Boston Scientific (BSX) 10-Q 1 May 24 2024 Q1 Quarterly report Financial data

Cover Document

Cover Document - $ / shares	3 Months Ended
	Mar. 31, 2024	Apr. 29, 2024
Entity Information [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
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 Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Listing, Par Value Per Share	$ 0.01
Entity Common Stock, Shares Outstanding		1,470,179,843
Entity Central Index Key	0000885725
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Amendment Flag	false
Common Stock, par value $0.01 per share
Entity Information [Line Items]
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	BSX
Security Exchange Name	NYSE
0.625% Senior Notes due 2027
Entity Information [Line Items]
Title of 12(b) Security	0.625% Senior Notes due 2027
Trading Symbol	BSX27
Security Exchange Name	NYSE

Consolidated Statements of Oper

Consolidated Statements of Operations (Unaudited) - USD ($) shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Net sales	$ 3,856	$ 3,389
Cost of products sold	1,209	1,040
Gross profit	2,648	2,349
Operating expenses:
Selling, general and administrative expenses	1,364	1,215
Research and development expenses	366	337
Royalty expense	10	11
Amortization expense	214	203
Contingent consideration net expense (benefit)	17	12
Restructuring net charges (credits)	3	20
Operating expenses	1,973	1,797
Operating income (loss)	675	552
Other income (expense):
Interest expense	(69)	(65)
Other, net	2	(43)
Income (loss) before income taxes	608	444
Income tax expense (benefit)	115	131
Net income (loss)	493	314
Preferred stock dividends	0	(14)
Net income (loss) attributable to noncontrolling interests	(1)	0
Net income (loss) attributable to Boston Scientific common stockholders	$ 495	$ 300
Net income (loss) per common share — basic	$ 0.34	$ 0.21
Net income (loss) per common share — diluted	$ 0.33	$ 0.21
Weighted-average shares outstanding
Basic	1,468.4	1,435.8
Diluted	1,481.7	1,446

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 493	$ 314
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustment	57	(42)
Net change in derivative financial instruments	22	(43)
Net change in defined benefit pensions and other items	0	(5)
Other comprehensive income (loss)	78	(91)
Comprehensive income (loss)	572	223
Comprehensive income (loss) attributable to noncontrolling interests	(6)	0
Comprehensive income attributable to Boston Scientific common stockholders	$ 578	$ 223

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 2,329	$ 865
Trade accounts receivable, net	2,304	2,228
Inventories	2,561	2,484
Prepaid income taxes	319	315
Other current assets	671	621
Total current assets	8,185	6,514
Property, plant and equipment, net	2,897	2,859
Goodwill	14,361	14,387
Other intangible assets, net	5,839	6,003
Deferred tax assets	3,792	3,841
Other long-term assets	1,596	1,531
TOTAL ASSETS	36,669	35,136
Current liabilities:
Current debt obligations	1,085	531
Accounts payable	921	942
Accrued expenses	2,083	2,646
Other current liabilities	827	814
Total current liabilities	4,916	4,933
Long-term debt	9,534	8,571
Deferred income taxes	132	134
Other long-term liabilities	1,919	1,967
Commitments and contingencies
Stockholders’ equity
Preferred stock, $0.01 par value - authorized 50,000,000 shares - 0 shares issued as of March 31, 2024 and December 31, 2023	0	0
Common stock, $0.01 par value - authorized 2,000,000,000 shares - issued 1,733,293,885 shares as of March 31, 2024 and 1,729,000,224 shares as of December 31, 2023	17	17
Treasury stock, at cost - 263,289,848 shares as of March 31, 2024 and December 31, 2023	(2,251)	(2,251)
Additional paid-in capital	20,713	20,647
Retained earnings	1,314	819
Accumulated other comprehensive income (loss), net of tax	132	49
Total stockholders’ equity	19,926	19,282
Noncontrolling interests	242	248
Total equity	20,168	19,530
TOTAL LIABILITIES AND EQUITY	$ 36,669	$ 35,136
Preferred Stock, Shares Issued	0	0

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
Condensed 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	0
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
Treasury Stock, Common, Shares	263,289,848	263,289,848

