, 2023 13,532 31 4.5 359 Expected to vest as of December 31, 2023 7,052 44 8.1 99 Total vested and expected to vest as of December 31, 2023 20,584 $ 36 5.8 $ 458 The total intrinsic value of stock options exercised was $89 million in 2023, $72 million in 2022 and $137 million in 2021. Non-Vested Stock We value RSAs and RSUs based on the closing trading value of our shares on the date of grant. Information related to non-vested stock awards is as follows: Non-Vested Stock Award Units (in thousands) Weighted Average Balance as of December 31, 2020 9,987 $ 34 Granted 4,240 39 Vested (1) (3,823) 31 Forfeited (658) 36 Balance as of December 31, 2021 9,745 $ 37 Granted 3,854 45 Vested (1) (3,482) 36 Forfeited (680) 44 Balance as of December 31, 2022 9,438 $ 41 Granted 3,958 49 Vested (1) (3,624) 39 Forfeited (485) 44 Balance as of December 31, 2023 9,287 $ 45 (1) The number of shares vested includes shares withheld on behalf of employees to satisfy statutory tax withholding requirements. The total vesting date fair value of shares that vested was approximately $171 million in 2023, $150 million in 2022 and $148 million in 2021. Market-based RSU Awards During 2023, 2022 and 2021 we granted market-based RSU awards to certain members of our senior management team. The number of shares ultimately issued to the recipient is based on the total stockholder return (TSR) of our common stock as compared to the TSR of the common stock of the other companies in the S&P 500 Health Care Index over a three-year period. The number of RSUs ultimately granted under this program range from 0 percent to 200 percent of the target number awarded to the participant as determined by achievement of the TSR criteria of the program. In addition, in general, award recipients must remain employed by us throughout the three-year period to attain the full amount of the market-based RSUs that satisfied the market performance criteria. We determined the fair value of the market-based RSU awards to be approximately $13 million for 2023, $12 million for 2022 and $11 million for 2021. We determined these fair values based on Monte Carlo simulations as of the date of grant, utilizing the following assumptions: 2023 2022 2021 Awards Awards Awards Stock price on date of grant $ 47.28 $ 44.19 $ 37.50 Measurement period (in years) 2.9 2.9 2.9 Risk-free rate 4.31 % 1.71 % 0.20 % We recognize the expense on these awards in our consolidated statements of operations on a straight-line basis over the three-year measurement period. Organic Net Sales Growth and Free Cash Flow Performance-based RSU Awards During 2023, we granted organic net sales growth (ONSG) performance-based RSU awards to certain members of our senior management team. The attainment of these performance-based RSUs is based on our organic net sales growth over a three-year performance period beginning January 1, 2023 and ending December 31, 2025 against a target set by the Committee. The number of RSUs ultimately granted under this program range from 0 percent to 200 percent of the target number of performance-based RSUs awarded to the participant as determined by achievement of the performance criteria of the program. During 2022 and 2021, we granted free-cash flow performance-based RSU awards to certain members of our senior management team. The attainment of these performance-based RSUs is based on our adjusted free cash flow (AFCF) measured against our goal set by the Committee, based on our internal annual financial plan performance for AFCF. AFCF was measured over a one-year performance period beginning January 1st of each year and ending December 31st. The number of RSUs ultimately granted under this program range from 0 percent to 150 percent of the target number of performance-based RSUs awarded to the participant as determined by achievement of the performance criteria of the program. In addition, in general, award recipients must remain employed by us throughout a three-year service period (inclusive of the one-year performance period) to attain the full amount of the performance-based RSUs that satisfied the performance criteria. The following table presents our assumptions used in determining the fair value of our ONSG and AFCF awards currently expected to vest as of December 31, 2023: 2023 ONSG 2022 AFCF 2021 AFCF Fair value, net of forfeitures to date (in millions) $ 20 $ 7 $ 12 Achievement of target payout (1) 200 % 88 % 131 % Stock price used in determining fair value $ 47.28 $ 46.27 $ 42.48 (1) Company's estimate of target payout as of December 31, 2023. We recognize the expense on these awards in our consolidated statements of operations over the vesting period which is three years after the date of grant. Expense Attribution We recognize compensation expense for our stock incentive plan using a straight-line method over the substantive vesting period. Most of our stock awards provide for immediate vesting upon death or disability of the participant. In addition, our stock grants to employees provide for accelerated vesting of our stock-based awards, other than performance-based and market-based awards, upon retirement, if the stock award has been held for at least one year by the recipient. In accordance with the terms of our stock grants, for employees who will become retirement eligible prior to the vest date we expense stock-based awards, other than performance-based and market-based awards, over the greater of one year or the period between grant date and retirement-eligibility. The performance-based and market-based awards discussed above do not contain provisions that would accelerate the full vesting of the awards upon retirement-eligibility. We recognize stock-based compensation expense for the value of the portion of awards that are ultimately expected to vest. FASB ASC Topic 718, Compensation – Stock Compensation allows forfeitures to be estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. The term “forfeitures” is distinct from “cancellations” or “expirations” and represents only the unvested portion of the surrendered stock-based award. We have applied, based on an analysis of our historical forfeitures, a weighted-average annual forfeiture rate of approximately five percent to all unvested stock-based awards as of December 31, 2023, which represents the portion that we expect will be forfeited each year over the vesting period. We re-evaluate this analysis annually or more frequently if there are significant changes in circumstances and adjust the forfeiture rate as necessary. Ultimately, we will only recognize expense for those shares that vest. Unrecognized Compensation Cost We expect to recognize the following future expense for awards outstanding as of December 31, 2023: Unrecognized Compensation Cost (in millions) (1) Weighted Average Remaining Vesting Period (in years) Stock options $ 40 Non-vested stock awards 203 $ 243 1.7 (1) Amounts presented represent compensation cost, net of estimated forfeitures. Employee Stock Purchase Plan In May 2022, our stockholders approved an additional 10 million shares that may be issued under our global employee stock purchase plan. Our global employee stock purchase plan provides for the granting of options to purchase up to 60 million shares of our common stock to all eligible employees. Under the global employee stock purchase plan, we grant each eligible employee, at the beginning of each six-month offering period, an option to purchase shares of our common stock equal to not more than ten percent of the employee’s eligible compensation or the statutory limit under the U.S. Internal Revenue Code. Such options may be exercised only to the extent of accumulated payroll deductions at the end of the offering period, at a purchase price equal to 85 percent of the fair market value of our common stock at the beginning or end of each offering period, whichever is less. As of December 31, 2023, there were approximately 9 million shares available for future issuance under the employee stock purchase plan. Information related to shares issued or to be issued in connection with the employee stock purchase plan based on employee contributions and the range of purchase prices is as follows: Year Ended December 31, 2023 2022 2021 Shares issued or to be issued (in thousands) 2,623 2,850 2,578 Range of purchase prices $ 39.11 - $ 45.51 $ 31.68 - $ 32.31 $ 29.98 - $ 36.11 Expense recognized (in millions) $ 29 $ 28 $ 24 We use the Black-Scholes option-pricing model to calculate the grant-date fair value of shares issued under the employee stock purchase plan. We recognize expense related to shares purchased through the employee stock purchase plan ratably over the offering period.

Weighted Average Shares Outstan

Weighted Average Shares Outstanding	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
WEIGHTED AVERAGE SHARES OUTSTANDING	NOTE L – WEIGHTED AVERAGE SHARES OUTSTANDING Year Ended December 31, (in millions) 2023 2022 2021 Weighted average shares outstanding - basic 1,453.0 1,430.5 1,422.3 Net effect of common stock equivalents 10.6 9.2 11.5 Weighted average shares outstanding - diluted 1,463.5 1,439.7 1,433.8 The following securities were excluded from the calculation of weighted average shares outstanding - diluted because their effect in the periods presented below would have been antidilutive: Year Ended December 31, (in millions) 2023 2022 2021 Stock options outstanding (1) 0 6 3 MCPS (2) 10 24 24 (1) Represents stock options outstanding pursuant to our employee stock-based compensation plans with exercise prices that were greater than the average fair market value of our common stock for the related periods. (2) Represents common stock issuable upon the conversion of MCPS. Refer to Note J – Stockholders' Equity for additional information. We base Net income (loss) per common share - diluted upon the weighted-average number of common shares and common stock equivalents outstanding during each year. Potential common stock equivalents are determined using the treasury stock method. We exclude stock options, stock awards and, prior to the Mandatory Conversion Date, our MCPS, from the calculation if the effect would be anti-dilutive. The dilutive effect of MCPS is calculated using the if-converted method. The if-converted method assumes that these securities were converted to shares of common stock at the beginning of the reporting period to the extent that the effect is dilutive. In 2023, 2022 and 2021, the effect of assuming the conversion of MCPS into shares of common stock was anti-dilutive, and therefore excluded from the calculation of earnings per share (EPS). Accordingly, Net income (loss) was reduced by cumulative Preferred stock dividends , as presented in our consolidated statements of operations, for purposes of calculating Net income (loss) attributable to Boston Scientific common stockholders . On June 1, 2023, all outstanding shares of MCPS automatically converted into shares of common stock.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
SEGMENT REPORTING	NOTE M – SEGMENT REPORTING In the first quarter of 2022, we reorganized our operational structure in order to strengthen our category leadership in the markets we serve, and, in particular, benefit our Cardiology customers and patients. Following the reorganization, we have aggregated our core businesses into two reportable segments: MedSurg and Cardiovascular, each of which generates revenues from the sale of medical devices. We have revised prior periods to conform to the current year presentation. In accordance with FASB ASC Topic 280, Segment Reporting, we identified our reportable segments based on the nature of our products, production processes, type of customer, selling and distribution methods and regulatory environment, as well as the economic characteristics of each of our operating segments. We measure and evaluate our reportable segments based on their respective net sales, operating income, excluding intersegment profits, and operating income as a percentage of net sales, all based on internally-derived standard currency exchange rates to exclude the impact of foreign currency, which may be updated from year to year. We exclude from operating income of reportable segments certain corporate-related expenses and certain transactions or adjustments that our chief operating decision maker (CODM) considers to be non-operational, such as amounts related to amortization expense, goodwill and other intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges (credits), certain litigation-related net charges (credits) and European Union (EU) Medical Device Regulation (MDR) implementation costs. Although we exclude these amounts from operating income of reportable segments, they are included in reported Income (loss) before income taxes within our consolidated statements of operations and are included in the reconciliation below. Refer to Note N – Revenue for net sales by reportable segment presented in accordance with GAAP. A reconciliation of the totals reported for the reportable segments to the applicable line items within our accompanying consolidated statements of operations is as follows (in millions, except percentages). Prior period amounts have been restated at constant currency to conform to the current year presentation. Year Ended December 31, Net sales 2023 2022 2021 MedSurg $ 5,320 $ 4,805 $ 4,389 Cardiovascular 8,630 7,599 6,721 Total net sales of reportable segments 13,949 12,404 11,109 Other (1) — (60) 12 Impact of foreign currency fluctuations 291 338 766 $ 14,240 $ 12,682 $ 11,888 Year Ended December 31, Income (loss) before income taxes 2023 2022 2021 MedSurg $ 1,796 $ 1,458 $ 1,368 Cardiovascular 2,235 1,748 1,572 Total operating income of reportable segments 4,031 3,206 2,940 Unallocated amounts: Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments (293) 96 67 Intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges (credits), certain litigation-related net charges (credits) and EU MDR implementation costs (567) (789) (1,070) Amortization expense (828) (803) (741) Other (1) — (60) 3 Operating income (loss) 2,343 1,649 1,199 Other income (expense), net (358) (508) (123) Income (loss) before income taxes $ 1,985 $ 1,141 $ 1,076 (1) In 2022, amounts reflect sales reserves established for Italian government payback provisions, which are being disputed in the Italian court system. These amounts were not allocated to our reportable segments or considered by our CODM for resource allocation and decision-making purposes. In 2021, amounts relate to our Specialty Pharmaceuticals business. On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Prior to the divestiture, we presented the Specialty Pharmaceuticals business as a standalone operating segment alongside our reportable segments Operating income of reportable segments as a percentage of net sales of reportable segments Year Ended December 31, 2023 2022 2021 MedSurg 33.8 % 30.3 % 31.2 % Cardiovascular 25.9 % 23.0 % 23.4 % Year Ended December 31, Depreciation expense 2023 2022 2021 MedSurg $ 103 $ 88 $ 91 Cardiovascular 263 245 261 Consolidated depreciation expense $ 367 $ 333 $ 352 As of December 31, Total assets 2023 2022 MedSurg $ 2,888 $ 2,501 Cardiovascular 5,988 5,205 Total assets of reportable segments 8,876 7,706 Goodwill 14,387 12,920 Other intangible assets, net 6,003 5,902 All other corporate assets 5,869 5,941 $ 35,136 $ 32,469 As of December 31, Long-lived assets 2023 2022 U.S. $ 1,300 $ 1,241 Ireland 598 478 Costa Rica 373 246 Other countries 587 481 Property, plant and equipment, net 2,859 2,446 Goodwill 14,387 12,920 Other intangible assets, net 6,003 5,902 Operating lease right-of-use assets in Other long-term assets 439 386 $ 23,688 $ 21,653

Revenue

Revenue	12 Months Ended
	Dec. 31, 2023
Revenue from Contract with Customer [Abstract]
REVENUE	NOTE N – REVENUE We generate revenue primarily from the sale of single-use medical devices and present revenue net of sales taxes within our consolidated statements of operations. Our business structure is organized into five operating segments. The following tables disaggregate our revenue from contracts with customers by business unit and geographic region (in millions). Generally, we allocate revenue from contracts with customers to geographic regions based on the location where the sale originated. Year Ended December 31, 2023 2022 2021 Businesses U.S. Int'l Total U.S. Int'l Total U.S. Int'l Total Endoscopy $ 1,511 $ 970 $ 2,482 $ 1,341 $ 880 $ 2,221 1,222 $ 919 $ 2,141 Urology 1,369 595 1,964 1,257 516 1,773 1,120 463 1,583 Neuromodulation 736 240 976 715 202 917 713 196 909 MedSurg 3,617 1,805 5,422 3,312 1,599 4,911 3,055 1,578 4,633 Interventional Cardiology Therapies 743 1,674 2,417 744 1,485 2,228 778 1,431 2,209 Watchman 1,155 119 1,274 915 103 1,019 729 100 829 Cardiac Rhythm Management 1,405 813 2,218 1,337 763 2,100 1,214 805 2,019 Electrophysiology 370 430 800 275 310 585 128 237 365 Cardiology 3,673 3,036 6,709 3,271 2,662 5,932 2,850 2,572 5,422 Peripheral Interventions 1,135 975 2,110 1,048 850 1,899 996 824 1,820 Cardiovascular 4,808 4,011 8,819 4,319 3,512 7,831 3,846 3,396 7,242 Other 1 — — — — — (60) 10 4 13 Total Net Sales $ 8,425 $ 5,816 $ 14,240 $ 7,632 $ 5,111 $ 12,682 $ 6,911 $ 4,978 $ 11,888 (1) In 2022, amounts reflect sales reserves established for Italian government payback provisions, which are being disputed in the Italian court system. These amounts were not allocated to our reportable segments or considered by our CODM for resource allocation and decision-making purposes. In 2021, amounts relate to our Specialty Pharmaceuticals business. On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Prior to the divestiture, we presented the Specialty Pharmaceuticals business as a standalone operating segment alongside our reportable segments. Specialty Pharmaceuticals net sales were substantially U.S. based. Refer to Note M – Segment Reporting for information on our reportable segments. Year Ended December 31, Geographic Regions 2023 2022 2021 U.S. $ 8,425 $ 7,632 $ 6,901 Europe, Middle East and Africa 2,856 2,526 2,518 Asia-Pacific 2,400 2,116 2,070 Latin America and Canada 560 469 386 Other 1 — (60) 13 Total Net Sales $ 14,240 $ 12,682 $ 11,888 Emerging Markets (2) $ 2,310 $ 1,968 $ 1,656 (2) Periodically, we assess our list of Emerging Markets countries, and effective January 1, 2023, modified our list to include all countries except the United States, Western and Central Europe, Japan, Australia, New Zealand and Canada. We have revised prior period amounts to conform to the current year's presentation. Deferred Revenue Contract liabilities are classified within Other current liabilities and Other long-term liabilities within our accompanying consolidated balance sheets. Our deferred revenue balance was $577 million as of December 31, 2023 and $509 million as of December 31, 2022. Our contract liabilities are primarily composed of deferred revenue related to the LATITUDE™ Patient Management System within our Cardiology business, for which revenue is recognized over the average service period based on device and patient longevity. Our contract liabilities also include deferred revenue related to the LUX-Dx™ Insertable Cardiac Monitor system, also within our Cardiology business, for which revenue is recognized over the average service period based on device longevity and usage. We recognized revenue of $213 million in 2023 that was included in the above contract liability balance as of December 31, 2022. We have elected not to disclose the transaction price allocated to unsatisfied performance obligations when the original expected contract duration is one year or less. In addition, we have not identified material unfulfilled performance obligations for which revenue is not currently deferred. We capitalize sales force commissions related to contracts with customers when the associated revenue is expected to be earned over a period that exceeds one year. Deferred commissions are primarily related to the sale of devices enabled with our LATITUDE™ Patient Management System. We have elected to expense commission costs when incurred for contracts with an expected duration of one year or less. Capitalized commission fees are amortized over the period the associated products or services are transferred. Similarly, we capitalize certain recoverable costs related to the delivery of the LATITUDE™ Remote Monitoring Service. These fulfillment costs are amortized over the average service period. Refer to Note A – Significant Accounting Policies for additional information on our accounting policies relating to revenue recognition.