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity (Unaudited) - 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
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total stockholders’ equity							$ 269
Beginning Balance (Shares Issued) at Dec. 31, 2022		10,062,500
Beginning Balance (Shares) at Dec. 31, 2022			1,696,633,993
Beginning Balance, Equity at Dec. 31, 2022		$ 0	$ 17	$ (2,251)	$ 20,289	$ (750)	269	$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation (Shares)			4,194,880
Preferred stock issuance		$ 0
Repurchase of common stock				0
Impact of stock-based compensation plans			$ 0		68
Net income (loss)	$ 314					314
Preferred stock dividends						(14)
Preferred stock issuance		0
Net income (loss) attributable to noncontrolling interests	0					0		0
Changes in other comprehensive income (loss)	(91)						(91)	0
Changes to noncontrolling ownership interest								259
Ending Balance (Shares Issued) at Mar. 31, 2023		10,062,500
Ending Balance (Shares) at Mar. 31, 2023			1,700,828,873
Ending Balance, Equity at Mar. 31, 2023	18,109	$ 0	$ 17	(2,251)	20,356	(450)	178	259
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total stockholders’ equity	17,850						178
Total stockholders’ equity	$ 19,282						49
Beginning Balance (Shares Issued) at Dec. 31, 2023		0
Beginning Balance (Shares) at Dec. 31, 2023	1,729,000,224		1,729,000,224
Beginning Balance, Equity at Dec. 31, 2023	$ 19,530	$ 0	$ 17	(2,251)	20,647	819	49	248
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation (Shares)			4,293,661
Preferred stock issuance		$ 0
Repurchase of common stock				0
Impact of stock-based compensation plans			$ 0		66
Net income (loss)	493					493
Preferred stock dividends						0
Preferred stock issuance		0
Net income (loss) attributable to noncontrolling interests	1					1		(1)
Changes in other comprehensive income (loss)	78						83	(5)
Changes to noncontrolling ownership interest								0
Ending Balance (Shares Issued) at Mar. 31, 2024		0
Ending Balance (Shares) at Mar. 31, 2024			1,733,293,885
Ending Balance, Equity at Mar. 31, 2024	20,168	$ 0	$ 17	$ (2,251)	$ 20,713	$ 1,314	132	$ 242
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Total stockholders’ equity	$ 19,926						$ 132

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Cash provided by (used for) operating activities
Net income (loss)	$ 493	$ 314
Depreciation and amortization	304	285
Deferred and prepaid income taxes	31	19
Stock-based compensation expense	63	55
Net loss (gain) on investments and notes receivable	2	31
Contingent consideration net expense (benefit)	17	12
Other, net	(4)	(2)
Trade accounts receivable	(114)	(86)
Inventories	(124)	(185)
Other assets	(55)	(41)
Accounts payable, accrued expenses and other liabilities	(450)	(211)
Cash provided by (used for) operating activities	164	190
Investing activities:
Purchases of property, plant and equipment and internal use software	(179)	(111)
Proceeds from sale of property, plant and equipment	1	3
Payments for acquisitions of businesses, net of cash acquired	(47)	(375)
Payments for investments and acquisitions of certain technologies, net of investment proceeds	(66)	(10)
Proceeds from royalty rights	7	9
Cash provided by (used for) investing activities	(285)	(484)
Financing activities:
Payment of contingent consideration previously established in purchase accounting	(34)	(34)
Payments for royalty rights	(15)	(34)
Payments for finance leases	(25)	0
Payments on short-term borrowings	(504)	0
Proceeds from long-term borrowings, net of debt issuance costs	2,145	0
Cash dividends paid on preferred stock	0	(14)
Cash used to net share settle employee equity awards	(78)	(50)
Proceeds from issuances of common stock pursuant to employee stock compensation and purchase plans	80	63
Cash provided by (used for) financing activities	1,569	(69)
Effect of foreign exchange rates on cash	(7)	0
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted cash equivalents	1,441	(363)
Cash, cash equivalents, restricted cash and restricted cash equivalents at beginning of period	1,055	1,126
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period	2,496	763
Supplemental Information
Stock-based compensation expense	63	55
Non-cash impact of transferred royalty rights	(7)	(9)
Cash and cash equivalents	2,329	570
Restricted cash and restricted cash equivalents included in Other current assets	93	135
Restricted cash equivalents included in Other long-term assets	74	57
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period	$ 2,496	$ 763