Changes in Other Comprehensive

Changes in Other Comprehensive Income	12 Months Ended
	Dec. 31, 2023
Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]
CHANGES IN OTHER COMPREHENSIVE INCOME	NOTE O – CHANGES IN OTHER COMPREHENSIVE INCOME The following table provides the reclassifications out of Other comprehensive income, net of tax attributable to Boston Scientific common stockholders: (in millions) Foreign Currency Translation Adjustments Net Change in Derivative Financial Instruments Net Change in Defined Benefit Pensions and Other Items Total Balance as of December 31, 2022 $ (1) $ 269 $ 1 $ 269 Other comprehensive income (loss) before reclassifications (87) 63 (10) (34) (Income) loss amounts reclassified from accumulated other comprehensive income (8) (178) 1 (185) Total other comprehensive income (loss) (95) (115) (9) (219) Balance as of December 31, 2023 $ (96) $ 154 $ (8) $ 49 (in millions) Foreign Currency Translation Adjustments Net Change in Derivative Financial Instruments Net Change in Defined Benefit Pensions and Other Items Total Balance as of December 31, 2021 $ 93 $ 206 $ (36) $ 263 Other comprehensive income (loss) before reclassifications (86) 214 36 163 (Income) loss amounts reclassified from accumulated other comprehensive income (8) (150) 1 (157) Total other comprehensive income (loss) (94) 63 37 6 Balance as of December 31, 2022 $ (1) $ 269 $ 1 $ 269 Refer to Note D – Hedging Activities and Fair Value Measurements for further detail on our net investment hedges recorded in Foreign currency translation adjustment and our cash flow hedges recorded in Net change in derivative financial instruments . The gains and losses on defined benefit and pension items before reclassifications and gains and losses on defined benefit and pension items reclassified from Accumulated other comprehensive income (loss), net of tax

New Accounting Pronouncements

New Accounting Pronouncements	12 Months Ended
	Dec. 31, 2023
Accounting Standards Update and Change in Accounting Principle [Abstract]
NEW ACCOUNTING PRONOUNCEMENTS	NOTE P – NEW ACCOUNTING PRONOUNCEMENTS Periodically, new accounting pronouncements are issued by the FASB or other standard setting bodies. Recently issued standards typically do not require adoption until a future effective date. Prior to their effective date, we evaluate the pronouncements to determine the potential effects of adoption on our consolidated financial statements. During 2023, we implemented the following standards, none of which had a material impact on our financial position or results of operations. ASC Update No. 2022-01 ASC Update No. 2022-01, Derivatives and Hedging (Topic 815): Fair Value Hedging - Portfolio Layer Method. Update No. 2022-01 expands the current single-layer method to allow multiple hedged layers of a single closed portfolio under the method, among other updates to these methods. We adopted Update No. 2022-01 on a prospective basis. ASC Update No. 2022-02 ASC Update No. 2022-02, Financial Instruments- Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures makes amendments related to troubled debt restructurings for entities that have adopted Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , as well as amendments related to vintage disclosures for entities with investments in financing receivables that have adopted Update No. 2016-13. We adopted Update No. 2022-02 on a prospective basis. ASC Update No. 2022-04 ASC Update No. 2022-04, Liabilities— Supplier Finance Programs (Subtopic 405-50) enhances the transparency of supplier finance programs by requiring that a buyer in a supplier finance program disclose sufficient qualitative and quantitative information about the program to allow a user of financial statements to understand the program's nature, activity during the period, changes from period to period, and potential magnitude. We adopted Update No. 2022-04 on a retrospective basis to each period in which a balance sheet is presented, except for the amendment on roll forward information, which we will apply prospectively beginning January 1, 2024. Standards to be Implemented In June 2022, the FASB issued ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions. Update No. 2022-03 clarifies the guidance in Topic 820 related to measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale of an equity security, as well as introduces new disclosure requirements for these types of equity securities. Update No. 2022-03 is effective for fiscal years beginning after December 15, 2023, including interim periods within those fiscal years. We do not expect the adoption to have a material impact on our financial position or results of operations. In November 2023, the FASB issued ASC Update No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. Update No. 2023-07 requires disclosure, on an annual and interim basis, of significant segment expenses that are regularly provided to the CODM and included within each reported measure of segment profit or loss in addition to disclosure of amounts for other segment items and a description of its composition. Update No. 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. We do not expect the adoption to have a material impact on our financial position or results of operations. In December 2023, the FASB issued ASC Update No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures . Update No. 2023-09 aims to enhance the transparency and decision usefulness of income tax disclosures. Update No. 2023-09 modifies the rules on income tax disclosures to require entities to disclose (1) specific categories in the rate reconciliation, (2) the income or loss from continuing operations before income tax expense or benefit (separated between domestic and foreign) and (3) income tax expense or benefit from continuing operations (separated by federal, state, and foreign). ASU 2023-09 also requires entities to disclose their income tax payments to international, federal, state and local jurisdictions, among other changes. Update No. 2023-09 is effective for fiscal years beginning after December 15, 2024. We expect to adopt Update No. 2023-09 prospectively. We are currently evaluating the potential impact of adopting this new guidance on our consolidated financial statements and related disclosures. No other new accounting pronouncements issued or effective in the period had or are expected to have a material impact on our consolidated financial statements.

Employee Retirement Plans (Note

Employee Retirement Plans (Notes)	12 Months Ended
	Dec. 31, 2023
Retirement Benefits [Abstract]
EMPLOYEE RETIREMENT PLANS	NOTE Q – EMPLOYEE RETIREMENT PLANS Defined Benefit Pension Plans Domestic Retirement Plans Following our 2006 acquisition of Guidant, we assumed the Guidant Supplemental Retirement Plan, a frozen, non-qualified defined benefit plan for certain former officers and employees of Guidant. The Guidant Supplemental Retirement Plan was partially funded through a Rabbi Trust that contains segregated company assets within restricted cash used to pay the benefit obligations related to the plan. We also maintain an Executive Retirement Plan, a defined benefit plan covering executive officers and other key contributors. Participants may retire with benefits once retirement conditions have been satisfied. U.K. Plan As a result of our 2019 acquisition of BTG plc. (BTG), we assumed a benefit obligation related to a defined benefit pension plan sponsored by BTG for eligible United Kingdom employees. During the second quarter of 2022, we transferred the benefit obligation and associated assets of the pension plan to third party insurers, and as a result, were relieved from primary responsibility of the benefit obligation and the related plan assets. The transaction did not have a material impact on our financial position or results of operations. Other International Retirement Plans In addition, we maintain retirement plans covering certain international employees. We use a December 31 measurement date for these plans and record the net unfunded and underfunded portion as a liability within non-current liabilities, with the current portion within accrued expenses, on the consolidated balance sheets, recognizing changes primarily through OCI. As of December 31, 2023 and 2022, the funded status of our plans were unfunded or underfunded in aggregate. The outstanding obligation is as follows: As of December 31, 2023 ( in millions) Accumulated Benefit Obligation (ABO) Projected Fair value of Plan Assets Unfunded/Underfunded Domestic Retirement Plans $ 54 $ 59 $ — $ 59 Other International Retirement Plans 145 159 101 58 $ 199 $ 218 $ 101 $ 117 As of December 31, 2022 ( in millions) Accumulated Benefit Obligation (ABO) Projected Fair value of Plan Assets Unfunded/Underfunded PBO Recognized Domestic Retirement Plans $ 50 $ 55 $ — $ 55 Other International Retirement Plans 140 152 101 51 $ 190 $ 207 $ 101 $ 105 A reconciliation of the changes in the PBO for our retirement plans is as follows: Year Ended December 31, (in millions) 2023 2022 Beginning obligations $ 207 $ 502 Service costs 10 13 Interest costs 7 3 Actuarial (gain) loss (4) (54) Plan curtailments/settlements (0) (191) Plan amendments and assumption changes 6 (25) Benefits paid (10) (6) Impact of foreign currency fluctuations 3 (37) Ending obligation $ 218 $ 207 The critical assumptions associated with our employee retirement plans for 2023 are as follows: Weighted Average Discount Rate Weighted Average Expected Return Weighted Average Rate of Compensation Increase (1) Domestic Retirement Plans 4.89% n/a 2.00% Other International Retirement Plans 2.85% 2.66% 3.00% (1) Rates of compensation increase were not weighted by relative fair value. As such, the amount represents the median of the inputs and is not a weighted average. The critical assumptions associated with our employee retirement plans for 2022 are as follows: Weighted Average Discount Rate Weighted Average Expected Return Weighted Average Rate of Compensation Increase (1) Domestic Retirement Plans 5.32% n/a 2.00% Other International Retirement Plans 2.62% 2.27% 3.00% (1) Rates of compensation increase were not weighted by relative fair value. As such, the amount represents the median of the inputs and is not a weighted average. A reconciliation of the changes in the fair value of plan assets for our funded retirement plans is as follows: Year Ended December 31, (in millions) 2023 2022 Beginning fair value $ 101 $ 336 Actual return on plan assets (1) (2) Employer contributions 11 16 Participant contributions 1 1 Plan curtailments/settlements (0) (185) Actuarial gain (loss) (0) (25) Benefits paid (10) (9) Impact of foreign currency fluctuations 0 (32) Ending fair value $ 101 $ 101 For our defined benefit plans, we base our discount rate on the rates of return available on high-quality bonds with maturities approximating the expected period over which benefits will be paid. The rate of compensation increase is based on historical and expected rate increases. We base our rate of expected return on plan assets on historical experience, our investment guidelines and expectations for long-term rates of return. Our assets are invested in a variety of securities, primarily equity securities and government bonds. These securities are considered Level 1 and Level 2 investments. Expected benefit payments are estimated based on the same assumptions used in determining our benefit obligation as of December 31, 2023. Actual benefit payments will depend on future employment and compensation, average years employed and average life spans, in addition to other factors. Changes in any of these factors could significantly impact these estimated future benefit payments. Benefit payments expected to be paid during the next ten years for our Domestic Retirement Plans and our Other International Retirement Plans are as follows: (in millions) Post Retirement Benefits 2024 $ 16 2025 13 2026 14 2027 15 2028 15 2029 - 2033 73 Defined Contribution Plan We also sponsor a voluntary 401(k) Retirement Savings Plan for eligible employees. We match 200 percent of employee elective deferrals for the first two percent of employee eligible compensation and 50 percent of employee elective deferrals greater than two percent, but not exceeding six percent, of employee eligible compensation. Total expense for our matching contributions to the plan was $135 million in 2023, $123 million in 2022 and $118 million in 2021.

Schedule II

Schedule II	12 Months Ended
	Dec. 31, 2018
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
SEC Schedule, 12-09, Schedule of Valuation and Qualifying Accounts Disclosure	Description (in millions) Balance at Credit loss exposure (1) Write-offs (2) Balance at Year Ended December 31, 2023: Allowances for credit losses $ 109 50 (48) $ 110 Year Ended December 31, 2022: Allowances for credit losses $ 108 35 (35) $ 109 Year Ended December 31, 2021: Allowances for credit losses $ 105 28 (25) $ 108 (1) We record credit loss reserves to Allowance for credit losses when we establish Trade accounts receivable if credit losses are expected over the asset's contractual life. Subsequent credit loss reserves are recorded when deemed uncollectible. Amounts shown within credit loss exposure above were established through selling, general and administrative expense. (2) Represents actual write-offs of uncollectible accounts.

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	12 Months Ended
	Dec. 31, 2023 shares	Dec. 31, 2023 shares
John Bradley Sorenson [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 6, 2023, John Bradley Sorenson, our Executive Vice President, Global Operations, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Sorenson’s plan covers the sale of 33,938 shares of our common stock to be acquired upon the exercise of stock options. Transactions under Mr. Sorenson’s plan are based upon pre-established dates and stock price thresholds and
Name	John Bradley Sorenson
Title	Executive Vice President, Global Operations
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 6, 2023
Arrangement Duration	421 days
Wendy Carruthers [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 17, 2023, Wendy Carruthers, our Executive Vice President, Human Resources, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Ms. Carruthers’ plan covers the sale of 76,113 shares of our common stock, including 46,893 shares to be acquired upon the exercise of stock options. Transactions under Ms. Carruthers’ plan are based upon pre-established dates and stock price thresholds and
Name	Wendy Carruthers
Title	Executive Vice President, Human Resources
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 17, 2023
Arrangement Duration	421 days
Arthur Butcher [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 22, 2023, Arthur Butcher, our Executive Vice President and Group President, MedSurg and Asia Pacific, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Butcher’s plan covers the sale of up to 77,687 shares of our common stock, including up to 54,514 shares to be acquired upon determination and/or vesting of performance share units and restricted share units, and 16,742 shares to be acquired upon the exercise of stock options. Transactions under Mr. Butcher’s plan are based upon pre-established dates and stock price thresholds and will only occur upon the expiration of the applicable mandatory cooling-off period. Mr. Butcher’s plan will terminate on the earlier of January 31, 2025 or the date all shares subject to the plan have been sold.
Name	Arthur Butcher
Title	Executive Vice President and Group President, MedSurg and Asia Pacific
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 22, 2023
Arrangement Duration	436 days
John Bradley Sorenson Rule Trading Arrangement, Common Stock [Member] | John Bradley Sorenson [Member]
Trading Arrangements, by Individual
Aggregate Available	33,938	33,938
Wendy Carruthers Rule Trading Arrangement, Common Stock [Member] | Wendy Carruthers [Member]
Trading Arrangements, by Individual
Aggregate Available	76,113	76,113
Wendy Carruthers Rule Trading Arrangement, Common Stock [Member] | Arthur Butcher [Member]
Trading Arrangements, by Individual
Aggregate Available	77,687	77,687
Wendy Carruthers Rule Trading Arrangement, Stock Options [Member] | Wendy Carruthers [Member]
Trading Arrangements, by Individual
Aggregate Available	46,893	46,893
Arthur Butcher Rule Trading Arrangement, PSU and RSU [Member] | Arthur Butcher [Member]
Trading Arrangements, by Individual
Aggregate Available	54,514	54,514
Arthur Butcher Rule Trading Arrangement, Stock Options [Member] | Arthur Butcher [Member]
Trading Arrangements, by Individual
Aggregate Available	16,742	16,742

Significant Accounting Polici_2

Significant Accounting Policies Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying consolidated financial statements and notes thereto have been prepared in accordance with accounting principles generally accepted in the United States (GAAP) and with the instructions to Form 10-K and Regulation S-X. Amounts reported in millions within this Annual Report on Form 10-K are computed based on the amounts in thousands. As a result, the sum of the components may not equal the total amount reported in millions due to rounding. Certain columns and rows within tables may not add due to the use of rounded numbers. Percentages presented are calculated from the underlying unrounded numbers.
Subsequent Events	Subsequent Events We evaluate events occurring after the date of our accompanying consolidated balance sheets for potential recognition or disclosure in our consolidated financial statements. Those items requiring recognition in the financial statements have been recorded and disclosed accordingly. Those items requiring disclosure (non-recognized subsequent events) in the financial statements have been disclosed accordingly. Refer to Note B – Acquisitions and Strategic Investments for further details.
Accounting Estimates	Accounting Estimates To prepare our consolidated financial statements in accordance with GAAP, management makes estimates and assumptions that may affect the reported amounts of our assets and liabilities, the disclosure of contingent liabilities as of the date of our consolidated financial statements and the reported amounts of our revenues and expenses during the reporting period. Our actual results may differ from these estimates. Refer to Critical Accounting Estimates included in Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations of this Annual Report on Form 10-K for further discussion.
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents Cash and Cash Equivalents We record Cash and cash equivalents in our consolidated balance sheets at cost, which approximates fair value. Our policy is to invest excess cash in short-term marketable securities earning a market rate of interest without assuming undue risk of loss of principal amounts invested and we limit our direct exposure to securities in any one industry or issuer. We consider cash equivalents to be all short-term marketable securities with remaining days to maturity of 90 days or less from the purchase date that can be readily converted to cash. Restricted Cash Amounts included in restricted cash represent cash on hand required to be set aside by a contractual agreement related to receivable factoring arrangements and deferred compensation plans and are included in Other current assets within our consolidated balance sheets. Generally, the restrictions related to the factoring arrangements lapse at the time we remit the customer payments collected by us for servicing previously sold customer receivables to the purchaser. Restrictions for deferred compensation lapse when amounts are paid to the employee. Restricted Cash Equivalents Restricted cash equivalents primarily represent amounts paid into various qualified settlement funds related to our ongoing transvaginal surgical mesh litigation and current amounts related to our non-qualified pension plan and are included in Other current assets within our consolidated balance sheets. The restrictions related to the various qualified settlement funds will lapse as we approve amounts payable to claimants, at which time we no longer have rights to a return of the amounts paid into the various qualified settlement funds. Restricted cash equivalents included in Other long-term assets
Concentrations of Credit Risk	Concentrations of Credit Risk Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, derivative financial instruments and accounts and notes receivable. Our investment policy limits exposure to concentrations of credit risk and changes in market conditions. Counterparties to financial instruments expose us to credit-related losses in the event of nonperformance. We transact our financial instruments with a diversified group of major financial institutions with investment grade credit ratings and actively monitor their credit ratings and our outstanding positions to limit our credit exposure. In the normal course, our payment terms with customers, including distributors, hospitals, health care agencies, clinics, doctors' offices and other private and governmental institutions, are typically 30 days in the U.S. but may be longer in international markets and generally do not require collateral. We record credit loss reserves to Allowance for credit losses when we establish Trade accounts receivable if credit losses are expected over the asset's contractual life. We base our estimates of credit loss reserves on historical experience and adjust, as necessary, to reflect current conditions using reasonable and supportable forecasts not already reflected in the historical loss information. We utilize an accounts receivable aging approach to determine the reserve to record at accounts receivable commencement for certain customers, applying country or region-specific factors. In performing the assessment of outstanding accounts receivable, regardless of country or region, we may consider significant factors relevant to collectability, including those specific to a customer such as bankruptcy, lengthy average payment cycles and type of account. We write-off amounts determined to be uncollectible against this reserve. We are not dependent on any single institution, and no single customer accounted for more than ten percent of our net sales in 2023, 2022 and 2021; however, large group purchasing organizations, hospital networks, international distributors and dealers and other buying groups are important to our business and represent a substantial portion of our net sales. We closely monitor outstanding receivables for potential collection risks, including those that may arise from economic conditions, in both the U.S. and international economies. Our sales to government-owned or supported customers, particularly in southern Europe, are subject to an increased number of days outstanding prior to payment relative to other countries. Further, the ongoing site-of-service trend of shifting procedure volumes in the U.S. toward non-hospital settings, particularly ambulatory surgery centers and office-based labs, continues. Many of these customers are smaller than those we have historically done business with and may have more limited liquidity. We have adjusted our estimates of credit loss reserves for these customers, regions and conditions, as appropriate. We believe our Allowance for credit losses
Revenue Recognition	Revenue Recognition We sell our products primarily through a direct sales force. In certain international markets, we sell our products through independent distributors or dealers. We consider revenue to be earned when all of the following criteria are met in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 606, Revenue from Contracts with Customers : • We have a contract with a customer that creates enforceable rights and obligations, • Promised products or services are identified, • The transaction price, or the amount we expect to receive, is determinable and • We have transferred control of the promised items to the customer. Transfer of control is evidenced upon passage of title and risk of loss to the customer unless we are required to provide additional services. We treat shipping and handling costs performed after a customer obtains control of the good as a fulfillment cost and record these costs as a component of Selling, general and administrative expenses when incurred. We recognize revenue from consignment arrangements based on product usage, or implant, which indicates that the sale is complete. We recognize a receivable at the point in time we have an unconditional right to payment. Payment terms are typically 30 days in the U.S. but may be longer in international markets. Deferred Revenue We record a contract liability, or deferred revenue, when we have an obligation to provide a product or service to the customer and payment is received or due in advance of our performance. When we sell a device with a future service obligation, we defer revenue on the unfulfilled performance obligation and recognize this revenue over the related service period. Many of our Cardiac Rhythm Management (CRM) product offerings combine the sale of a device with our LATITUDE™ Patient Management System, which represents a future service obligation. Generally, we do not have observable evidence of the standalone selling price related to our future service obligations; therefore, we estimate the selling price using an expected cost plus a margin approach. We allocate the transaction price using the relative standalone selling price method. The use of alternative estimates could result in a different amount of revenue deferral. Contract liabilities are classified within Other current liabilities and Other long-term liabilities on our accompanying consolidated balance sheets. Our contract liabilities are primarily composed of deferred revenue related to the LATITUDE™ Patient Management System. Revenue is recognized over the average service period which is based on device and patient longevity. Our contract liabilities also include deferred revenue related to the LUX-Dx™ Insertable Cardiac Monitor system, also within our CRM business, for which revenue is recognized over the average service period based on device longevity and usage. We have elected not to disclose the transaction price allocated to unsatisfied performance obligations when the original expected contract duration is one year or less. In addition, we have not identified material unfulfilled performance obligations for which revenue is not currently deferred. Variable Consideration We generally allow our customers to return defective, damaged and, in certain cases, expired products for credit. We base our estimate for sales returns upon historical trends and record the amount as a reduction to revenue when we sell the initial product. In addition, we may allow customers to return previously purchased products for next-generation product offerings. For these transactions, we defer recognition of revenue on the sale of the earlier generation product based upon an estimate of the amount of product to be returned when the next-generation products are shipped to the customer. Uncertain timing of next-generation product approvals, variability in product launch strategies, product recalls and variation in product utilization all affect our estimates related to sales returns and could cause actual returns to differ from these estimates. We also offer sales rebates and discounts to certain customers. We treat sales rebates and discounts as a reduction of revenue and classify the corresponding liability as current. We estimate rebates for products where there is sufficient historical information available to predict the volume of expected future rebates. If we are unable to reasonably estimate the expected rebates, we record a liability for the maximum rebate percentage offered. We have entered certain agreements with group purchasing organizations to sell our products to participating hospitals at negotiated prices. We recognize revenue from these agreements following the same revenue recognition criteria discussed above. Post-Implant Services We provide non-contractual services to customers, where necessary, to ensure the safe and effective use of certain implanted devices. Because the revenue related to the immaterial services is recognized before they are delivered, we forward accrue the costs to provide these services at the time the devices are sold. We record these costs to Selling, general and administrative expenses within our consolidated statements of operations. We estimate the amount of time spent by our representatives performing these services and their compensation throughout the device life to determine the service cost. Changes to our business practice or the use of alternative estimates could result in a different amount of accrued cost.
Warranty Obligations	Warranty Obligations We offer warranties on certain of our product offerings. The majority of our warranty liability relates to implantable devices offered by our CRM business, which include implantable defibrillator and pacemaker systems. These products come with a standard limited warranty covering the replacement of these devices. We offer a full warranty for a portion of the period post-implant and a partial warranty for a period of time thereafter. We estimate the costs that we may incur under our warranty programs based on the number of units sold, historical and anticipated rates of warranty claims and cost per claim and record a liability equal to these estimated costs as Cost of products sold at the time the product sale occurs. We assess the adequacy of our recorded warranty liabilities on a quarterly basis and adjust these amounts as necessary.
Inventories	Inventories We state inventories at the lower of first-in, first-out cost or net realizable value. We utilize a standard costing system, capitalizing variances between estimated and actual production costs during periods of normal production, and amortize to Cost of products sold over inventory turns. We expense manufacturing variances during periods of abnormal production, or less than 75 percent of manufacturing capacity. We did not record any abnormal production variances during the years ended December 31, 2023, 2022 or 2021.
Property, Plant and Equipment	Property, Plant and Equipment We state property, plant, equipment and leasehold improvements at historical cost. We charge expenditures for maintenance and repairs to expense and capitalize additions and improvements that extend the life of the underlying asset. We provide for depreciation using the straight-line method at rates that approximate the estimated useful lives of the assets. We depreciate buildings over a maximum life of 40 years; building improvements over the remaining useful life of the building structure; equipment, furniture and fixtures over a three seven
Valuation of Business Combinations	Valuation of Business Combinations We allocate the amounts we pay for each acquisition to the assets we acquire and liabilities we assume based on their fair values at the date of acquisition, including identifiable intangible assets and in-process research and development (IPR&D), which either arise from a contractual or legal right or are separable from goodwill. We base the fair value of identifiable intangible assets acquired in a business combination, including IPR&D, on detailed valuations that use information and assumptions provided by management, which consider management’s best estimates of inputs and assumptions that a market participant would use. We allocate to goodwill any excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Transaction costs associated with these acquisitions are expensed as incurred through Selling, general and administrative expenses . In cases where we acquire a company in which we previously held an equity stake, we attribute a portion of the purchase price to the previously-held equity interest, which is implied based on the total purchase consideration allocable to each of the shareholders, including Boston Scientific, according to priority of equity interests. We record a gain or loss in Other, net equal to the difference between the implied fair value of our prior ownership and the book value immediately prior to the acquisition. Where an acquisition involves a contingent consideration arrangement, we recognize a liability equal to the fair value of the contingent payments we expect to make as of the acquisition date. We re-measure this liability each reporting period and record changes in the fair value through Contingent consideration net expense (benefit) on our consolidated statements of operations. Increases or decreases in the fair value of the contingent consideration liability can result from changes in discount rates, periods, timing and amount of projected revenue or timing or likelihood of achieving regulatory, revenue or commercialization-based milestones. Payment of additional consideration is generally contingent on the acquired company reaching certain performance milestones after the acquisition date, including attaining specified revenue levels, achieving product development targets and/or obtaining regulatory approvals for products in development at the date of the acquisition.
Indefinite-lived Intangibles and IPR&D	Indefinite-lived Intangibles and IPR&D Our indefinite-lived intangible assets, which are not subject to amortization, include acquired balloon and other technology, which are foundational to our ongoing operations, as well as IPR&D intangible assets acquired in a business combination. Our IPR&D represents intangible assets that are used in research and development activities but have not yet reached technological feasibility, regardless of whether they have alternative future use. The primary basis for determining the technological feasibility or completion of these projects is obtaining regulatory approval to market the underlying products in an applicable geographic region. We classify IPR&D as an indefinite-lived intangible asset until the completion or abandonment of the associated research and development efforts. Upon completion of the associated research and development efforts, we will determine the useful life of the technology and begin amortizing the assets to reflect their use over their remaining lives. Upon permanent abandonment, we write-off the remaining carrying amount of the associated IPR&D intangible asset. We test our indefinite-lived intangible assets at least annually during the third quarter for impairment and reassess their classification as indefinite-lived assets. In addition, we review our indefinite-lived intangible assets for classification and impairment more frequently if impairment indicators exist. We assess qualitative factors to determine whether the existence of events and circumstances indicate that it is more likely than not that our indefinite-lived intangible assets are impaired. If we conclude that it is more likely than not that the asset is impaired, we then determine the fair value of the intangible asset and perform the quantitative impairment test by comparing the fair value with the carrying value in accordance with FASB ASC Topic 350, Intangibles - Goodwill and Other (FASB ASC Topic 350) . If the carrying value exceeds the fair value of the indefinite-lived intangible asset, we write the carrying value down to the fair value. We use the income approach to determine the fair values of our IPR&D. We base our revenue assumptions on estimates of relevant market sizes, expected market growth rates, expected trends in technology and expected levels of market share. In arriving at the value of the in-process projects, we consider, among other factors, the in-process projects’ stage of completion, the complexity of the work completed as of the acquisition date, the costs already incurred, the projected costs to complete, the contribution of other acquired assets, the expected regulatory path and introduction dates by region and the estimated useful life of the technology. See Note C – Goodwill and Other Intangible Assets for more information related to indefinite-lived intangibles, including IPR&D.
Amortization and Impairment of Intangible Assets	Amortization and Impairment of Intangible Assets We record definite-lived intangible assets at historical cost and amortize them over their estimated useful lives. We use a straight-line method of amortization, unless a method that better reflects the pattern in which the economic benefits of the intangible asset are consumed or otherwise used up can be reliably determined. The approximate useful lives for amortization of our intangible assets are as follows: patents and licenses, two five one Cost of products sold; Selling, general and administrative expenses and Research and development expenses, as appropriate within our accompanying consolidated statements of operations, and include in Amortization expense only that associated with intangible assets acquired in a business combination or asset acquisition, as well as internally-developed patents. We review intangible assets subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may indicate impairment include, but are not limited to, a significant adverse change in legal factors or business climate that could affect the value of an asset, a product recall or an adverse action or assessment by a regulator. If we determine it is more likely than not that the asset is impaired based on our qualitative assessment of impairment indicators, we test the intangible asset for recoverability. For purposes of the recoverability test, we group our amortizable intangible assets with other assets and liabilities at the lowest level of identifiable cash flows if the intangible asset does not generate cash flows independent of other assets and liabilities. If the carrying value of the intangible asset or asset group exceeds the undiscounted cash flows expected to result from the use and eventual disposition of the intangible asset or asset group, we will write the carrying value down to fair value in the period impairment is identified. We calculate fair value of our intangible assets as the present value of estimated future cash flows we expect to generate from the asset. In determining our estimated future cash flows associated with our intangible assets, we use estimates and assumptions about future revenue contributions, cost structures and remaining useful lives of the asset or asset group. See Note C – Goodwill and Other Intangible Assets for more information related to impairments of intangible assets.
Goodwill Valuation	Goodwill Valuation We allocate any excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired in a business combination to goodwill. We test our goodwill balances, utilizing both the qualitative and quantitative approach described in FASB ASC Topic 350, Intangibles - Goodwill and Other , in the second quarter of each year as of April 1 for impairment, or more frequently if impairment indicators are present or changes in circumstances suggest an impairment may exist. We assess goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment, referred to as a component. For our 2023 annual impairment assessment, we identified the following reporting units for purposes of our annual goodwill impairment test: Interventional Cardiology, Rhythm Management, Peripheral Interventions, Endoscopy, Urology and Neuromodulation. Based on the criteria prescribed in FASB ASC Topic 350, we aggregated the Interventional Cardiology Therapies and Watchman components of our Cardiology operating segment into a single Interventional Cardiology reporting unit and aggregated the Cardiac Rhythm Management and Electrophysiology components into a single Rhythm Management reporting unit. In performing annual impairment assessments, the qualitative approach is used for testing reporting units where fair value has historically exceeded carrying value by greater than 100 percent, and all other reporting units are tested using the quantitative approach. When a quantitative test is performed, we typically use the income approach, specifically the Discounted Cash Flow method, to derive the fair value of each of our reporting units in preparing our goodwill impairment assessments. We historically selected this method as being the most meaningful in preparing our goodwill assessments because we believe the income approach most appropriately measures the fair value of our income producing assets. We make assumptions about the amount and timing of future expected cash flows, terminal value growth rates and appropriate discount rates. The amount and timing of future cash flows within our Discounted Cash Flow analysis is based on our most recent operational budgets, long range strategic plans and other estimates.
Investments in Publicly Traded and Privately-Held Entities	Investments in Publicly Traded and Privately-Held Entities For publicly-held equity securities for which we do not have the ability to exercise significant influence, we measure at fair value with changes in fair value recognized currently in Other, net within our accompanying consolidated statements of operations. For privately-held equity securities for which we do not have the ability to exercise significant influence, we apply the measurement alternative approach and measure these investments at cost minus impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer. We account for investments in entities for which we have the ability to exercise significant influence under the equity method if we hold 50 percent or less of the voting stock and the entity is not a VIE in which we are the primary beneficiary in accordance with FASB ASC Topic 323, Investments - Equity Method and Joint Ventures . We record these investments initially at cost and adjust the carrying amount to reflect our share of the earnings or losses of the investee, including all adjustments similar to those made in preparing consolidated financial statements. Lastly, we have notes receivable from certain companies that we account for in accordance with FASB ASC Topic 320 , Investments - Debt and Equity Securities . Refer to Note B – Acquisitions and Strategic Investments for additional details on our investment balances. Each reporting period, we evaluate our investments to determine if there are any events or circumstances that are likely to have a significant adverse effect on the fair value of the investment. Examples of such impairment indicators include, but are not limited to, a significant deterioration in earnings performance, recent financing rounds at reduced valuations, a significant adverse change in the regulatory, economic or technological environment of an investee or a significant doubt about an investee’s ability to continue as a going concern. If we identify an impairment indicator, we will estimate the fair value of the investment and compare it to its carrying value. Our estimation of fair value considers financial information related to the investee available to us, including valuations based on recent third-party equity investments in the investee. For our investments for which we apply the measurement alternative, if the fair value of the investment is less than its carrying value, the investment is impaired and we recognize an impairment loss equal to the difference between an investment’s carrying value and its fair value. For our equity method investments, if we determine an impairment is other-than-temporary, we recognize an impairment loss equal to the difference between an investment’s carrying value and its fair value. We deem an impairment to be other-than-temporary unless available evidence indicates that the valuation is more likely than not to recover up to the carrying value of the investment in a reasonable period of time, and we have both the ability and intent to hold the investment for at least the period of time needed to recover the value. Net gains and losses and impairments associated with our investment portfolio are included within Other, net
Income Taxes	Income Taxes We utilize the asset and liability method of accounting for income taxes. Under this method, we determine deferred tax assets and liabilities based on differences between the financial reporting and tax bases of our assets and liabilities. We measure deferred tax assets and liabilities using the enacted tax rates and laws that will be in effect when we expect the differences to reverse. We reduce our deferred tax assets by a valuation allowance if, based upon the weight of available evidence, it is more likely than not that we will not realize some portion or all of the deferred tax assets. We consider relevant evidence, both positive and negative, to determine the need for a valuation allowance. Information evaluated includes our financial condition and results of operations for the current and preceding years, the availability of deferred tax liabilities and tax carrybacks, as well as estimates of the impact of future taxable income and available prudent and feasible tax-planning strategies. We recognize interest and penalties related to income taxes as a component of income tax expense. As part of the Tax Cuts and Jobs Act (TCJA), we are subject to a territorial tax system in which we are required to establish an accounting policy in providing for tax on Global Intangible Low Taxed Income (GILTI) earned by certain foreign subsidiaries. We have elected to treat the impact of GILTI as a period cost and report it as part of continuing operations. See Note H – Income Taxes for further information and discussion of our income tax provision and balances including a discussion of the impacts of the TCJA.
Legal and Product Liability Costs	Legal and Product Liability Costs We are involved in various legal and regulatory proceedings, including intellectual property, breach of contract, securities and product liability litigation. In some cases, the claimants seek damages, as well as other relief, which, if granted, could require significant expenditures or impact our ability to sell our products. We are also the subject of certain governmental investigations, which could result in substantial fines, penalties and administrative remedies. We maintain an insurance policy providing limited coverage against securities claims, and we are substantially self-insured with respect to product liability claims and fully self-insured with respect to intellectual property infringement claims. We accrue anticipated costs of settlement, damages, losses for product liability claims and, under certain conditions, costs of defense, based on historical experience or to the extent specific losses are probable and estimable. Otherwise, we expense these costs as incurred. If the estimate of a probable loss is a range and no amount within the range is more likely, we accrue the minimum amount of the range. We analyze litigation settlements to identify each element of the arrangement. We allocate arrangement consideration to patent licenses received based on estimates of fair value and capitalize these amounts as assets if the license will provide an ongoing future benefit. We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related charges (credits) in our consolidated statements of operations; all other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses within our consolidated statements of operations. See Note I – Commitments and Contingencies for discussion of our individual material legal proceedings. In accordance with FASB ASC Topic 450, Contingencies , we accrue anticipated costs of settlement, damages, losses for product liability claims and, under certain conditions, costs of defense, based on historical experience or to the extent specific losses are probable and estimable. Otherwise, we expense these costs as incurred. If the estimate of a probable loss is a range and no amount within the range is more likely, we accrue the minimum amount of the range. We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related net charges (credits) within our accompanying consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses
Costs Associated with Exit Activities	Costs Associated with Exit Activities We record employee termination costs in accordance with FASB ASC Topic 712 , Compensation - Nonretirement and Postemployment Benefits , if we pay the benefits as part of an ongoing benefit arrangement, which includes benefits provided as part of our established severance policies or that we provide in accordance with international statutory requirements. We accrue employee termination costs associated with an ongoing benefit arrangement if the obligation is attributable to prior services rendered, the rights to the benefits have vested, the payment is probable and we can reasonably estimate the liability. We account for involuntary employee termination benefits that represent a one-time benefit in accordance with FASB ASC Topic 420, Exit or Disposal Cost Obligations (FASB ASC Topic 420). We record such costs into expense over the employee’s future service period, if any. Other costs associated with exit activities may include contract termination costs and consulting fees, which are expensed in accordance with FASB ASC Topic 420 and are included within Restructuring net charges (credits) in our consolidated statements of operations. We recorded Restructuring net charges (credits) of $69 million in 2023, $24 million in 2022 and $40 million in 2021. The restructuring reserve balance as of December 31, 2023 and 2022 was $41 million and $10 million, respectively. Additionally, costs directly related to our active restructuring initiatives, including program management costs, accelerated depreciation, fixed asset write-offs and costs to transfer product lines among facilities are included within Costs of products sold, Selling, general and administrative expenses and Research and development expenses within our consolidated statements of operations. Impairment of right of use lease assets and lease termination costs directly related to our active restructuring initiatives are expensed in accordance with FASB ASC Topic 842, Leases (FASB ASC Topic 842) and included within Costs of products sold or Selling, general and administrative expenses
Translation of Foreign Currency	Translation of Foreign Currency We translate all assets and liabilities of foreign subsidiaries from the functional currency, which is generally the local currency, into U.S. dollars using the year-end exchange rate. We show the net effect of these translation adjustments within our consolidated financial statements as a component of Accumulated other comprehensive income (loss), net of tax . We translate revenues and expenses at the average exchange rates in effect during the year. For any significant foreign subsidiaries located in highly inflationary economies, we re-measure their financial statements as if the functional currency were the U.S. dollar. Foreign currency transaction gains and losses are included within Other, net
Financial Instruments	Financial Instruments We recognize all derivative financial instruments in our consolidated financial statements at fair value in accordance with FASB ASC Topic 815 , Derivatives and Hedging (FASB ASC Topic 815), and we present assets and liabilities associated with our derivative financial instruments on a gross basis in our consolidated financial statements. In accordance with FASB ASC Topic 815, for those derivative instruments that are designated and qualify as hedging instruments, the hedging instrument must be designated, based upon the exposure being hedged, as a fair value hedge, cash flow hedge, or a hedge of a net investment in a foreign operation. The accounting for changes in the fair value of a derivative instrument depends on whether it qualifies for, and has been designated as part of a hedging relationship, as well as on the type of hedging relationship. Our derivative instruments do not subject our earnings to material risk, as gains and losses on these derivatives generally offset gains and losses on the item being hedged, and we do not enter into derivative transactions for speculative purposes. Refer to Note D – Hedging Activities and Fair Value Measurements for more information on our hedging instruments.
Research and Development	Research and Development We expense research and development (R&D) costs, including new product development programs, regulatory compliance and clinical research as incurred. Refer to Indefinite-lived Intangibles and IPR&D above for our policy regarding R&D projects acquired in connection with our business combinations and asset purchases.
Fair Value Measurement	FASB ASC Topic 815 requires all derivative and nonderivative instruments to be recognized at their fair values as either assets or liabilities on the balance sheet. We determine the fair value of our derivative and nonderivative instruments using the framework prescribed by FASB ASC Topic 820, Fair Value Measurements and Disclosures (