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	NOTE A – BASIS OF PRESENTATION The accompanying unaudited consolidated financial statements of Boston Scientific Corporation have been prepared in accordance with accounting principles generally accepted in the United States (GAAP) and with the instructions to Form 10-Q and Article 10 of Regulation S-X, and they do not include all of the information and footnotes required by GAAP for complete financial statements. When used in this report, the terms, "we," "us," "our," and "the Company" mean Boston Scientific Corporation and its divisions and subsidiaries. In the opinion of management, all adjustments (consisting only of normal recurring adjustments) considered necessary for fair presentation have been included. Operating results for the three months ended March 31, 2024 are not necessarily indicative of the results that may be expected for the year ending December 31, 2024. Accordingly, our unaudited consolidated financial statements and footnotes thereto should be read in conjunction with our audited consolidated financial statements and footnotes thereto included in Item 8 of our most recent Annual Report on Form 10-K. The accompanying unaudited consolidated financial statements include the accounts of the Company's wholly owned- subsidiaries and entities for which the Company has a controlling financial interest. All intercompany balances and transactions have been eliminated in consolidation. Amounts reported in millions within this Quarterly Report on Form 10-Q 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 amounts. Subsequent Events We evaluate events occurring after the date of our accompanying unaudited consolidated balance sheet for potential recognition or disclosure within our 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 H – Commitments and Contingencies for further details.

Acquisitions, Divestitures and

Acquisitions, Divestitures and Strategic Investments	3 Months Ended
	Mar. 31, 2024
Business Combinations [Abstract]
ACQUISITIONS AND STRATEGIC INVESTMENTS	NOTE B – ACQUISITIONS AND STRATEGIC INVESTMENTS Our accompanying unaudited 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 accompanying unaudited consolidated financial statements. Further, transaction costs were immaterial to our accompanying unaudited 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 for 100% of the fully diluted equity. On April 3, 2024, we and Axonics each received a request for additional information (Second Request) from the United States Federal Trade Commission (FTC) in connection with the FTC's review of the transaction. The issuance of the Second Request extends the waiting period under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended (HSR Act), until 30 days after both we and Axonics have substantially complied with the Second Request, unless the waiting period is extended voluntarily by the parties or terminated earlier by the FTC. We and Axonics expect to promptly respond to the Second Request and to continue to work cooperatively with the FTC in its review. The transaction is expected to be completed in the second half of 2024, subject to the expiration or termination of the waiting period under the HSR Act and the satisfaction (or waiver) of other customary closing conditions. The Axonics business will be integrated into our Urology division. 2023 Acquisition On February 20, 2023, we completed the acquisition of a majority stake investment in Acotec Scientific Holdings Limited (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. Purchase Price Allocation We accounted for our majority stake investment in Acotec as a business combination in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 805, Business Combinations (FASB ASC Topic 805). The final purchase price was comprised of the amount presented below: (in millions) Acotec (1) Payment for majority stake investment $ 381 $ 381 (1) Excludes approximately $140 million of cash on hand at the closing of the transaction We recorded the assets acquired, liabilities assumed and the noncontrolling interest at their respective fair values as of the closing date of the transaction. The final purchase price allocation was comprised of the components presented below, with the excess of the purchase price over the fair value of net assets acquired recorded to goodwill: (in millions) Acotec Goodwill $ 337 Amortizable intangible assets 334 Other assets acquired 93 Liabilities assumed (48) Net deferred tax liabilities (76) Fair value of noncontrolling interest (259) $ 381 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 in Stockholders' equity within our accompanying unaudited consolidated balance sheets. Goodwill was primarily established for Acotec due to opportunities for collaboration in research and development, manufacturing and commercial strategies and was not 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 $ 308 11 14% Customer relationships 15 11 14% Other intangible assets 11 13 14% $ 334 Contingent Consideration Changes in the fair value of our contingent consideration liability during the first quarter of 2024 associated with prior period acquisitions were as follows: (in millions) Balance as of December 31, 2023 $ 404 Contingent consideration net expense (benefit) 17 Contingent consideration payments and other adjustments (148) Balance as of March 31, 2024 $ 273 The payments made during the first quarter of 2024 primarily related to our acquisition of Farapulse, Inc (Farapulse) following the achievement of revenue-based earnouts as a result of over-performance. The maximum amount we could be required to pay for certain contingent consideration is not determinable as it is uncapped and based on a percent of certain sales. As of March 31, 2024, the fair value of such uncapped contingent consideration is estimated at $164 million. As of March 31, 2024, the maximum amount that we could be required to pay under our other contingent consideration arrangements (undiscounted) is approximately $275 million. Refer to Note B – Acquisitions and Strategic Investments to our audited financial statements contained in Item 8. Financial Statements and Supplementary Data of our most recent Annual Report on Form 10-K for additional information. 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 March 31, 2024 Valuation Technique Unobservable Input Range Weighted Average (1) Revenue-based Payments and Milestones $273 million Discounted Cash Flow Discount Rate 6% - 11% 6% Probability of Payment 100% 100% 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 March 31, 2024. Strategic Investments The aggregate carrying amount of our strategic investments was comprised of the following: As of (in millions) March 31, 2024 December 31, 2023 Equity method investments $ 211 $ 219 Measurement alternative investments (1, 2) 218 194 $ 429 $ 413 (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 unaudited consolidated statements of operations. (2) Includes publicly-held securities and convertible notes measured at fair value with changes in fair value recognized in Other, net within our accompanying unaudited consolidated statements of operations. These investments are classified as Other long-term assets within our accompanying unaudited consolidated balance sheets, in accordance with GAAP and our accounting policies.