Acquisitions and Strategic In_2

Acquisitions and Strategic Investments (Tables)	12 Months Ended
	Dec. 31, 2023
Business Combinations [Abstract]
Schedule of Business Acquisitions, by Acquisition	We accounted for these transactions as business combinations in accordance with FASB ASC Topic 805 , Business Combinations (FASB ASC Topic 805). The preliminary purchase prices were comprised of the amounts presented below: (in millions) Acotec (1) Apollo Relievant Payment for acquisition, net of cash acquired (2) $ 381 $ 636 $ 794 Fair value of contingent consideration — — 273 $ 381 $ 636 $ 1,067 (1) Excludes approximately $140 million of cash on hand at the closing of the transaction (2) Related to Acotec, represents our majority stake investment We accounted for the acquisition of Baylis Medical as a business combination in accordance with FASB ASC Topic 805. The final purchase price was comprised of the amount presented below: (in millions) Payment for acquisition, net of cash acquired $ 1,463 $ 1,463
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The preliminary purchase price allocations were comprised of the components presented below, which represent the preliminary determination of the fair value of identifiable assets acquired and liabilities assumed, as well as goodwill. The final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with FASB ASC Topic 805: (in millions) Acotec Apollo Relievant Goodwill $ 337 $ 378 $ 731 Amortizable intangible assets 334 248 325 Other assets acquired 93 50 24 Liabilities assumed (48) (33) (15) Net deferred tax liabilities (76) (5) 1 Fair value of noncontrolling interest (259) — — $ 381 $ 636 $ 1,067 We recorded the assets acquired and liabilities assumed at their respective fair values as of the acquisition date. The final purchase price allocation was comprised of the following components: (in millions) Goodwill $ 988 Amortizable intangible assets 657 Other assets acquired 112 Liabilities assumed (287) Net deferred tax liabilities (7) $ 1,463
Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination	We allocated a portion of the purchase price to the specific intangible asset categories as follows: Amount Assigned (in millions) Weighted Average Amortization Period (in years) Risk-Adjusted Discount Acotec: Amortizable intangible assets: Technology-related $ 308 11 14% Customer relationships 15 11 14% Other intangible assets 11 13 14% $ 334 Apollo: Amortizable intangible assets: Technology-related $ 222 11 12% Customer relationships 26 11 12% $ 248 Relievant Amortizable intangible assets: Technology-related $ 287 12 12% Customer relationships 38 12 12% $ 325 We allocated a portion of the purchase price to the specific intangible asset categories as follows: Amount Assigned (in millions) Weighted Average Amortization Period (in years) Risk-Adjusted Discount Amortizable intangible assets: Technology-related 622 11 11% Other intangible assets 36 11 11% $ 657
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	Changes in the fair value of our contingent consideration liability during 2023 and 2022 associated with current and prior period acquisitions were as follows: (in millions) Balance as of December 31, 2021 $ 486 Contingent consideration net expense (benefit) 35 Contingent consideration payments (371) Balance as of December 31, 2022 $ 149 Amount recorded related to current year acquisitions 273 Contingent consideration net expense (benefit) 58 Contingent consideration payments (76) Balance as of December 31, 2023 $ 404
Fair Value Measurement Inputs and Valuation Techniques	The recurring Level 3 fair value measurements of our contingent consideration liability that we expect to be required to settle include the following significant unobservable inputs: Contingent Consideration Liability Fair Value as of December 31, 2023 Valuation Technique Unobservable Input Range Weighted Average (1) Revenue-based Payments and Milestones $404 million Discounted Cash Flow Discount Rate 6 % - 12% 10% Probability of Payment 90% - 100% 98% Projected Year of Payment 2024 - 2027 2025 (1) Unobservable inputs were weighted by the relative fair value of the contingent consideration liability. For projected year of payment, the amount represents the median of the inputs and is not a weighted average.
Investment	The aggregate carrying amount of our strategic investments was comprised of the following: As of December 31, (in millions) 2023 2022 Equity method investments $ 219 $ 188 Measurement alternative investments (1, 2) 194 219 $ 413 $ 407 (1) Measurement alternative investments are privately-held equity securities without readily determinable fair values that are measured at cost less impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer, recognized in Other, net within our accompanying consolidated statements of operations. (2) Includes publicly-held equity securities and convertible notes measured at fair value with changes in fair value recognized in Other, net within our consolidated statements of operations.

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets Goodwill and Other Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets and Goodwill	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 Gross Carrying Amount Accumulated 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
Schedule of Goodwill	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
Schedule of Expected Amortization Expense	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

Hedging Activities and Fair V_2

Hedging Activities and Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Notional Amounts of Outstanding Derivative Positions	The following table presents the contractual amounts of our hedging instruments outstanding: (in millions) FASB ASC Topic 815 Designation As of December 31, 2023 2022 Forward currency contracts Cash flow hedge $ 2,284 $ 2,725 Forward currency contracts Net investment hedge 333 365 Foreign currency-denominated debt (1) Net investment hedge 997 997 Forward currency contracts Non-designated 3,282 4,235 Total Notional Outstanding $ 6,896 $ 8,321 (1) Foreign currency-denominated debt is the €900 million debt principal designated as a net investment hedge.
Derivative Instruments, Gain (Loss)	The following presents the effect of our derivative and nonderivative instruments designated as cash flow and net investment hedges under FASB ASC Topic 815 in our accompanying consolidated statements of operations. Refer to Note O – Changes in Other Comprehensive Income for the total amounts relating to derivative and nonderivative instruments presented within our consolidated statements of comprehensive income (loss). Effect of Hedging Relationships on Accumulated Other Comprehensive Income Amount Recognized in OCI on Hedges Consolidated Statements of Operations (1) Amount Reclassified from AOCI into Earnings (in millions) Pre-Tax Gain (Loss) Tax Benefit (Expense) Gain (Loss) Net of Tax Location of Amount Reclassified and Total Amount of Line Item Pre-Tax (Gain) Loss Tax (Benefit) Expense (Gain) Loss Net of Tax Year Ended December 31, 2023 Forward currency contracts Cash flow hedges $ 81 $ (18) $ 63 Cost of products sold $ 4,345 $ (235) $ 53 $ (182) Net investment hedges (2) 32 (7) 25 Interest expense 265 (10) 2 (8) Foreign currency-denominated debt Net investment hedges (3) (34) 8 (27) Other, net 93 — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 265 3 (1) 2 Year Ended December 31, 2022 Forward currency contracts Cash flow hedges $ 276 $ (62) $ 214 Cost of products sold $ 3,956 $ (209) $ 47 $ (162) Net investment hedges (2) 41 (10) 32 Interest expense 470 (10) 2 (8) Foreign currency-denominated debt Net investment hedges (3) 61 (14) 47 Other, net 38 — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 470 16 (4) 13 Year Ended December 31, 2021 Forward currency contracts Cash flow hedges $ 268 $ (60) $ 208 Cost of products sold $ 3,711 $ (54) $ 12 $ (42) Net investment hedges (2) 56 (13) 43 Interest expense 341 (13) 3 (10) Foreign currency-denominated debt Net investment hedges (3) 82 (19) 64 Other, net (218) — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 341 5 (1) 4 (1) In all periods presented in the table above, the pre-tax (gain) loss amounts reclassified from AOCI to earnings represent the effect of the hedging relationships on earnings. (2) For our outstanding forward currency contracts designated as net investment hedges, the net gain or loss reclassified from AOCI to earnings as a reduction of Interest expense represents the straight-line amortization of the excluded component as calculated at the date of designation. This initial value of the excluded component has been excluded from the assessment of effectiveness in accordance with FASB ASC Topic 815. In the current and prior periods, we did not recognize any gains or losses on the components included in the assessment of hedge effectiveness in earnings. (3) For our outstanding euro-denominated debt principal designated as a net investment hedge, the change in fair value attributable to changes in the spot rate is recorded in the CTA component of OCI. No amounts were reclassified from AOCI to current period earnings.
Derivative Instruments, Gain (Loss) that may be Reclassified from AOCI to Earnings within Twelve Months	As of December 31, 2023, pre-tax net gains or losses for our derivative instruments designated, or previously designated, as cash flow and net investment hedges under FASB ASC Topic 815 that may be reclassified from AOCI to earnings within the next twelve months are presented below (in millions): Designated Hedging Instrument FASB ASC Topic 815 Designation Location on Consolidated Statements of Operations Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings Forward currency contracts Cash flow hedge Cost of products sold $ 152 Forward currency contracts Net investment hedge Interest expense 9 Interest rate derivative contracts Cash flow hedge Interest expense (1)
Derivatives Not Designated as Hedging Instruments	Net gains and losses on currency hedge contracts not designated as hedging instruments offset by net gains and losses from currency transaction exposures are presented below: (in millions) Location on Consolidated Statements of Operations Year Ended December 31, 2023 2022 2021 Net gain (loss) on currency hedge contracts Other, net $ 3 $ (53) $ (16) Net gain (loss) on currency transaction exposures Other, net (44) 21 (12) Net currency exchange gain (loss) $ (41) $ (31) $ (27)
Schedule of Derivative Instruments in Statement of Financial Position, Fair Value	The following are the balances of our derivative and nonderivative assets and liabilities: (in millions) Location on Consolidated Balance Sheets (1) As of December 31, 2023 2022 Derivative and Nonderivative Assets: Designated Hedging Instruments Forward currency contracts Other current assets $ 140 $ 196 Forward currency contracts Other long-term assets 107 149 246 345 Non-Designated Hedging Instruments Forward currency contracts Other current assets 20 36 Total Derivative and Nonderivative Assets $ 266 $ 381 Derivative and Nonderivative Liabilities: Designated Hedging Instruments Forward currency contracts Other current liabilities $ 15 $ — Forward currency contracts Other long-term liabilities 9 1 Foreign currency-denominated debt (2) Long-term debt 988 952 1,012 953 Non-Designated Hedging Instruments Forward currency contracts Other current liabilities 38 52 Total Derivative and Nonderivative Liabilities $ 1,050 $ 1,005 (1) We classify derivative and nonderivative assets and liabilities as current when the settlement date of the contract is one year or less. (2) Foreign currency-denominated debt is the €900 million debt principal designated as a net investment hedge. A portion of this notional is subject to de-designation and re-designation based on changes in the underlying hedged item.
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	Assets and liabilities measured at fair value on a recurring basis consist of the following: As of December 31, 2023 December 31, 2022 (in millions) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Assets Money market funds and time deposits $ 454 $ — $ — $ 454 $ 673 $ — $ — $ 673 Publicly-held securities 18 — — 18 2 — — 2 Hedging instruments — 266 — 266 — 381 — 381 Licensing arrangements — — 77 77 — — 127 127 $ 472 $ 266 $ 77 $ 816 $ 674 $ 381 $ 127 $ 1,182 Liabilities Hedging instruments $ — $ 1,050 $ — $ 1,050 $ — $ 1,005 $ — $ 1,005 Contingent consideration liability — — 404 404 — — 149 149 Licensing arrangements — — 90 90 — — 159 159 $ — $ 1,050 $ 494 $ 1,545 $ — $ 1,005 $ 308 $ 1,313 The recurring Level 3 fair value measurements of our licensing arrangements recognized in our consolidated balance sheets as of December 31, 2023 include the following significant unobservable inputs: Licensing Arrangements Fair Value as of December 31, 2023 Valuation Technique Unobservable Input Range Weighted Average (1) Financial Asset $77 million Discounted Cash Flow Discount Rate 15% 15% Projected Year of Payment 2024 - 2025 2024 Financial Liability $90 million Discounted Cash Flow Discount Rate 12% - 15% 13% Projected Year of Payment 2024 - 2026 2025 (1) Unobservable inputs relate to a single financial asset and liability. As such, unobservable inputs were not weighted by the relative fair value of the instruments. For projected year of payment, the amount represents the median of the inputs and is not a weighted average. Changes in the fair value of our licensing arrangements' financial asset were as follows: (in millions) Balance as of December 31, 2021 $ 246 Proceeds from royalty rights (141) Fair value adjustment (expense) benefit 22 Balance as of December 31, 2022 $ 127 Proceeds from royalty rights (61) Fair value adjustment (expense) benefit 11 Balance as of December 31, 2023 $ 77 Changes in the fair value of our licensing arrangements' financial liability were as follows: (in millions) Balance as of December 31, 2021 $ 281 Payments for royalty rights (145) Fair value adjustment expense (benefit) 23 Balance as of December 31, 2022 $ 159 Payments for royalty rights (80) Fair value adjustment expense (benefit) 12 Balance as of December 31, 2023 $ 90

Contractual Obligations and C_2

Contractual Obligations and Commitments (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	The debt maturity schedule for our long-term debt obligations is presented below: Issuance Date Maturity Date As of December 31, Coupon Rate (1) (in millions, except interest rates) 2023 2022 March 2024 Notes February 2019 March 2024 — 504 3.450% March 2025 Senior Notes (3) March 2022 March 2025 1,105 1,067 0.750% June 2025 Senior Notes May 2020 June 2025 500 500 1.900% March 2026 Senior Notes February 2019 March 2026 255 255 3.750% December 2027 Senior Notes (3) November 2019 December 2027 995 960 0.625% March 2028 Senior Notes (3) March 2022 March 2028 829 800 1.375% March 2028 Senior Notes February 2018 March 2028 344 344 4.000% March 2029 Senior Notes February 2019 March 2029 272 272 4.000% June 2030 Senior Notes May 2020 June 2030 1,200 1,200 2.650% March 2031 Senior Notes (3) March 2022 March 2031 829 800 1.625% March 2034 Senior Notes (3) March 2022 March 2034 553 534 1.875% November 2035 Senior Notes (2) November 2005 November 2035 350 350 6.500% March 2039 Senior Notes February 2019 March 2039 450 450 4.550% January 2040 Senior Notes December 2009 January 2040 300 300 7.375% March 2049 Senior Notes February 2019 March 2049 650 650 4.700% Unamortized Debt Issuance Discount and Deferred Financing Costs 2024 - 2049 (65) (76) Finance Lease Obligation Various 5 5 Long-term debt $ 8,571 $ 8,915 (1) Coupon rates are semi-annual, except for the euro-denominated notes, which bear an annual coupon. (2) Corporate credit rating improvements may result in a decrease in the adjusted interest rate on our November 2035 Notes to the extent that our lowest credit rating is above BBB- or Baa3. The interest rates on our November 2035 Notes will be permanently reinstated to the issuance rate of 6.25% if the lowest credit ratings assigned to these senior notes is either A- or A3 or higher. (3) These notes are euro-denominated and presented in U.S. dollars based on the exchange rate in effect as of December 31, 2023 and 2022, respectively.
Contractual Obligation, Fiscal Year Maturity	Contractual maturities of our long-term debt outstanding as of December 31, 2023 are as follows ( in millions ): Fiscal Year 2025 1,605 2026 255 2027 995 2028 1,173 Thereafter 4,604
Summary Of Term Loan And Revolving Credit Facility Agreement Compliance With Debt Covenants	As of December 31, 2023, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility. Covenant Requirement Actual Maximum permitted leverage ratio (1) 3.75 times 2.33 times (1) Ratio of total debt to deemed consolidated Earnings Before Interest, Taxes, Depreciation and Amortization (EBITDA), as defined by the 2021 Revolving Credit Facility credit agreement, as amended.
Transfer of Financial Assets Accounted for as Sales	Amounts de-recognized for accounts and notes receivable, which are excluded from Trade accounts receivable, net in our accompanying consolidated balance sheets, are aggregated by contract denominated currency below (in millions): As of December 31, 2023 As of December 31, 2022 Factoring Arrangements Amount Weighted Average Interest Rate Amount Weighted Average Interest Rate Euro denominated $ 206 5.1 % $ 161 2.4 % Yen denominated 214 0.6 % 194 0.6 % Renminbi denominated 14 2.9 % 13 3.1 %
Long-term Purchase Commitment	As of December 31, 2023, future minimum purchase obligations, relating primarily to non-cancellable inventory commitments and capital expenditures entered in the normal course of business, were (in millions): Fiscal Year Unrecorded Purchase Obligations 2024 $ 951 2025 283 2026 155 2027 45 2028 31 Thereafter 150 $ 1,615

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2023
Leases [Abstract]
Supplemental Balance Sheet Information Related to Leases	The following table presents supplemental balance sheet information related to our operating leases: As of December 31, (in millions) 2023 2022 Assets Operating lease right-of-use assets in Other long-term assets $ 439 $ 386 Liabilities Operating lease liabilities in Other current liabilities 76 61 Operating lease liabilities in Other long-term liabilities 390 347
Lease, Cost	The following table presents the weighted average remaining lease term and discount rate information related to our operating leases: As of December 31, 2023 2022 Weighted average remaining lease term 9 years 10 years Weighted average discount rate 4.5% 3.3%
Supplemental Cash Flow Information Related to Leases	The following table presents supplemental cash flow information related to our operating leases: Year Ended December 31, (in millions) 2023 2022 Cash paid for amounts included in the measurement of operating lease liabilities Operating cash flows from operating leases $ 93 $ 91
Maturities of Lease Liabilities	The following table presents the maturities of our operating lease liabilities as of December 31, 2023 (in millions): Fiscal year Operating Leases (1) 2024 $ 89 2025 78 2026 65 2027 49 2028 41 Thereafter 217 Total future minimum operating lease payments 539 Less: imputed interest (74) Present value of operating lease liabilities $ 466 (1) Excludes expected lease payments for lease terms that have not yet commenced.