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024 As of December 31, 2023 (in millions) Gross Carrying Amount Accumulated Amortization/ Write-offs Gross Carrying Amount Accumulated Amortization/ Write-offs Technology-related $ 13,223 $ (8,287) $ 13,207 $ (8,101) Patents 480 (385) 480 (387) Other intangible assets 2,159 (1,527) 2,130 (1,500) Amortizable intangible assets $ 15,863 $ (10,198) $ 15,817 $ (9,988) Goodwill $ 24,261 $ (9,900) $ 24,287 $ (9,900) IPR&D $ 54 $ 54 Technology-related 120 120 Indefinite-lived intangible assets $ 174 $ 174 The following represents a roll-forward of our goodwill balance by reportable segment: (in millions) MedSurg Cardiovascular Total As of December 31, 2023 $ 5,347 $ 9,041 $ 14,387 Goodwill acquired 24 — 24 Impact of foreign currency fluctuations and purchase price and other adjustments (29) (22) (51) As of March 31, 2024 $ 5,342 $ 9,019 $ 14,361 Goodwill and Other Intangible Asset Impairments We did not record any goodwill or intangible asset impairment charges in the first quarter of 2024 or 2023. Refer to Note A – Significant Accounting Policies

Hedging Activities and Fair Val

Hedging Activities and Fair Value Measurements	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [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 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 forecasted transactions denominated primarily in euro, Chinese renminbi, Japanese yen, British pound sterling, Australian dollar and Swiss franc. 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 , Derivatives and Hedging (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 unaudited 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 within our unaudited 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 within our unaudited 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 Chinese renminbi and Japanese yen. 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 within our unaudited 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 March 31, 2024 and December 31, 2023, 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 within our accompanying unaudited 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 within our accompanying unaudited 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 March 31, 2024 or December 31, 2023. 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 March 31, 2024 or December 31, 2023. 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 March 31, 2024 December 31, 2023 Forward currency contracts Cash flow hedge $ 2,242 $ 2,284 Forward currency contracts Net investment hedge 645 333 Foreign currency-denominated debt (1) Net investment hedge 997 997 Forward currency contracts Non-designated 3,070 3,282 Total Notional Outstanding $ 6,954 $ 6,896 (1) Foreign currency-denominated debt is the €900 million debt principal associated with our 2027 Notes designated as a net investment hedge. The remaining time to maturity as of March 31, 2024 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 within our accompanying unaudited consolidated statements of operations. Refer to Note M – Changes in Other Comprehensive Income for the total amounts relating to derivative and nonderivative instruments presented within our accompanying unaudited consolidated statements of comprehensive income (loss). Effect of Hedging Relationships on Accumulated Other Comprehensive Income Amount Recognized in OCI on Hedges Unaudited 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 Three Months Ended March 31, 2024 Forward currency contracts Cash flow hedges $ 76 $ (17) $ 59 Cost of products sold $ 1,209 $ (49) $ 11 $ (38) Net investment hedges (2) 27 (6) 21 Interest expense 69 (4) 1 (3) Foreign currency-denominated debt Net investment hedges (3) 23 (5) 18 Other, net (2) — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 69 1 (0) 0 Effect of Hedging Relationships on Accumulated Other Comprehensive Income Amount Recognized in OCI on Hedges Unaudited 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 Three Months Ended March 31, 2023 Forward currency contracts Cash flow hedges $ 13 $ (3) $ 10 Cost of products sold $ 1,040 $ (69) $ 16 $ (54) Net investment hedges (2) 6 (1) 4 Interest expense 65 (3) 1 (2) Foreign currency-denominated debt Net investment hedges (3) (19) 4 (14) Other, net 43 — — — Interest rate derivative contracts Cash flow hedges — — — Interest Expense 65 1 — 1 (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 March 31, 2024, 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): FASB ASC Topic 815 Designation Location on Unaudited Consolidated Statements of Operations Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings Designated Hedging Instrument Forward currency contracts Cash flow hedge Cost of products sold $ 173 Forward currency contracts Net investment hedge Interest expense 15 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: Location on Unaudited Consolidated Statements of Operations Three Months Ended March 31, (in millions) 2024 2023 Net gain (loss) on currency hedge contracts Other, net $ 15 $ (8) Net gain (loss) on currency transaction exposures Other, net (20) (6) Net currency exchange gain (loss) $ (5) $ (14) 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: Location on Unaudited Consolidated Balance Sheets (1) As of (in millions) March 31, 2024 December 31, 2023 Derivative and Nonderivative Assets: Designated Hedging Instruments Forward currency contracts Other current assets $ 160 $ 140 Forward currency contracts Other long-term assets 125 107 285 246 Non-Designated Hedging Instruments Forward currency contracts Other current assets 17 20 Total Derivative and Nonderivative Assets $ 302 $ 266 Derivative and Nonderivative Liabilities: Designated Hedging Instruments Forward currency contracts Other current liabilities $ 3 $ 15 Forward currency contracts Other long-term liabilities 1 9 Foreign currency-denominated debt (2) Long-term debt 966 988 969 1,012 Non-Designated Hedging Instruments Forward currency contracts Other current liabilities 17 38 Total Derivative and Nonderivative Liabilities $ 986 $ 1,050 (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 associated with our 2027 Notes 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 March 31, 2024 December 31, 2023 (in millions) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Assets Money market funds and time deposits $ 1,979 $ — $ — $ 1,979 $ 454 $ — $ — $ 454 Publicly-held equity securities 20 — — 20 18 — — 18 Hedging instruments — 302 — 302 — 266 — 266 Licensing arrangements — — 66 66 — — 77 77 $ 1,999 $ 302 $ 66 $ 2,367 $ 472 $ 266 $ 77 $ 816 Liabilities Hedging instruments $ — $ 986 $ — $ 986 $ — $ 1,050 $ — $ 1,050 Contingent consideration liability — — 273 273 — — 404 404 Licensing arrangements — — 71 71 — — 90 90 $ — $ 986 $ 344 $ 1,330 $ — $ 1,050 $ 494 $ 1,545 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 or Other current assets within our accompanying unaudited consolidated balance sheets, in accordance with GAAP and our accounting policies. In addition to $1.979 billion invested in money market funds and time deposits as of March 31, 2024 and $454 million as of December 31, 2023, we held $384 million in interest-bearing and non-interest-bearing bank accounts as of March 31, 2024 and $411 million as of December 31, 2023. 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 maintain a financial asset and associated liability for our licensing arrangements measured at fair value within our unaudited consolidated balance sheets 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. Refer to Note D – Hedging Activities and Fair Value Measurements to our audited financial statements contained in Item 8. Financial Statements and Supplementary Data of our most recent Annual Report on Form 10-K for additional information. The recurring Level 3 fair value measurements of our licensing arrangements recognized within our accompanying unaudited consolidated balance sheets as of March 31, 2024 include the following significant unobservable inputs: Licensing Arrangements Fair Value as of March 31, 2024 Valuation Technique Unobservable Input Range Weighted Average (1) Financial Asset $66 million Discounted Cash Flow Discount Rate 15% 15% Projected Year of Payment 2024 - 2025 2025 Financial Liability $71 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, 2023 $ 77 Proceeds from royalty rights (14) Fair value adjustment (expense) benefit 2 Balance as of March 31, 2024 $ 66 Changes in the fair value of our licensing arrangements' financial liability were as follows: (in millions) Balance as of December 31, 2023 $ 90 Payments for royalty rights (22) Fair value adjustment expense (benefit) 2 Balance as of March 31, 2024 $ 71 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 $10.224 billion as of March 31, 2024 and $8.735 billion as of December 31, 2023. 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	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
CONTRACTUAL OBLIGATIONS AND COMMITMENTS	NOTE E – CONTRACTUAL OBLIGATIONS AND COMMITMENTS Borrowings and Credit Arrangements We had total debt outstanding of $10.619 billion as of March 31, 2024 and $9.102 billion as of December 31, 2023, with current obligations of $1.085 billion as of March 31, 2024 and $531 million as of December 31, 2023. The debt maturity schedule for our long-term debt obligations is presented below: (in millions, except interest rates) Issuance Date Maturity Date As of Coupon Rate (1) March 31, December 31, March 2025 Senior Notes (3) March 2022 March 2025 — 1,105 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 972 995 0.625% March 2028 Senior Notes (3) March 2022 March 2028 810 829 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% March 2029 Senior Notes (3) February 2024 March 2029 810 — 3.375% June 2030 Senior Notes May 2020 June 2030 1,200 1,200 2.650% March 2031 Senior Notes (3) March 2022 March 2031 810 829 1.625% March 2032 Senior Notes (3) February 2024 March 2032 1,349 — 3.500% March 2034 Senior Notes (3) March 2022 March 2034 540 553 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 (81) (65) Finance Lease Obligation Various 4 5 Long-term debt $ 9,534 $ 8,571 (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 March 31, 2024 and December 31, 2023, respectively. 