Supplemental Balance Sheet In_2

Supplemental Balance Sheet Information (Tables)	12 Months Ended
	Dec. 31, 2023
Supplemental Balance Sheet Information [Abstract]
Trade accounts receivable, net	Components of selected captions in our accompanying consolidated balance sheets are as follows: Trade accounts receivable, net As of December 31, (in millions) 2023 2022 Trade accounts receivable $ 2,338 $ 2,079 Allowance for credit losses (110) (109) $ 2,228 $ 1,970 The following is a rollforward of our Allowance for credit losses : Year Ended December 31, (in millions) 2023 2022 2021 Beginning balance $ 109 $ 108 $ 105 Credit loss expense 50 35 28 Write-offs (48) (35) (25) Ending balance $ 110 $ 109 $ 108
Schedule of Inventory, Current	Inventories As of December 31, (in millions) 2023 2022 Finished goods $ 1,537 $ 1,171 Work-in-process 174 147 Raw materials 773 548 $ 2,484 $ 1,867
Schedule of Other Current Assets	Other current assets As of December 31, (in millions) 2023 2022 Restricted cash and restricted cash equivalents $ 130 $ 149 Derivative assets 159 232 Licensing arrangements 47 60 Other 285 290 $ 621 $ 731
Property, plant and equipment, net	Property, plant and equipment, net As of December 31, (in millions) 2023 2022 Land $ 140 $ 137 Buildings and improvements 1,843 1,695 Equipment, furniture and fixtures 3,503 3,297 Capital in progress 857 598 6,343 5,728 Less: accumulated depreciation 3,484 3,282 $ 2,859 $ 2,446
Schedule of Other Assets	Other long-term assets As of December 31, (in millions) 2023 2022 Restricted cash equivalents $ 60 $ 48 Operating lease right-of-use assets 439 386 Derivative assets 107 149 Investments 413 407 Licensing arrangements 30 67 Indemnification asset 176 172 Other 306 271 $ 1,531 $ 1,500
Schedule of Accrued Liabilities	Accrued expenses As of December 31, (in millions) 2023 2022 Legal reserves $ 206 $ 231 Payroll and related liabilities 1,051 830 Rebates 389 352 Contingent consideration 304 74 Other 696 674 $ 2,646 $ 2,160
Other Current Liabilities	Other current liabilities As of December 31, (in millions) 2023 2022 Deferred revenue $ 266 $ 220 Licensing arrangements 49 79 Taxes payable 220 232 Other 278 230 $ 814 $ 761
Other long-term liabilities	Other long-term liabilities As of December 31, (in millions) 2023 2022 Accrued income taxes $ 470 $ 597 Legal reserves 172 212 Contingent consideration 100 75 Licensing arrangements 41 80 Operating lease liabilities 390 347 Deferred revenue 311 289 Other 484 434 $ 1,967 $ 2,035

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Schedule of Income before Income Tax, Domestic and Foreign	Our Income (loss) before income taxes consisted of the following: Year Ended December 31, (in millions) 2023 2022 2021 Domestic $ (394) $ (1,119) $ (648) Foreign 2,379 2,260 1,724 $ 1,985 $ 1,141 $ 1,076
Schedule of Components of Income Tax Expense (Benefit)	The related expense (benefit) for income taxes consisted of the following: Year Ended December 31, (in millions) 2023 2022 2021 Current Federal $ 189 $ 51 $ 18 State 15 19 33 Foreign 116 381 127 320 451 178 Deferred Federal (82) (92) (256) State (22) (32) (3) Foreign 176 117 117 73 (7) (142) $ 393 $ 443 $ 36
Schedule of Deferred Tax Assets and Liabilities	Significant components of our deferred tax assets and liabilities are as follows: As of December 31, (in millions) 2023 2022 Deferred Tax Assets: Inventory costs and related reserves $ 30 $ 19 Tax benefit of net operating losses and credits 744 511 Reserves and accruals 305 304 Restructuring-related charges 14 6 Litigation and product liability reserves 88 103 Investment write-down 58 38 Compensation related 154 136 Federal benefit of uncertain tax positions 11 9 Intangible assets 3,394 3,668 Capitalized R&D 232 160 Property, plant and equipment — 2 5,029 4,954 Less: valuation allowance (1,220) (1,004) 3,809 3,950 Deferred Tax Liabilities: Property, plant and equipment 24 — Unrealized gains and losses on derivative financial instruments 66 117 Other 12 34 102 151 Net Deferred Tax Assets 3,707 3,799 Prepaid on intercompany profit 315 264 Net Deferred Tax Assets and Prepaid on Intercompany Profit $ 4,022 $ 4,062 Our deferred tax assets, deferred tax liabilities and prepaid on intercompany profit are included in the following locations within our accompanying consolidated balance sheets (in millions): Location on Consolidated Balance Sheets As of December 31, Component 2023 2022 Prepaid on intercompany profit Prepaid income taxes $ 315 $ 264 Non-current deferred tax asset Deferred tax assets 3,841 3,942 Deferred Tax Assets and Prepaid on Intercompany Profit 4,157 4,206 Non-current deferred tax liability Deferred tax liabilities 134 144 Deferred Tax Liabilities 134 144 Net Deferred Tax Assets and Prepaid on Intercompany Profit $ 4,022 $ 4,062
Summary of Income Tax Contingencies	A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows: Year Ended December 31, (in millions) 2023 2022 2021 Beginning Balance $ 492 $ 255 $ 261 Additions based on positions related to the current year 65 88 8 Additions based on positions related to prior years 67 177 41 Reductions for tax positions of prior years (114) (20) (36) Settlements with taxing authorities (14) (1) (2) Statute of limitation expirations (29) (8) (17) Ending Balance $ 467 $ 492 $ 255
Tax rate	The reconciliation of income taxes at the federal statutory rate to the actual expense (benefit) for income taxes is as follows: Year Ended December 31, 2023 2022 2021 U.S. federal statutory income tax rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 0.7 % 0.7 % 2.5 % Domestic taxes on foreign earnings 6.9 % 15.3 % 6.8 % Effect of foreign taxes (15.3) % (3.8) % (14.3) % Acquisition-related 2.2 % 4.4 % (8.1) % Research credit (2.9) % (4.5) % (3.0) % Valuation allowance 7.5 % (1.3) % 0.8 % Compensation-related 0.5 % 0.6 % (0.6) % Non-deductible expenses 0.4 % 0.4 % 0.4 % Uncertain tax positions (0.5) % 7.7 % 1.2 % Return to provision (0.1) % (2.1) % (5.7) % Change in tax rates (0.6) % (0.2) % 1.9 % Other, net — % 0.7 % 0.4 % 19.8 % 38.9 % 3.3 %

Stock Incentive and Purchase Pl

Stock Incentive and Purchase Plans (Tables)	12 Months Ended
	Dec. 31, 2023
Stock Incentive and Purchase Plans [Abstract]
Schedule of Employee Service Share-based Compensation, Allocation of Recognized	The following presents the impact of stock-based compensation on our consolidated statements of operations: Year Ended December 31, (in millions, except per share data) 2023 2022 2021 Cost of products sold $ 12 $ 12 $ 11 Selling, general and administrative expenses 179 167 147 Research and development expenses 42 41 36 233 220 194 Income tax (benefit) expense (35) (32) (29) $ 198 $ 188 $ 165 Net impact per common share - basic $ 0.14 $ 0.13 $ 0.12 Net impact per common share - assuming dilution $ 0.14 $ 0.13 $ 0.12
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	We use the Black-Scholes option-pricing model to calculate the grant-date fair value of stock options granted to employees under our stock incentive plans. We calculated the fair value for options granted using the following estimated weighted-average assumptions: Year Ended December 31, 2023 2022 2021 Options granted (in thousands) 2,934 3,287 3,822 Weighted-average exercise price $ 47.43 $ 44.02 $ 37.69 Weighted-average grant-date fair value $ 16.83 $ 13.64 $ 10.77 Black-Scholes Assumptions Expected volatility 26 % 28 % 29 % Expected term (in years, weighted) 6.3 6.1 5.9 Risk-free interest rate 3.62% - 4.75% 1.42% - 3.87% 0.66% - 1.20%
Schedule of Share-based Compensation, Restricted Stock Units Award Activity	Information related to non-vested stock awards is as follows: Non-Vested Stock Award Units (in thousands) Weighted Average Balance as of December 31, 2020 9,987 $ 34 Granted 4,240 39 Vested (1) (3,823) 31 Forfeited (658) 36 Balance as of December 31, 2021 9,745 $ 37 Granted 3,854 45 Vested (1) (3,482) 36 Forfeited (680) 44 Balance as of December 31, 2022 9,438 $ 41 Granted 3,958 49 Vested (1) (3,624) 39 Forfeited (485) 44 Balance as of December 31, 2023 9,287 $ 45 (1) The number of shares vested includes shares withheld on behalf of employees to satisfy statutory tax withholding requirements.
Schedule of Share-based Compensation, Employee Stock Purchase Plan, Activity	Information related to shares issued or to be issued in connection with the employee stock purchase plan based on employee contributions and the range of purchase prices is as follows: Year Ended December 31, 2023 2022 2021 Shares issued or to be issued (in thousands) 2,623 2,850 2,578 Range of purchase prices $ 39.11 - $ 45.51 $ 31.68 - $ 32.31 $ 29.98 - $ 36.11 Expense recognized (in millions) $ 29 $ 28 $ 24
Schedule of Unrecognized Compensation	We expect to recognize the following future expense for awards outstanding as of December 31, 2023: Unrecognized Compensation Cost (in millions) (1) Weighted Average Remaining Vesting Period (in years) Stock options $ 40 Non-vested stock awards 203 $ 243 1.7 (1) Amounts presented represent compensation cost, net of estimated forfeitures.
Market-based awards, valuation assumptions	We determined the fair value of the market-based RSU awards to be approximately $13 million for 2023, $12 million for 2022 and $11 million for 2021. We determined these fair values based on Monte Carlo simulations as of the date of grant, utilizing the following assumptions: 2023 2022 2021 Awards Awards Awards Stock price on date of grant $ 47.28 $ 44.19 $ 37.50 Measurement period (in years) 2.9 2.9 2.9 Risk-free rate 4.31 % 1.71 % 0.20 %
Free Cash Flow Performance-based DSU Awards, Fair Value Assumptions	The following table presents our assumptions used in determining the fair value of our ONSG and AFCF awards currently expected to vest as of December 31, 2023: 2023 ONSG 2022 AFCF 2021 AFCF Fair value, net of forfeitures to date (in millions) $ 20 $ 7 $ 12 Achievement of target payout (1) 200 % 88 % 131 % Stock price used in determining fair value $ 47.28 $ 46.27 $ 42.48 (1) Company's estimate of target payout as of December 31, 2023.
Share-based Compensation, Stock Options, Activity	Information related to stock options under stock incentive plans are as follows: Stock Options (in thousands) Weighted Weighted Average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in millions) Outstanding as of December 31, 2020 23,122 $ 24 Granted 3,822 38 Exercised (4,796) 13 Cancelled/forfeited (699) 26 Outstanding as of December 31, 2021 21,448 $ 29 Granted 3,287 44 Exercised (2,745) 17 Cancelled/forfeited (502) 34 Outstanding as of December 31, 2022 21,489 $ 32 Granted 2,934 47 Exercised (3,325) 25 Cancelled/forfeited (249) 44 Outstanding as of December 31, 2023 20,850 $ 36 5.8 462 Exercisable as of December 31, 2023 13,532 31 4.5 359 Expected to vest as of December 31, 2023 7,052 44 8.1 99 Total vested and expected to vest as of December 31, 2023 20,584 $ 36 5.8 $ 458

Weighted Average Shares Outst_2

Weighted Average Shares Outstanding (Tables)	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Schedule of Weighted Average Number of Shares	Year Ended December 31, (in millions) 2023 2022 2021 Weighted average shares outstanding - basic 1,453.0 1,430.5 1,422.3 Net effect of common stock equivalents 10.6 9.2 11.5 Weighted average shares outstanding - diluted 1,463.5 1,439.7 1,433.8
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following securities were excluded from the calculation of weighted average shares outstanding - diluted because their effect in the periods presented below would have been antidilutive: Year Ended December 31, (in millions) 2023 2022 2021 Stock options outstanding (1) 0 6 3 MCPS (2) 10 24 24 (1) Represents stock options outstanding pursuant to our employee stock-based compensation plans with exercise prices that were greater than the average fair market value of our common stock for the related periods. (2) Represents common stock issuable upon the conversion of MCPS. Refer to Note J – Stockholders' Equity for additional information.

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
Reconciliation of Revenue from Segments to Consolidated	A reconciliation of the totals reported for the reportable segments to the applicable line items within our accompanying consolidated statements of operations is as follows (in millions, except percentages). Prior period amounts have been restated at constant currency to conform to the current year presentation. Year Ended December 31, Net sales 2023 2022 2021 MedSurg $ 5,320 $ 4,805 $ 4,389 Cardiovascular 8,630 7,599 6,721 Total net sales of reportable segments 13,949 12,404 11,109 Other (1) — (60) 12 Impact of foreign currency fluctuations 291 338 766 $ 14,240 $ 12,682 $ 11,888
Reconciliation of Operating Profit (Loss) from Segments to Consolidated	Year Ended December 31, Income (loss) before income taxes 2023 2022 2021 MedSurg $ 1,796 $ 1,458 $ 1,368 Cardiovascular 2,235 1,748 1,572 Total operating income of reportable segments 4,031 3,206 2,940 Unallocated amounts: Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments (293) 96 67 Intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges (credits), certain litigation-related net charges (credits) and EU MDR implementation costs (567) (789) (1,070) Amortization expense (828) (803) (741) Other (1) — (60) 3 Operating income (loss) 2,343 1,649 1,199 Other income (expense), net (358) (508) (123) Income (loss) before income taxes $ 1,985 $ 1,141 $ 1,076 (1) In 2022, amounts reflect sales reserves established for Italian government payback provisions, which are being disputed in the Italian court system. These amounts were not allocated to our reportable segments or considered by our CODM for resource allocation and decision-making purposes. In 2021, amounts relate to our Specialty Pharmaceuticals business. On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Prior to the divestiture, we presented the Specialty Pharmaceuticals business as a standalone operating segment alongside our reportable segments
Segment operating income as percentage of net sales	Operating income of reportable segments as a percentage of net sales of reportable segments Year Ended December 31, 2023 2022 2021 MedSurg 33.8 % 30.3 % 31.2 % Cardiovascular 25.9 % 23.0 % 23.4 %
Reconciliation of Assets from Segment to Consolidated	Year Ended December 31, Depreciation expense 2023 2022 2021 MedSurg $ 103 $ 88 $ 91 Cardiovascular 263 245 261 Consolidated depreciation expense $ 367 $ 333 $ 352 As of December 31, Total assets 2023 2022 MedSurg $ 2,888 $ 2,501 Cardiovascular 5,988 5,205 Total assets of reportable segments 8,876 7,706 Goodwill 14,387 12,920 Other intangible assets, net 6,003 5,902 All other corporate assets 5,869 5,941 $ 35,136 $ 32,469
Schedule of Revenue from External Customers and Long-Lived Assets, by Geographical Areas	As of December 31, Long-lived assets 2023 2022 U.S. $ 1,300 $ 1,241 Ireland 598 478 Costa Rica 373 246 Other countries 587 481 Property, plant and equipment, net 2,859 2,446 Goodwill 14,387 12,920 Other intangible assets, net 6,003 5,902 Operating lease right-of-use assets in Other long-term assets 439 386 $ 23,688 $ 21,653

Revenue (Tables)

Revenue (Tables)	12 Months Ended
	Dec. 31, 2023
Disaggregation of Revenue [Abstract]
Disaggregation of Revenue	The following tables disaggregate our revenue from contracts with customers by business unit and geographic region (in millions). Generally, we allocate revenue from contracts with customers to geographic regions based on the location where the sale originated. Year Ended December 31, 2023 2022 2021 Businesses U.S. Int'l Total U.S. Int'l Total U.S. Int'l Total Endoscopy $ 1,511 $ 970 $ 2,482 $ 1,341 $ 880 $ 2,221 1,222 $ 919 $ 2,141 Urology 1,369 595 1,964 1,257 516 1,773 1,120 463 1,583 Neuromodulation 736 240 976 715 202 917 713 196 909 MedSurg 3,617 1,805 5,422 3,312 1,599 4,911 3,055 1,578 4,633 Interventional Cardiology Therapies 743 1,674 2,417 744 1,485 2,228 778 1,431 2,209 Watchman 1,155 119 1,274 915 103 1,019 729 100 829 Cardiac Rhythm Management 1,405 813 2,218 1,337 763 2,100 1,214 805 2,019 Electrophysiology 370 430 800 275 310 585 128 237 365 Cardiology 3,673 3,036 6,709 3,271 2,662 5,932 2,850 2,572 5,422 Peripheral Interventions 1,135 975 2,110 1,048 850 1,899 996 824 1,820 Cardiovascular 4,808 4,011 8,819 4,319 3,512 7,831 3,846 3,396 7,242 Other 1 — — — — — (60) 10 4 13 Total Net Sales $ 8,425 $ 5,816 $ 14,240 $ 7,632 $ 5,111 $ 12,682 $ 6,911 $ 4,978 $ 11,888 (1) In 2022, amounts reflect sales reserves established for Italian government payback provisions, which are being disputed in the Italian court system. These amounts were not allocated to our reportable segments or considered by our CODM for resource allocation and decision-making purposes. In 2021, amounts relate to our Specialty Pharmaceuticals business. On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Prior to the divestiture, we presented the Specialty Pharmaceuticals business as a standalone operating segment alongside our reportable segments. Specialty Pharmaceuticals net sales were substantially U.S. based. Refer to Note M – Segment Reporting for information on our reportable segments. Year Ended December 31, Geographic Regions 2023 2022 2021 U.S. $ 8,425 $ 7,632 $ 6,901 Europe, Middle East and Africa 2,856 2,526 2,518 Asia-Pacific 2,400 2,116 2,070 Latin America and Canada 560 469 386 Other 1 — (60) 13 Total Net Sales $ 14,240 $ 12,682 $ 11,888 Emerging Markets (2) $ 2,310 $ 1,968 $ 1,656 (2) Periodically, we assess our list of Emerging Markets countries, and effective January 1, 2023, modified our list to include all countries except the United States, Western and Central Europe, Japan, Australia, New Zealand and Canada. We have revised prior period amounts to conform to the current year's presentation. Deferred Revenue