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 March 31, 2024 or December 31, 2023. Financial Covenant As of March 31, 2024, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility. Covenant Requirement Actual as of March 31, 2024 as of March 31, 2024 Maximum permitted leverage ratio (1) 3.75 times 2.08 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 credit agreement provides for higher leverage ratios, at our election, for the period following a Qualified Acquisition, as defined by the agreement, 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 elected to designate the Axonics acquisition as a Qualified Acquisition under the credit agreement, and upon closing, will increase the maximum permitted leverage ratio at that time. The agreement also provides for an exclusion of any debt incurred to fund a Qualified Acquisition, until the earlier of the acquisition close date or date of abandonment, termination or expiration of the acquisition agreement. As of March 31, 2024, we excluded $2.138 billion of debt incurred from our leverage ratio calculation in connection with the Axonics acquisition. 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 March 31, 2024, we had $273 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 March 31, 2024, we had $1.457 billion of the litigation exclusion remaining. Any inability to maintain compliance with this covenant could require us to seek to 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 March 31, 2024 and December 31, 2023. Senior Notes We had senior notes outstanding of $10.690 billion as of March 31, 2024 and $9.136 billion as of December 31, 2023. 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 (refer to Other Arrangements below). In February 2024, American Medical Systems Europe B.V. (AMS Europe), an indirect, wholly owned subsidiary of Boston Scientific, completed a registered public offering (the Offering) of €2.000 billion in aggregate principal amount of euro-denominated senior notes comprised of €750 million of 3.375% Senior Notes due 2029 and €1.250 billion of 3.500% Senior Notes due 2032 (collectively, the 2024 Eurobonds). Boston Scientific has fully and unconditionally guaranteed all of AMS Europe's obligations under the 2024 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 $2.145 billion, net of investor discounts and issuance costs. We used the net proceeds from the Offering of the 2024 Eurobonds to fund the repayment at maturity of our 3.450% Senior Notes due March 2024 and to pay accrued and unpaid interest with respect to such notes. Additionally, we plan to use the remaining net proceeds from the Offering to fund a portion of the purchase price of the Axonics acquisition and to pay related fees and expenses, and for general corporate purposes. The transaction is expected to be completed in the second half of 2024, subject to the expiration or termination of the waiting period under the HSR Act and the satisfaction (or waiver) of other customary closing conditions. If (i) the Axonics acquisition is not consummated on or before the later of (x) January 8, 2025 (as such date may be extended in accordance with the merger agreement to no later than January 8, 2026) and (y) the date that is five business days after any later date to which we and Axonics may agree to extend the "Outside Date" in the merger agreement or (ii) AMS Europe notifies the trustee that we will not pursue consummation of the Axonics Acquisition, AMS Europe will be required to redeem each series of the notes at a special mandatory redemption price equal to 101% of the aggregate principal amount of such series of notes, plus accrued and unpaid interest, if any, to, but excluding, the date on which the notes will be redeemed. Refer to Note B – Acquisitions and Strategic Investments for more information on the Axonics acquisition. 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 within our accompanying unaudited consolidated balance sheets, are aggregated by contract denominated currency below (in millions): Factoring Arrangements As of March 31, 2024 As of December 31, 2023 Amount Weighted Average Amount Weighted Average Euro denominated $ 175 5.5 % $ 206 5.1 % Yen denominated 191 0.6 % 214 0.6 % Renminbi denominated 21 1.8 % 14 2.9 % Other Contractual Obligations and Commitments We had outstanding letters of credit of $174 million as of March 31, 2024 and December 31, 2023, which consisted primarily of bank guarantees and collateral for workers' compensation insurance arrangements. As of March 31, 2024 and December 31, 2023 we had not recognized a related liability for our outstanding letters of credit within our accompanying unaudited consolidated balance sheets. 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 $140 million as of March 31, 2024 and $152 million as of December 31, 2023. Refer to Note E – Contractual Obligations and Commitments to our audited financial statements contained in Item 8. Financial Statements and Supplementary Data of our most recent Annual Report on Form 10-K for additional information on our borrowings and credit agreements.

Supplemental Balance Sheet Info

Supplemental Balance Sheet Information	3 Months Ended
	Mar. 31, 2024
Supplemental Balance Sheet Information [Abstract]
SUPPLEMENTAL BALANCE SHEET INFORMATION	NOTE F – SUPPLEMENTAL BALANCE SHEET INFORMATION Components of selected captions within our accompanying unaudited consolidated balance sheets are as follows: Trade accounts receivable, net As of (in millions) March 31, 2024 December 31, 2023 Trade accounts receivable $ 2,413 $ 2,338 Allowance for credit losses (109) (110) $ 2,304 $ 2,228 The following is a roll forward of our Allowance for credit losses : Three Months Ended March 31, (in millions) 2024 2023 Beginning balance $ 110 $ 109 Credit loss expense 9 16 Write-offs (10) (6) Ending balance $ 109 $ 118 Inventories As of (in millions) March 31, 2024 December 31, 2023 Finished goods $ 1,555 $ 1,537 Work-in-process 188 174 Raw materials 818 773 $ 2,561 $ 2,484 Other current assets As of (in millions) March 31, 2024 December 31, 2023 Restricted cash and restricted cash equivalents $ 93 $ 130 Derivative assets 177 159 Licensing arrangements 44 47 Other 357 285 $ 671 $ 621 Property, plant and equipment, net As of (in millions) March 31, 2024 December 31, 2023 Land $ 141 $ 140 Buildings and improvements 1,856 1,843 Equipment, furniture and fixtures 3,550 3,503 Capital in progress 880 857 6,427 6,343 Less: accumulated depreciation 3,530 3,484 $ 2,897 $ 2,859 Depreciation expense was $90 million for the first quarter of 2024 and $82 million for the first quarter of 2023. Other long-term assets As of (in millions) March 31, 2024 December 31, 2023 Restricted cash equivalents $ 74 $ 60 Operating lease right-of-use assets 430 439 Derivative assets 125 107 Investments 429 413 Licensing arrangements 22 30 Indemnification asset 175 176 Other 341 306 $ 1,596 $ 1,531 Accrued expenses As of (in millions) March 31, 2024 December 31, 2023 Legal reserves $ 129 $ 206 Payroll and related liabilities 749 1,051 Rebates 384 389 Contingent consideration 182 304 Other 639 696 $ 2,083 $ 2,646 Other current liabilities As of (in millions) March 31, 2024 December 31, 2023 Deferred revenue $ 280 $ 266 Licensing arrangements 45 49 Taxes payable 257 220 Other 246 278 $ 827 $ 814 Other long-term liabilities As of (in millions) March 31, 2024 December 31, 2023 Accrued income taxes $ 466 $ 470 Legal reserves 154 172 Contingent consideration 90 100 Licensing arrangements 26 41 Operating lease liabilities 382 390 Deferred revenue 314 311 Other 486 484 $ 1,919 $ 1,967