Changes in Other Comprehensiv_2

Changes in Other Comprehensive Income (Tables)	12 Months Ended
	Dec. 31, 2023
Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]
Schedule of Accumulated Other Comprehensive Income (Loss)	The following table provides the reclassifications out of Other comprehensive income, net of tax attributable to Boston Scientific common stockholders: (in millions) Foreign Currency Translation Adjustments Net Change in Derivative Financial Instruments Net Change in Defined Benefit Pensions and Other Items Total Balance as of December 31, 2022 $ (1) $ 269 $ 1 $ 269 Other comprehensive income (loss) before reclassifications (87) 63 (10) (34) (Income) loss amounts reclassified from accumulated other comprehensive income (8) (178) 1 (185) Total other comprehensive income (loss) (95) (115) (9) (219) Balance as of December 31, 2023 $ (96) $ 154 $ (8) $ 49 (in millions) Foreign Currency Translation Adjustments Net Change in Derivative Financial Instruments Net Change in Defined Benefit Pensions and Other Items Total Balance as of December 31, 2021 $ 93 $ 206 $ (36) $ 263 Other comprehensive income (loss) before reclassifications (86) 214 36 163 (Income) loss amounts reclassified from accumulated other comprehensive income (8) (150) 1 (157) Total other comprehensive income (loss) (94) 63 37 6 Balance as of December 31, 2022 $ (1) $ 269 $ 1 $ 269

Employee Retirement Plans (Tabl

Employee Retirement Plans (Tables)	12 Months Ended
	Dec. 31, 2023
Retirement Benefits [Abstract]
Pension and Other Postretirement Plans, Policy [Policy Text Block]	We also sponsor a voluntary 401(k) Retirement Savings Plan for eligible employees. We match 200 percent of employee elective deferrals for the first two percent of employee eligible compensation and 50 percent of employee elective deferrals greater than two percent, but not exceeding six percent, of employee eligible compensation. Total expense for our matching contributions to the plan was $135 million in 2023, $123 million in 2022 and $118 million in 2021.
Schedule of Accumulated Benefit Obligations in Excess of Fair Value of Plan Assets [Table Text Block]	The outstanding obligation is as follows: As of December 31, 2023 ( in millions) Accumulated Benefit Obligation (ABO) Projected Fair value of Plan Assets Unfunded/Underfunded Domestic Retirement Plans $ 54 $ 59 $ — $ 59 Other International Retirement Plans 145 159 101 58 $ 199 $ 218 $ 101 $ 117 As of December 31, 2022 ( in millions) Accumulated Benefit Obligation (ABO) Projected Fair value of Plan Assets Unfunded/Underfunded PBO Recognized Domestic Retirement Plans $ 50 $ 55 $ — $ 55 Other International Retirement Plans 140 152 101 51 $ 190 $ 207 $ 101 $ 105
Schedule of Changes in Projected Benefit Obligations [Table Text Block]	A reconciliation of the changes in the PBO for our retirement plans is as follows: Year Ended December 31, (in millions) 2023 2022 Beginning obligations $ 207 $ 502 Service costs 10 13 Interest costs 7 3 Actuarial (gain) loss (4) (54) Plan curtailments/settlements (0) (191) Plan amendments and assumption changes 6 (25) Benefits paid (10) (6) Impact of foreign currency fluctuations 3 (37) Ending obligation $ 218 $ 207
Schedule of Defined Benefit Plans Disclosures [Table Text Block]	The critical assumptions associated with our employee retirement plans for 2023 are as follows: Weighted Average Discount Rate Weighted Average Expected Return Weighted Average Rate of Compensation Increase (1) Domestic Retirement Plans 4.89% n/a 2.00% Other International Retirement Plans 2.85% 2.66% 3.00% (1) Rates of compensation increase were not weighted by relative fair value. As such, the amount represents the median of the inputs and is not a weighted average. The critical assumptions associated with our employee retirement plans for 2022 are as follows: Weighted Average Discount Rate Weighted Average Expected Return Weighted Average Rate of Compensation Increase (1) Domestic Retirement Plans 5.32% n/a 2.00% Other International Retirement Plans 2.62% 2.27% 3.00% (1) Rates of compensation increase were not weighted by relative fair value. As such, the amount represents the median of the inputs and is not a weighted average.
Schedule of Changes in Fair Value of Plan Assets [Table Text Block]	A reconciliation of the changes in the fair value of plan assets for our funded retirement plans is as follows: Year Ended December 31, (in millions) 2023 2022 Beginning fair value $ 101 $ 336 Actual return on plan assets (1) (2) Employer contributions 11 16 Participant contributions 1 1 Plan curtailments/settlements (0) (185) Actuarial gain (loss) (0) (25) Benefits paid (10) (9) Impact of foreign currency fluctuations 0 (32) Ending fair value $ 101 $ 101
Schedule of Expected Benefit Payments	Benefit payments expected to be paid during the next ten years for our Domestic Retirement Plans and our Other International Retirement Plans are as follows: (in millions) Post Retirement Benefits 2024 $ 16 2025 13 2026 14 2027 15 2028 15 2029 - 2033 73

Significant Accounting Polici_3

Significant Accounting Policies Significant Accounting Policies (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Significant Accounting Policies [Line Items]
Restructuring Charges	$ 69	$ 24	$ 40
Restructuring Reserve	$ 41	$ 10
Building
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	40 years
Minimum | Patents and Licenses
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Assets, Useful Life	2 years
Minimum | Technology Related and Customer Relationships
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Assets, Useful Life	5 years
Minimum | Software Development
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Assets, Useful Life	1 year
Minimum | Equipment, Furniture, Fixtures
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	3 years
Maximum | Patents and Licenses
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Assets, Useful Life	20 years
Maximum | Technology Related and Customer Relationships
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Assets, Useful Life	25 years
Maximum | Software Development
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Assets, Useful Life	15 years
Maximum | Equipment, Furniture, Fixtures
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	7 years

Acquisitions and Strategic In_3

Acquisitions and Strategic Investments - Narrative (Details) $ / shares in Units, $ in Millions						12 Months Ended
	Jan. 08, 2024 USD ($) $ / shares	Nov. 17, 2023 USD ($)	Apr. 04, 2023 USD ($)	Feb. 20, 2023 USD ($)	Feb. 20, 2023 HKD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Business Acquisition [Line Items]
Payment for acquisition, net of cash acquired (2)						$ 1,811	$ 1,542	$ 2,258
Contingent consideration net expense (benefit)						58	$ 35	$ (136)
Contingent Liability Exposure						398
Uncapped Contingent Considertation						177
Equity Method Investment, Difference Between Carrying Amount and Underlying Equity						261
Acotec
Business Acquisition [Line Items]
Subsidiary, Ownership Percentage, Noncontrolling Owner				35%	35%
Axonics | Subsequent Event [Member]
Business Acquisition [Line Items]
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value	$ 3,670
Business Acquisition, Percentage of Voting Interests Acquired	100%
Business Acquisition, Share Price | $ / shares	$ 71
Acotec
Business Acquisition [Line Items]
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value				$ 519	$ 20
Business Acquisition, Percentage of Voting Interests Acquired				65%	65%
Payment for acquisition, net of cash acquired (2)						381
Apollo
Business Acquisition [Line Items]
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value			$ 636
Business Acquisition, Percentage of Voting Interests Acquired			100%
Payment for acquisition, net of cash acquired (2)						636
Relievant Medsystems
Business Acquisition [Line Items]
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value		$ 794
Business Acquisition, Percentage of Voting Interests Acquired		100%
Payment for acquisition, net of cash acquired (2)						794
Uncapped Contingent Considertation		$ 273
Baylis Medical
Business Acquisition [Line Items]
Payment for acquisition, net of cash acquired (2)						$ 1,463

Acquisitions and Strategic In_4

Acquisitions and Strategic Investments - Price Allocation (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Feb. 20, 2023
Business Acquisition [Line Items]
Payment for acquisition, net of cash acquired (2)	$ 1,811	$ 1,542	$ 2,258
Fair value of contingent consideration	404	149	486
Cash	411	256
Goodwill	14,387	$ 12,920	$ 11,988
Acotec
Business Acquisition [Line Items]
Payment for acquisition, net of cash acquired (2)	381
Fair value of contingent consideration	0
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net	381
Cash				$ 140
Goodwill	337
Amortizable intangible assets	334
Other assets acquired	93
Liabilities assumed	(48)
Net deferred tax liabilities	(76)
Fair value of noncontrolling interest	(259)
Apollo
Business Acquisition [Line Items]
Payment for acquisition, net of cash acquired (2)	636
Fair value of contingent consideration	0
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net	636
Goodwill	378
Amortizable intangible assets	248
Other assets acquired	50
Liabilities assumed	(33)
Net deferred tax liabilities	(5)
Fair value of noncontrolling interest	0
Relievant Medsystems
Business Acquisition [Line Items]
Payment for acquisition, net of cash acquired (2)	794
Fair value of contingent consideration	273
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net	1,067
Goodwill	731
Amortizable intangible assets	325
Other assets acquired	24
Liabilities assumed	(15)
Net deferred tax liabilities	1
Fair value of noncontrolling interest	0
Baylis Medical
Business Acquisition [Line Items]
Payment for acquisition, net of cash acquired (2)	1,463
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net	1,463
Goodwill	988
Amortizable intangible assets	657
Other assets acquired	112
Liabilities assumed	(287)
Net deferred tax liabilities	$ (7)

Acquisitions and Strategic In_5

Acquisitions and Strategic Investments - Intangible Assets (Details) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Acotec
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 334
Acotec | Technology-related
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 308
Weighted Average Amortization Period (in years)	11 years
Acotec | Technology-related | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	14%
Acotec | Customer relationships
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 15
Weighted Average Amortization Period (in years)	11 years
Acotec | Customer relationships | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	14%
Acotec | Other intangible assets
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 11
Weighted Average Amortization Period (in years)	13 years
Acotec | Other intangible assets | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	14%
Apollo
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 248
Apollo | Technology-related
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 222
Weighted Average Amortization Period (in years)	11 years
Apollo | Technology-related | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	12%
Apollo | Customer relationships
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 26
Weighted Average Amortization Period (in years)	11 years
Apollo | Customer relationships | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	12%
Relievant Medsystems
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 325
Relievant Medsystems | Technology-related
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 287
Weighted Average Amortization Period (in years)	12 years
Relievant Medsystems | Technology-related | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	12%
Relievant Medsystems | Customer relationships
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 38
Weighted Average Amortization Period (in years)	12 years
Relievant Medsystems | Customer relationships | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	12%
Baylis Medical
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 657
Baylis Medical | Technology-related
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 622
Weighted Average Amortization Period (in years)	11 years
Baylis Medical | Technology-related | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	11%
Baylis Medical | Other intangible assets
Business Acquisition [Line Items]
Amount Assigned (in millions)	$ 36
Weighted Average Amortization Period (in years)	11 years
Baylis Medical | Other intangible assets | Risk-Adjusted Discount Rates used in Purchase Price Allocation
Business Acquisition [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	11%

Acquisitions and Strategic In_6

Acquisitions and Strategic Investments - Contingent Consideration (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Combinations [Abstract]
Business Combination, Contingent Consideration, Liability	$ 149	$ 486
Contingent consideration net expense (benefit)	58	35	$ (136)
Payment of contingent consideration	(76)	(371)
Fair value of contingent consideration recorded in purchase accounting	273	0	440
Business Combination, Contingent Consideration, Liability	$ 404	$ 149	$ 486

Acquisitions and Strategic In_7

Acquisitions and Strategic Investments - Strategic Investments (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Investments [Abstract]
Equity method investments	$ 219	$ 188
Measurement alternative investments(1, 2)	194	219
Investments	$ 413	$ 407

Acquisitions and Strategic In_8

Acquisitions and Strategic Investments - Level 3 (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Fair value of contingent consideration	$ 404	$ 149	$ 486
Revenue-based Payments and Milestones | Discount Rate
Business Acquisition [Line Items]
Fair value of contingent consideration	$ 404
Revenue-based Payments and Milestones | Discount Rate | Minimum
Business Acquisition [Line Items]
contingent consideration liability, probability of payment	90%
Risk-Adjusted Discount Rates used in Purchase Price Allocation	6%
Revenue-based Payments and Milestones | Discount Rate | Maximum
Business Acquisition [Line Items]
contingent consideration liability, probability of payment	100%
Risk-Adjusted Discount Rates used in Purchase Price Allocation	12%
Revenue-based Payments and Milestones | Discount Rate | Weighted Average
Business Acquisition [Line Items]
contingent consideration liability, probability of payment	98%
Risk-Adjusted Discount Rates used in Purchase Price Allocation	10%

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Other Intangible Assets
Finite-Lived Intangible Assets, Gross	$ 15,817	$ 14,843
Finite-Lived Intangible Assets, Accumulated Amortization	(9,988)	(9,173)
Goodwill, Gross	24,287	22,820
Goodwill, Impaired, Accumulated Impairment Loss	(9,900)	(9,900)
Indefinite-lived Intangible Assets (Excluding Goodwill)	174	232
Intangible asset impairment charges	58	132	$ 370
Goodwill (Roll Forward)
Goodwill, Beginning Balance	12,920	11,988
Foreign currency fluctuations and other changes	20	(98)
Goodwill acquired	1,447	1,030
Goodwill, Ending Balance	14,387	12,920	11,988
Other Intangible Assets (Textuals) [Abstract]
Future Amortization Expense, Year One	828
Future Amortization Expense, Year Two	757
Future Amortization Expense, Year Three	737
Future Amortization Expense, Year Four	714
Future Amortization Expense, Year Five	690
MedSurg
Goodwill (Roll Forward)
Goodwill, Beginning Balance	4,237	4,246
Foreign currency fluctuations and other changes	0	(10)
Goodwill acquired	1,110	0
Goodwill, Ending Balance	5,347	4,237	4,246
Cardiovascular
Goodwill (Roll Forward)
Goodwill, Beginning Balance	8,684	7,741
Foreign currency fluctuations and other changes	20	(88)
Goodwill acquired	337	1,030
Goodwill, Ending Balance	9,041	8,684	$ 7,741
IPR&D
Goodwill and Other Intangible Assets
Indefinite-lived Intangible Assets (Excluding Goodwill)	54	112
Technology-related
Goodwill and Other Intangible Assets
Indefinite-lived Intangible Assets (Excluding Goodwill)	120	120
Technology-related
Goodwill and Other Intangible Assets
Finite-Lived Intangible Assets, Gross	13,207	12,397
Finite-Lived Intangible Assets, Accumulated Amortization	(8,101)	(7,378)
Patents
Goodwill and Other Intangible Assets
Finite-Lived Intangible Assets, Gross	480	486
Finite-Lived Intangible Assets, Accumulated Amortization	(387)	(394)
Other intangible assets
Goodwill and Other Intangible Assets
Finite-Lived Intangible Assets, Gross	2,130	1,960
Finite-Lived Intangible Assets, Accumulated Amortization	$ (1,500)	$ (1,400)

Hedging Activities and Fair V_3

Hedging Activities and Fair Value Measurements (Details) € in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($) units	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2021 EUR (€)
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	$ 6,896	$ 8,321
Cost of Goods and Services Sold	4,345	3,956	$ 3,711
Interest Expense	265	470	341
Other Operating Income (Expense), Net	93	38	(218)
Derivative Asset, Fair Value, Gross Asset	266	381
Derivative Liability, Fair Value, Gross Liability	1,050	1,005
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative assets	107	149
Licensing arrangements	$ 30	67
Derivative Liability, Statement of Financial Position [Extensible Enumeration]	Other Liabilities, Noncurrent
Fair value of contingent consideration	$ 404	149	486
Licensing arrangements	41	80
Cash	411	256
Debt Instrument, Fair Value Disclosure	8,735	8,203
November 2019 Aggregate Offering
Derivative Instruments, Gain (Loss) [Line Items]
Long-term Debt | €				€ 900
December 2027 Notes
Derivative Instruments, Gain (Loss) [Line Items]
Long-term Debt	$ 995	960
Debt Instrument, Interest Rate, Stated Percentage	0.625%
Financial Asset
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	15%
Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Licensing arrangements	$ 77
Licensing arrangements	90
Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	454	673
Equity Securities, FV-NI	18	2
Derivative assets	266	381
Licensing arrangements	77	127
Assets, Fair Value Disclosure	816	1,182
Foreign Currency Contracts, Liability, Fair Value Disclosure	1,050	1,005
Fair value of contingent consideration	404	149
Licensing arrangements	90	159
Financial and Nonfinancial Liabilities, Fair Value Disclosure	1,545	1,313
Fair Value, Measurements, Recurring [Member] | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	454	673
Equity Securities, FV-NI	18	2
Derivative assets	0	0
Licensing arrangements	0	0
Assets, Fair Value Disclosure	472	674
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	0
Fair value of contingent consideration	0	0
Licensing arrangements	0	0
Financial and Nonfinancial Liabilities, Fair Value Disclosure	0	0
Fair Value, Measurements, Recurring [Member] | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	0	0
Equity Securities, FV-NI	0	0
Derivative assets	266	381
Licensing arrangements	0	0
Assets, Fair Value Disclosure	266	381
Foreign Currency Contracts, Liability, Fair Value Disclosure	1,050	1,005
Fair value of contingent consideration	0	0
Licensing arrangements	0	0
Financial and Nonfinancial Liabilities, Fair Value Disclosure	1,050	1,005
Fair Value, Measurements, Recurring [Member] | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	0	0
Equity Securities, FV-NI	0	0
Derivative assets	0	0
Licensing arrangements	77	127
Assets, Fair Value Disclosure	77	127
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	0
Fair value of contingent consideration	404	149
Licensing arrangements	90	159
Financial and Nonfinancial Liabilities, Fair Value Disclosure	494	308
Fair Value, Measurements, Recurring [Member] | Level 3 | Financial Asset
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Licensing arrangements	77	127	246
Proceeds from Royalties Received	(61)	(141)
Increase (Decrease) in Fair Value Adjustments on Other Assets (Liabilities) Carried at Fair Value under Fair Value Option	11	22
Fair Value, Measurements, Recurring [Member] | Level 3 | Financial Liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Licensing arrangements	90	159	281
Payments for Royalties	(80)	(145)
Increase (Decrease) in Fair Value Adjustments on Other Assets (Liabilities) Carried at Fair Value under Fair Value Option	12	23
Designated as Hedging Instrument [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	246	345
Derivative Instruments in Hedges, Liabilities, at Fair Value	1,012	953
Designated as Hedging Instrument [Member] | Other long-term liabilities
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	$ 988	952
Designated as Hedging Instrument [Member] | Forward currency contracts
Derivative Instruments, Gain (Loss) [Line Items]
Forward Currency Contracts, Time to Maturity | units	36
Designated as Hedging Instrument [Member] | Forward currency contracts | Other long-term assets
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	$ 107	149
Designated as Hedging Instrument [Member] | Forward currency contracts | Other current liabilities
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	15	0
Designated as Hedging Instrument [Member] | Forward currency contracts | Other long-term liabilities
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	9	1
Designated as Hedging Instrument [Member] | Forward currency contracts | Other current assets
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	140	196
Not Designated as Hedging Instrument [Member] | Other, net
Derivative Instruments, Gain (Loss) [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	3	(53)	(16)
Foreign Currency Transaction Gain (Loss), before Tax	(44)	21	(12)
Net gain (loss) from foreign currency transaction exposures	44	(21)	12
Net currency exchange gain (loss)	(41)	(31)	(27)
Not Designated as Hedging Instrument [Member] | Forward currency contracts
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	3,282	4,235
Not Designated as Hedging Instrument [Member] | Forward currency contracts | Other current liabilities
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments Not Designated as Hedging Instruments, Liability, at Fair Value	38	52
Not Designated as Hedging Instrument [Member] | Forward currency contracts | Other current assets
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments Not Designated as Hedging Instruments, Asset, at Fair Value	$ 20	36
Weighted Average | Financial Asset
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	15%
Weighted Average | Financial Liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	13%
Minimum | Financial Liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	12%
Maximum | Financial Liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Risk-Adjusted Discount Rates used in Purchase Price Allocation	15%
Cash flow hedge | Forward currency contracts | Cost of products sold
Derivative Instruments, Gain (Loss) [Line Items]
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 152
Cash flow hedge | Interest rate derivative contracts | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	(1)
Cash flow hedge | Designated as Hedging Instrument [Member] | Forward currency contracts
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	2,284	2,725
Cash flow hedge | Designated as Hedging Instrument [Member] | Forward currency contracts | Cost of products sold
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	81	276	268
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	(18)	(62)	(60)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	63	214	208
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	(235)	(209)	(54)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	53	47	12
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	(182)	(162)	(42)
Cash flow hedge | Designated as Hedging Instrument [Member] | Interest rate derivative contracts | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	0	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	0	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	0	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	3	16	5
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	(1)	(4)	(1)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	2	13	4
Net investment hedge | Forward currency contracts | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Used in Net Investment Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	9
Net investment hedge | Designated as Hedging Instrument [Member] | Forward currency contracts
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	333	365
Net investment hedge | Designated as Hedging Instrument [Member] | Forward currency contracts | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax	32	41	56
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax	(7)	(10)	(13)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax	25	32	43
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), Reclassification, before Tax	(10)	(10)	(13)
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), after Reclassification, Tax	2	2	3
Gain (Loss) on Derivative Used in Net Investment Hedge, after Tax	(8)	(8)	(10)
Net investment hedge | Designated as Hedging Instrument [Member] | Foreign currency denominated in debt
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	997	997
Net investment hedge | Designated as Hedging Instrument [Member] | Foreign currency denominated in debt | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax	(34)	61	82
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax	8	(14)	(19)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax	(27)	47	64
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), Reclassification, before Tax	0	0	0
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), after Reclassification, Tax	0	0	0
Gain (Loss) on Derivative Used in Net Investment Hedge, after Tax	$ 0	$ 0	$ 0

Contractual Obligations and C_3

Contractual Obligations and Commitments (Details) € in Millions, $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2022 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2023 EUR (€)	Dec. 31, 2023	Dec. 31, 2023 Rate	May 10, 2021 USD ($)
Debt Instrument [Line Items]
Total debt			$ 8,935		$ 9,102
Debt, Current			20		531
Long-term Debt and Capital Lease Obligations			8,915		8,571
Deemed Consolidated EBITDA [Member]		$ 1,000
Exclusion from EBITDA for Restructuring Charges					500
Restructuring charges remaining to be excluded from calculation of consolidated EBITDA					317
Litigation and Debt Exclusion from EBITDA					1,000
Letters of Credit Outstanding, Amount			135		174
Legal payments remaining to be excluded from calculation of consolidated EBITDA					1,484
Purchase Obligations, Future Minimum Payments Due, Current					951
Purchase Obligations, Future Minimum Payments, Due in Two Years					283
Purchase Obligations, Future Minimum Payments, Due in Three Years					155
Purchase Obligations, Future Minimum Payments, Due in Four Years					45
Purchase Obligations, Future Minimum Payments, Due in Five Years					31
Purchase Obligations, Future Minimum Payments, Due Thereafter					150
Purchase Obligations, Future Minimum Payments Due					1,615
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Two					1,605
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Three					255
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Four					995
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Five					1,173
Long-term Debt, Maturities, Repayments of Principal in Rolling after Year Five					4,604
Proceeds from long-term borrowings, net of debt issuance costs		0	3,270	$ 0
Gain (Loss) on Extinguishment of Debt	$ 194	$ 0	(194)	$ 0
Supplier Finance Program, Obligation			$ 129		152
Supplier Finance Program, Obligation, Statement of Financial Position [Extensible Enumeration]		Accounts Payable, Current	Accounts Payable, Current
Actual, Covenant
Debt Instrument [Line Items]
Maximum Leverage Ratio							2.33
Requirement, as of March 31, 2021
Debt Instrument [Line Items]
Maximum Leverage Ratio							3.75
Requirement, as of December 31, 2021 and through remaining term of facility
Debt Instrument [Line Items]
Maximum Leverage Ratio							3.75
Requirement, four quarters following material acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio							4.75
Requirement, fifth quarter following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio							4.50
Requirement, sixth quarter following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio							4.25
Requirement, seventh quarter following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio							4
Requirement, eighth quarter and thereafter following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio							3.75
Revolving Credit Facility
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity									$ 2,750
October 2023 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(3.45%)
Long-term Debt			$ 504		0
March 2024 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(0.75%)
Long-term Debt			1,067		1,105
June 2025 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(1.90%)
Long-term Debt			500		500
March 2026 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(3.75%)
Long-term Debt			255		255
December 2027 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(0.625%)
Long-term Debt			960		995
March 2028 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(4.00%)
Long-term Debt			344		344
March 2029 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(4.00%)
Long-term Debt			272		272
June 2030 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(2.65%)
Long-term Debt			1,200		1,200
November 2035 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(6.50%)
Long-term Debt			350		350
March 2039 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(4.55%)
Long-term Debt			450		450
January 2040 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(7.375%)
Long-term Debt			300		300
March 2049 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(4.70%)
Long-term Debt			650		650
Finance Lease Obligation
Debt Instrument [Line Items]
Long-term Debt			5		5
Senior Notes
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net			76		65
Long-term Debt			8,986		9,136
March 2028 Senior Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(1.375%)	(1.375%)
Long-term Debt			800		829	€ 750
March 2031 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(1.625%)	(1.625%)
Long-term Debt			800		829	750
March 2034 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage							(1.875%)	(1.875%)
Long-term Debt			534		553	500
the Offering - aggregate principal amount
Debt Instrument [Line Items]
Long-term Debt | €						3,000
March 2025 Notes
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage | Rate								(0.75%)
Long-term Debt | €						€ 1,000
the Offering - early redemption of combined aggregate principal SN
Debt Instrument [Line Items]
Long-term Debt					3,275
Euro denominated
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized			$ 161		206
Average interest rate of de-recognized receivables		5.10%	2.40%
Yen denominated
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized			$ 194		214
Average interest rate of de-recognized receivables		0.60%	0.60%
Renminbi denominated
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized			$ 13		$ 14
Average interest rate of de-recognized receivables		2.90%	3.10%

Leases (Details)

Leases (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating Leased Assets [Line Items]
Lessee, Operating Lease, Liability, to be Paid	$ 539
Operating lease right-of-use assets	$ 439	$ 386
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other current liabilities	Other current liabilities
Operating Lease, Liability, Current	$ 76	$ 61
Operating lease liabilities	$ 390	$ 347
Operating Lease, Weighted Average Remaining Lease Term	9 years	10 years
Operating Lease, Weighted Average Discount Rate, Percent	4.50%	3.30%
Operating Lease, Cost	$ 96	$ 91	$ 90
Operating Lease, Payments	93	91
Right-of-Use Asset Obtained in Exchange for Operating Lease Liability	123	$ 43
Lessee, Operating Lease, Liability, Payments, Due Next Rolling Twelve Months	89
Lessee, Operating Lease, Liability, Payments, Due in Rolling Year Two	78
Lessee, Operating Lease, Liability, Payments, Due in Rolling Year Three	65
Lessee, Operating Lease, Liability, Payments, Due in Rolling Year Four	49
Lessee, Operating Lease, Liability, Payments, Due in Rolling Year Five	41
Lessee, Operating Lease, Liability, Payments, Due after Rolling Year Five	217
Lessee, Operating Lease, Liability, Undiscounted Excess Amount	(74)
Operating Lease, Liability	466
Lessee, Operating Lease, Lease Not Yet Commenced, Undiscounted Amount	$ 500
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets, Noncurrent	Other Assets, Noncurrent
Minimum
Operating Leased Assets [Line Items]
Lessee, Operating Lease, Term of Contract	1 year
Lessee, Operating Lease, Lease Not yet Commenced, Term of Contract	20 years
Maximum
Operating Leased Assets [Line Items]
Lessee, Operating Lease, Term of Contract	53 years
Lessee, Operating and Finance Leases, Option to Extend	10 years
Lessee, Operating Lease, Lease Not yet Commenced, Term of Contract	25 years

Supplemental Balance Sheet In_3

Supplemental Balance Sheet Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Trade accounts receivable, net
Trade accounts receivable	$ 2,338	$ 2,079
Allowance for credit losses	(110)	(109)
Trade accounts receivable, net	2,228	1,970
Allowance for doubtful accounts
Beginning balance	109	108	$ 105
Credit loss expense	50	35	28
Write-offs	(48)	(35)	(25)
Ending balance	110	109	108
Inventory, Net [Abstract]
Inventory, Finished Goods, Net of Reserves	1,537	1,171
Inventory, Work in Process, Net of Reserves	174	147
Inventory, Raw Materials, Net of Reserves	773	548
Inventories	2,484	1,867
Other Current Assets [Abstract]
Restricted cash and restricted cash equivalents included in Other current assets	130	149	188
Derivative assets	159	232
Licensing arrangements	47	60
Other	285	290
Other Assets, Current	$ 621	$ 731
Supplemental Balance Sheet Information (Textuals)
Percent of finished goods at consignment	22%	27%
Depreciation	$ 367	$ 333	352
Property, plant and equipment, net
Land	140	137
Buildings and improvements	1,843	1,695
Equipment, furniture and fixtures	3,503	3,297
Capital in progress	857	598
Property, plant and equipment	6,343	5,728
Less: accumulated depreciation	3,484	3,282
Property, plant and equipment, net	2,859	2,446
Other Assets, Noncurrent [Abstract]
Restricted cash equivalents	60	48	$ 55
Operating lease right-of-use assets	439	386
Derivative assets	107	149
Investments	413	407
Licensing arrangements	30	67
Indemnification asset	176	172
Other	306	271
Other long-term assets (total)	1,531	1,500
Accrued expenses
Legal reserves	206	231
Payroll and related liabilities	1,051	830
Rebates	389	352
Contingent consideration	304	74
Other	696	674
Accrued liabilities, current	2,646	2,160
Other Liabilities, Current [Abstract]
Deferred revenue	266	220
Licensing arrangements	49	79
Taxes payable	220	232
Other	278	230
Other current liabilities	814	761
Other long-term liabilities
Accrued income taxes	470	597
Legal reserves	172	212
Contingent consideration	100	75
Licensing arrangements	41	80
Operating lease liabilities	$ 390	$ 347
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other long-term liabilities	Other long-term liabilities
Deferred revenue	$ 311	$ 289
Other	484	434
Other long-term liabilities	$ 1,967	$ 2,035

Income Taxes (Details - Rate Ta

Income Taxes (Details - Rate Table)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Taxes [Abstract]
U.S. federal statutory income tax rate	21%	21%	21%
State income taxes, net of federal benefit	0.70%	0.70%	2.50%
Domestic taxes on foreign earnings	6.90%	15.30%	6.80%
Effect of foreign taxes	(15.30%)	(3.80%)	(14.30%)
Acquisition-related	2.20%	4.40%	(8.10%)
Research credit	(2.90%)	(4.50%)	(3.00%)
Valuation allowance	7.50%	(1.30%)	0.80%
Compensation-related	0.50%	0.60%	(0.60%)
Non-deductible expenses	0.40%	0.40%	0.40%
Uncertain tax positions	(0.50%)	7.70%	1.20%
Return to provision	(0.10%)	(2.10%)	(5.70%)
Change in tax rates	(0.60%)	(0.20%)	1.90%
Other, net	0%	0.70%	0.40%
Reported tax rate	19.80%	38.90%	3.30%

Income Taxes Income Taxes (Deta

Income Taxes Income Taxes (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Taxes [Abstract]
Income (Loss) from Continuing Operations before Income Taxes, Domestic	$ (394)	$ (1,119)	$ (648)
Income (Loss) from Continuing Operations before Income Taxes, Foreign	2,379	2,260	1,724
Income (loss) before income taxes	1,985	1,141	1,076
Current Federal Tax Expense (Benefit)	189	51	18
Current State and Local Tax Expense (Benefit)	15	19	33
Current Foreign Tax Expense (Benefit)	116	381	127
Current Income Tax Expense (Benefit)	320	451	178
Deferred Federal Income Tax Expense (Benefit)	(82)	(92)	(256)
Deferred State and Local Income Tax Expense (Benefit)	(22)	(32)	(3)
Deferred Foreign Income Tax Expense (Benefit)	176	117	117
Deferred Income Tax Expense (Benefit)	73	(7)	(142)
Income Tax Expense (Benefit)	393	443	36
Deferred Tax Assets, Inventory	30	19
Deferred Tax Assets, Operating Loss Carryforwards	744	511
Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals	305	304
Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Restructuring Charges	14	6
Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Contingencies	88	103
Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Impairment Losses	58	38
Deferred Tax Assets, Tax Deferred Expense, Compensation and Benefits, Share-based Compensation Cost	154	136
Federal benefit of uncertain tax positions	11	9
Deferred Tax Assets, Goodwill and Intangible Assets	3,394	3,668
Deferred Tax Assets, in Process Research and Development	232	160
Deferred Tax Assets, Property, Plant and Equipment	0	2
Deferred Tax Assets, Tax Deferred Expense	5,029	4,954
Deferred Tax Assets, Valuation Allowance	(1,220)	(1,004)
Deferred Tax Assets, Net of Valuation Allowance	3,809	3,950
Deferred Tax Liabilities, Property, Plant and Equipment	24	0
Deferred Tax Liabilities, Derivatives	66	117
Deferred Tax Liabilities, Other	12	34
Deferred Tax Liabilities, Gross	102	151
Deferred Tax Assets, Gross	3,707	3,799
Deferred Tax Assets, Prepaid on Intercompany Profit	315	264
Net Deferred Tax Liabilities and Prepaid on Intercompany Profit	4,022	4,062
Deferred Tax Assets, Operating Loss Carryforwards, Domestic	540	464
Deferred Tax Assets, Operating Loss Carryforwards, Foreign	203	47
Other Comprehensive Income (Loss), Tax	(39)	(56)	81
Free Trade Zone Regime Tax Incentive	212	162	149
Tax Incentives in Puerto Rico	16	21	27
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	395	410	177
Unrecognized Tax Benefits	467	492	255	$ 261
Unrecognized Tax Benefits, Increases Resulting from Current Period Tax Positions	65	88	8
Unrecognized Tax Benefits, Increases Resulting from Prior Period Tax Positions	67	177	41
Unrecognized Tax Benefits, Decreases Resulting from Prior Period Tax Positions	(114)	(20)	(36)
Unrecognized Tax Benefits, Decreases Resulting from Settlements with Taxing Authorities	(14)	(1)	(2)
Unrecognized Tax Benefits, Reductions Resulting from Lapse of Applicable Statute of Limitations	(29)	(8)	(17)
Tax Adjustments, Settlements, and Unusual Provisions	44	16
Income Tax Examination, Penalties and Interest Accrued	70	$ 77	$ 43
Decrease in Unrecognized Tax Benefits is Reasonably Possible	24
Tax Cuts and Jobs Act, Transition Tax for Accumulated Foreign Earnings, Liability	937
One-time transaction tax post-1986 E&P - net payment	$ 586
Free Trade Zone Regime Tax Incentive, impact on Net income (loss) per common share - assuming dilution	$ 0.15	$ 0.11	$ 0.10
Tax Incentives in Puerto Rico, impact on Net income (loss) per common share, assuming dilution	$ 0.01	$ 0.02	$ 0.02
transition tax payment remaining	$ 264
Tax incentives in Malaysia	$ 20	$ 17	$ 0
Tax Incentives in Malaysia, impact on Net income (loss) per common share, assuming dilution	$ 0.01
Tax Cuts and Jobs Act, Transition Tax for Accumulated Foreign Earnings, Income Tax Expense	$ 8

Income Taxes - Net Deferred Tax

Income Taxes - Net Deferred Tax Assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Income Taxes [Line Items]
Deferred Tax Assets	$ 4,157	$ 4,206
Deferred Tax Liabilities, Net	134	144
Net Deferred Tax Liabilities and Prepaid on Intercompany Profit	4,022	4,062
Other current assets
Income Taxes [Line Items]
Deferred Tax Assets	315	264
Deferred tax assets
Income Taxes [Line Items]
Deferred Tax Assets	3,841	3,942
Deferred tax liabilities
Income Taxes [Line Items]
Deferred Tax Liabilities, Net	$ 134	$ 144

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions		12 Months Ended
	Jan. 31, 2023 USD ($)	Dec. 31, 2023 USD ($) Unit	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Accrual for legal matters that are probable and estimable		$ 377	$ 443
Restricted cash and restricted cash equivalents included in Other current assets		130	149	$ 188
Litigation-related net charges (credits)		$ (111)	$ 173	$ 430
Litigation Settlement, Amount Awarded to Other Party	$ 42
Brazil CADE - # of individuals for alleged anti-competitive behavior | Unit		29
Litigation Settlement, Amount Awarded from Other Party		$ 158

Stockholders' Equity (Details)

Stockholders' Equity (Details) - USD ($) $ / shares in Units, $ in Millions			12 Months Ended
	Jun. 01, 2023	May 27, 2020	Dec. 31, 2023	Dec. 31, 2022	Dec. 14, 2020
Class of Stock [Line Items]
Preferred Stock, Shares Authorized			50,000,000	50,000,000
Preferred Stock, Shares Issued			0	10,062,500
Common Stock, Shares Authorized			2,000,000,000	2,000,000,000
Common Stock, Par or Stated Value Per Share			$ 0.01	$ 0.01
Stock Issued During Period, Shares, New Issues	24,000,000
Stock Repurchase Program, Authorized Amount					$ 1,000
Dividends, Cash			$ 28
Treasury Stock, Shares			263,289,848	263,289,848
5.50% MCPS, Series A
Class of Stock [Line Items]
Preferred Stock, Shares Issued		10,062,500
Preferred Stock, Dividend Rate, Percentage		5.50%
Preferred Stock, Liquidation Preference Per Share		$ 100
Net proceeds from issuance of preferred stock in connection with public offering		$ 975
Preferred Stock, Dividends, Per Share, Cash Paid			$ 1.3750
5.50% MCPS, Series A | Minimum
Class of Stock [Line Items]
Convertible Preferred Stock, Terms of Conversion			2.3834

Stock Incentive and Purchase _2

Stock Incentive and Purchase Plans (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Feb. 17, 2021	Dec. 31, 2020	Oct. 01, 2020	Feb. 18, 2020	Feb. 21, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of market based awards	$ 13	$ 12	$ 11
Share Price	$ 47.28	$ 46.27	$ 42.48	$ 47.28			$ 44.19	$ 37.50
Unrecognized Compensation Cost - Stock Options	$ 40
Stock Issued During Period, Shares, Employee Stock Purchase Plans	2,623,000	2,850,000	2,578,000
Employee Stock Ownership Plan (ESOP), Weighted Average Purchase Price of Shares Purchased	$ 39.11	$ 31.68
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number	9,287,000	9,438,000	9,745,000		9,987,000
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value	$ 45	$ 41	$ 37		$ 34
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period	3,958,000	3,854,000	4,240,000
Measurement period - market based awards	2 years 10 months 24 days	2 years 10 months 24 days	2 years 10 months 24 days
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	4.31%	1.71%	0.20%
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 49	$ 45	$ 39
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period	(3,624,000)	(3,482,000)	(3,823,000)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Weighted Average Grant Date Fair Value	$ 39	$ 36	$ 31
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeited in Period	(485,000)	(680,000)	(658,000)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeited in Period, Weighted Average Grant Date Fair Value	$ 44	$ 44	$ 36
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Number	20,850,000	21,489,000	21,448,000		23,122,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross	2,934,000	3,287,000	3,822,000
Share-based Compensation Arrangements by Share-based Payment Award, Options, Grants in Period, Weighted Average Exercise Price	$ 47.43	$ 44.02	$ 37.69
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period	(3,325,000)	(2,745,000)	(4,796,000)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Weighted Average Exercise Price	$ 25	$ 17	$ 13
Share-based Compensation Arrangement by Share-based Payment Award, Options, Forfeitures and Expirations in Period	(249,000)	(502,000)	(699,000)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Forfeitures and Expirations in Period, Weighted Average Exercise Price	$ 44	$ 34	$ 26
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Intrinsic Value	$ 462
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term	5 years 9 months 18 days
Stock-based compensation expense	$ 233	$ 220	$ 194
Common Stock, Shares Authorized	2,000,000,000	2,000,000,000
Common Stock, Capital Shares Reserved for Future Issuance	145,000,000
Employee Service Share-based Compensation, Tax Benefit from Compensation Expense	$ (35)	$ (32)	(29)
Share-based compensation, net of tax benefit	$ 198	$ 188	$ 165
compensation expense, per share - basic	$ 0.14	$ 0.13	$ 0.12
compensation expense, per share - diluted	0.14	0.13	0.12
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 16.83	$ 13.64	$ 10.77
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Volatility Rate	26%	28%	29%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term	6 years 3 months 18 days	6 years 1 month 6 days	5 years 10 months 24 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Total Intrinsic Value	$ 89	$ 72	$ 137
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price	$ 36	$ 32	$ 29		$ 24
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Number	13,532,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Exercise Price	$ 31
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Remaining Contractual Term	4 years 6 months
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Intrinsic Value	$ 359
Options expected to vest	7,052,000
Options expected to vest, weighted average exercise price	$ 44
Options expected to vest, weighted average remaining contractual life	8 years 1 month 6 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Expected to Vest, Outstanding, Aggregate Intrinsic Value	$ 99
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding, Number	20,584,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding, Weighted Average Exercise Price	$ 36
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding, Weighted Average Remaining Contractual Term	5 years 9 months 18 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding, Aggregate Intrinsic Value	$ 458
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Total Fair Value	$ 171	$ 150	$ 148
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized	60,000,000
Amount of employees total compensation eligible for GESOP purchase	10%
Global Employee Stock Purchase Plan - Exercise Amount equivalent to 85% of Fair Market Value of Common Stock at beginning or end of each offering period (whichever is less)	85%
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant	9,000,000
Unrecognized Compensation Cost - Non-vested stock awards	$ 203
Unrecognized Compensation Cost	$ 243
weighted average remaining vesting period	1 year 8 months 12 days
annualweightedaverageforfeiturerate	5%
Voting power of all classes of stock	10%
Exercise price of the fair market value of our common stock on the date of grant	110%
Qualified options exercise price	$ 0
Fair value of the Free Cash Flow (FCF) performance awards		$ 7	$ 12
target payout of organic net sales growth (ONSG) performance-based RSU	200%
Target payout of Free Cash Flows (FCF) performance awards		88%	131%
Employee Stock Ownership Plan (ESOP), Compensation Expense	$ 29	$ 28	$ 24
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized	10,000,000
Fair value of the organic net sales growth (ONSG) performance awards	$ 20
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of the target number of performance-based DSUs awarded	0%	0%
Employee Stock Ownership Plan (ESOP), Weighted Average Purchase Price of Shares Purchased			$ 29.98
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	3.62%	1.42%	0.66%
Range of the target number of market-based DSUs awarded	0%
High end of range [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of the target number of performance-based DSUs awarded	200%	150%
Employee Stock Ownership Plan (ESOP), Weighted Average Purchase Price of Shares Purchased	$ 45.51	$ 32.31	$ 36.11
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	4.75%	3.87%	1.20%
Range of the target number of market-based DSUs awarded	200%
2011 LTIP Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common Stock, Shares Authorized						171,000,000
Cost of products sold
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 12	$ 12	$ 11
Selling, General and Administrative Expenses [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	179	167	147
Research and Development Expense [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 42	$ 41	$ 36

Weighted Average Shares Outst_3

Weighted Average Shares Outstanding (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Weighted Average Number of Shares Outstanding, Basic	1,453,000	1,430,500	1,422,300
Weighted Average Number Diluted Shares Outstanding Adjustment	10,600	9,200	11,500
Weighted Average Number of Shares Outstanding, Diluted	1,463,500	1,439,700	1,433,800
Share-based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0	6,000	3,000
5.50% MCPS, Series A
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	10,000	24,000	24,000

Segment Reporting (Details)

Segment Reporting (Details) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($) reportablesegments	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Segment Reporting Information [Line Items]
Number of Reportable Segments | reportablesegments	2
Impact of foreign currency fluctuations on net sales	$ 291	$ 338	$ 766
Net sales	14,240	12,682	11,888
Other
Segment Reporting Information [Line Items]
Revenues from contracts with customers, disaggregated - performance measurement	0	(60)	12
Net sales	0	(60)	13
Operating Segments
Segment Reporting Information [Line Items]
Revenues from contracts with customers, disaggregated - performance measurement	13,949	12,404	11,109
Operating Segments | MedSurg
Segment Reporting Information [Line Items]
Revenues from contracts with customers, disaggregated - performance measurement	5,320	4,805	4,389
Net sales	5,422	4,911	4,633
Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Revenues from contracts with customers, disaggregated - performance measurement	8,630	7,599	6,721
Net sales	$ 8,819	$ 7,831	$ 7,242

Segment Reporting - Income (los

Segment Reporting - Income (loss) before income taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Operating Income Unallocated to Segment	$ (567)	$ (789)	$ (1,070)
Amortization expense	(828)	(803)	(741)
Other(1)	0	(60)	3
Operating Income (Loss)	2,343	1,649	1,199
Other income (expense), net	(358)	(508)	(123)
Income (loss) before income taxes	1,985	1,141	1,076
Operating Segments
Segment Reporting Information [Line Items]
Operating Income (Loss) Allocated to Reportable Segments	4,031	3,206	2,940
Operating Segments | MedSurg
Segment Reporting Information [Line Items]
Operating Income (Loss) Allocated to Reportable Segments	1,796	1,458	1,368
Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Operating Income (Loss) Allocated to Reportable Segments	2,235	1,748	1,572
Corporate, Non-Segment
Segment Reporting Information [Line Items]
Operating Income Unallocated to Segment	$ (293)	$ 96	$ 67

Segment Reporting - Operating i

Segment Reporting - Operating income of reportable segments as a percentage of net sales of reportable segments (Details) - Operating Segments	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
MedSurg
Segment Reporting Information [Line Items]
Segment operating income as percentage of net sales	33.80%	30.30%	31.20%
Cardiovascular
Segment Reporting Information [Line Items]
Segment operating income as percentage of net sales	25.90%	23%	23.40%

Segment Reporting - Depreciatio

Segment Reporting - Depreciation expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Depreciation	$ 367	$ 333	$ 352
Operating Segments
Segment Reporting Information [Line Items]
Depreciation	367	333	352
MedSurg | Operating Segments
Segment Reporting Information [Line Items]
Depreciation	103	88	91
Cardiovascular | Operating Segments
Segment Reporting Information [Line Items]
Depreciation	$ 263	$ 245	$ 261

Segment Reporting - Total Asset

Segment Reporting - Total Assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Other Assets	$ 35,136	$ 32,469
Goodwill	14,387	12,920	$ 11,988
Intangible Assets, Net (Excluding Goodwill)	6,003	5,902
MedSurg
Segment Reporting Information [Line Items]
Goodwill	5,347	4,237	4,246
Cardiovascular
Segment Reporting Information [Line Items]
Goodwill	9,041	8,684	$ 7,741
Operating Segments
Segment Reporting Information [Line Items]
Other Assets	8,876	7,706
Operating Segments | MedSurg
Segment Reporting Information [Line Items]
Other Assets	2,888	2,501
Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Other Assets	5,988	5,205
Corporate, Non-Segment
Segment Reporting Information [Line Items]
Other Assets	$ 5,869	$ 5,941

Segment Reporting - Long-lived

Segment Reporting - Long-lived assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-Lived Assets	$ 23,688	$ 21,653
Property, Plant and Equipment, Net	2,859	2,446
Goodwill	14,387	12,920	$ 11,988
Intangible Assets, Net (Excluding Goodwill)	6,003	5,902
Operating lease right-of-use assets	439	386
U.S.
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-Lived Assets	1,300	1,241
Ireland
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-Lived Assets	598	478
Costa Rica
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-Lived Assets	373	246
Other countries
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-Lived Assets	$ 587	$ 481

Revenue (Details)

Revenue (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Net sales	$ 14,240	$ 12,682	$ 11,888
Contract with Customer, Liability [Abstract]
Contract with Customer, Liability	577	509
Change in Contract with Customer, Liability [Abstract]
Contract with Customer, Liability, Revenue Recognized	213
UNITED STATES
Disaggregation of Revenue [Line Items]
Net sales	8,425	7,632	6,911
Non-US [Member]
Disaggregation of Revenue [Line Items]
Net sales	5,816	5,111	4,978
EMEA [Member]
Disaggregation of Revenue [Line Items]
Net sales	2,856	2,526	2,518
APAC [Member]
Disaggregation of Revenue [Line Items]
Net sales	2,400	2,116	2,070
Latin America and Canada [Member]
Disaggregation of Revenue [Line Items]
Net sales	560	469	386
Emerging Markets [Member]
Disaggregation of Revenue [Line Items]
Net sales	2,310	1,968	1,656
country_US excluding Other Net Sales
Disaggregation of Revenue [Line Items]
Net sales	8,425	7,632	6,901
Global Endoscopy (Endo) Reporting Unit [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	2,482	2,221	2,141
Global Endoscopy (Endo) Reporting Unit [Member] | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,511	1,341	1,222
Global Endoscopy (Endo) Reporting Unit [Member] | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	970	880	919
Global Urology and Pelvic Health Reporting Unit [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,964	1,773	1,583
Global Urology and Pelvic Health Reporting Unit [Member] | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,369	1,257	1,120
Global Urology and Pelvic Health Reporting Unit [Member] | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	595	516	463
Global Neuromodulation (NM) Reporting Unit [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	976	917	909
Global Neuromodulation (NM) Reporting Unit [Member] | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	736	715	713
Global Neuromodulation (NM) Reporting Unit [Member] | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	240	202	196
Global Peripheral Interventions (PI) Reporting Unit [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	2,110	1,899	1,820
Global Peripheral Interventions (PI) Reporting Unit [Member] | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,135	1,048	996
Global Peripheral Interventions (PI) Reporting Unit [Member] | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	975	850	824
Interventional Cardiology Therapies | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	2,417	2,228	2,209
Interventional Cardiology Therapies | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	743	744	778
Interventional Cardiology Therapies | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,674	1,485	1,431
Cardiac Rhythm Management | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	2,218	2,100	2,019
Cardiac Rhythm Management | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,405	1,337	1,214
Cardiac Rhythm Management | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	813	763	805
Electrophysiology (EP) | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	800	585	365
Electrophysiology (EP) | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	370	275	128
Electrophysiology (EP) | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	430	310	237
Watchman | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,274	1,019	829
Watchman | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,155	915	729
Watchman | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	119	103	100
Global Cardiology Reporting Unit | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	6,709	5,932	5,422
Global Cardiology Reporting Unit | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	3,673	3,271	2,850
Global Cardiology Reporting Unit | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	3,036	2,662	2,572
Other
Disaggregation of Revenue [Line Items]
Net sales	0	(60)	13
Other | UNITED STATES
Disaggregation of Revenue [Line Items]
Net sales	0	0	10
Other | Non-US [Member]
Disaggregation of Revenue [Line Items]
Net sales	0	0	4
MedSurg | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	5,422	4,911	4,633
MedSurg | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	3,617	3,312	3,055
MedSurg | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	1,805	1,599	1,578
Cardiovascular | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	8,819	7,831	7,242
Cardiovascular | UNITED STATES | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	4,808	4,319	3,846
Cardiovascular | Non-US [Member] | Operating Segments
Disaggregation of Revenue [Line Items]
Net sales	$ 4,011	$ 3,512	$ 3,396

Changes in Other Comprehensiv_3

Changes in Other Comprehensive Income (AOCI Rollforward with Reclassification) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	$ 17,573	$ 16,622
Other comprehensive income (loss)	(230)	6	$ 56
Ending Stockholders' Equity	19,282	17,573	16,622
Accumulated other comprehensive income (loss), net of tax
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	269	263	207
Other comprehensive income (loss) before reclassifications	(34)	163
(Income) loss amounts reclassified from accumulated other comprehensive income	(185)	(157)
Other comprehensive income (loss)	(219)	6
Ending Stockholders' Equity	49	269	263
Foreign Currency Translation Adjustments
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	(1)	93
Other comprehensive income (loss) before reclassifications	(87)	(86)
(Income) loss amounts reclassified from accumulated other comprehensive income	(8)	(8)
Other comprehensive income (loss)	(95)	(94)
Ending Stockholders' Equity	(96)	(1)	93
Net Change in Derivative Financial Instruments
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	269	206
Other comprehensive income (loss) before reclassifications	63	214
(Income) loss amounts reclassified from accumulated other comprehensive income	(178)	(150)
Other comprehensive income (loss)	(115)	63
Ending Stockholders' Equity	154	269	206
Net Change in Defined Benefit Pensions and Other Items
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	1	(36)
Other comprehensive income (loss) before reclassifications	(10)	36
(Income) loss amounts reclassified from accumulated other comprehensive income	1	1
Other comprehensive income (loss)	9	(37)
Ending Stockholders' Equity	$ (8)	$ 1	$ (36)

Changes in Other Comprehensiv_4

Changes in Other Comprehensive Income - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]
Reclassification adjustment from AOCI, tax impact	$ 5	$ 6

Employee Retirement Plans (Deta

Employee Retirement Plans (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Defined Benefit Plan, Accumulated Benefit Obligation	$ 199	$ 190
Defined Benefit Plan, Benefit Obligation	218	207	$ 502
Defined Benefit Plan, Plan Assets, Amount	101	101	336
Defined Benefit Plan, Amounts for Asset (Liability) Recognized in Statement of Financial Position	117	105
Defined Benefit Plan, Service Cost	10	13
Defined Benefit Plan, Interest Cost	7	3
Defined Benefit Plan, Benefit Obligation, Increase (Decrease) for Plan Amendment	6	(25)
pension benefit obligation, benefits paid	(10)	(6)
Defined Benefit Plan, Plan Assets, Foreign Currency Translation Gain (Loss)	3	(37)
Defined Benefit Plan, Plan Assets, Payment for Settlement	0	(185)
Defined Benefit Plan, Plan Assets, Increase (Decrease) for Actual Return (Loss)	(1)	(2)
Defined Benefit Plan, Benefit Obligation, Actuarial Gain (Loss)	(4)	(54)
Defined Benefit Plan, Plan Assets, Payment for Settlement, PBO	0	191
Defined Benefit Plan, Plan Assets, Contributions by Employer	11	16
Defined Benefit Plan, Plan Assets, Contributions by Plan Participant	1	1
Defined Benefit Plan, Benefit Obligation, Actuarial Gain (Loss)	0	(25)
Defined Benefit Plan, Benefit Obligation, Benefits Paid	(10)	(9)
Defined Benefit Plan, Benefit Obligation, Foreign Currency Translation Gain (Loss)	0	(32)
Expense related to matching contributions	135	$ 123	$ 118
Defined Benefit Plan, Expected Future Benefit Payment, Year One	16
Defined Benefit Plan, Expected Future Benefit Payment, Year Two	13
Defined Benefit Plan, Expected Future Benefit Payment, Year Three	14
Defined Benefit Plan, Expected Future Benefit Payment, Year Four	15
Defined Benefit Plan, Expected Future Benefit Payment, Year Five	15
Defined Benefit Plan, Expected Future Benefit Payment, after Year Five for Next Five Years	$ 73
Domestic Plan
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Executive Retirement Plan Discount Rate	4.89%	5.32%
Executive Retirement Plan Rate of Compensation Increase	2%	2%
Other International Plans
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Defined Benefit Plan, Plan Assets, Assumptions used to Determine Expected Return	2.66%	2.27%
Executive Retirement Plan Discount Rate	2.85%	2.62%
Executive Retirement Plan Rate of Compensation Increase	3%	3%
Executive retirement plan [Member]
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Defined Benefit Plan, Accumulated Benefit Obligation	$ 54	$ 50
Defined Benefit Plan, Benefit Obligation	59	55
Defined Benefit Plan, Plan Assets, Amount	0	0
Defined Benefit Plan, Amounts for Asset (Liability) Recognized in Statement of Financial Position	59	55
International retirement plans [Member]
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Defined Benefit Plan, Accumulated Benefit Obligation	145	140
Defined Benefit Plan, Benefit Obligation	159	152
Defined Benefit Plan, Plan Assets, Amount	101	101
Defined Benefit Plan, Amounts for Asset (Liability) Recognized in Statement of Financial Position	$ 58	$ 51

Schedule II (Details)

Schedule II (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Beginning balance	$ 109	$ 108	$ 105
Net (credits) charges to expenses	50	35	28
Utilization of allowances	(48)	(35)	(25)
Ending balance	$ 110	$ 109	$ 108