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
INCOME TAXES	NOTE G – INCOME TAXES Our effective tax rate from continuing operations is presented below: Three Months Ended March 31, 2024 2023 Effective tax rate from continuing operations 18.9 % 29.4 % Our reported tax rate is affected by recurring items such as the amount of our earnings subject to differing tax rates in foreign jurisdictions and the impact of certain receipts and charges that are taxed at rates that differ from our effective tax rate. The principal reason for the difference between the statutory rate and our reported tax rate in the first quarter of 2024 primarily relates to certain charges for acquisition expenses as well as certain discrete benefits related to unrecognized tax benefits and stock-based compensation. In the first quarter of 2023, the primary difference between the statutory tax rate and our reported tax rate relates to certain discrete charges related to provision-to-return adjustments. As of March 31, 2024, we had $465 million of gross unrecognized tax benefits, of which a net $393 million, if recognized, would affect our effective tax rate. 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. The change in our gross unrecognized tax benefit is primarily related to current year activity and audit activities. 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 $11 million.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	NOTE H – 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. For additional information, refer to Note I – Commitments and Contingencies to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K. 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 unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses within our accompanying unaudited consolidated statements of operations. Our accrual for legal matters that are probable and estimable was $283 million as of March 31, 2024 and $377 million as of December 31, 2023 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 $93 million as of March 31, 2024 and $130 million as of December 31, 2023. Refer to Note F – Supplemental Balance Sheet Information for additional information. We did not record any litigation-related net charges during the first quarter of 2024 or 2023. 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 disclosed in our most recent Annual Report on Form 10-K and 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 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 Court granted the motion for preliminary approval of the proposed settlement on December 27, 2023, and approved the settlement at a hearing on 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. On March 26, 2024, the Company reached an agreement in principle with all of the plaintiffs to resolve the matters.

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2024
Stockholders' Equity Note [Abstract]
STOCKHOLDERS' EQUITY	NOTE I – 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. Refer to Note J – Stockholders' Equity to our audited financial statements contained in Item 8. Financial Statements and Supplementary Data of our most recent Annual Report on Form 10-K for information on the pertinent rights and privileges of our outstanding common stock.

Weighted Average Shares Outstan

Weighted Average Shares Outstanding	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Weighted Average Number Of Shares Outstanding [Text Block]	NOTE J – WEIGHTED AVERAGE SHARES OUTSTANDING Three Months Ended March 31, (in millions) 2024 2023 Weighted average shares outstanding — basic 1,468.4 1,435.8 Net effect of common stock equivalents 13.4 10.2 Weighted average shares outstanding - diluted 1,481.7 1,446.0 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: Three Months Ended March 31, (in millions) 2024 2023 Stock options outstanding (1) 2 3 MCPS (2) — 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 I – 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. For the first quarter of 2023, 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 within our accompanying unaudited consolidated statements of operations, for purposes of calculating Net income attributable to Boston Scientific common stockholders . On June 1, 2023, all outstanding shares of MCPS automatically converted into shares of common stock. We issued approximately four million shares of our common stock in the first quarter of 2024 and 2023 following the exercise of stock options, vesting of restricted stock units or purchases under our employee stock purchase plan. We did not repurchase any shares of our common stock in the first quarter of 2024 or 2023. 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. As of March 31, 2024, we had the full amount remaining available under the authorization.

Segment Reporting

Segment Reporting	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Segment Reporting	NOTE K – SEGMENT REPORTING We aggregate our core businesses into two reportable segments: MedSurg and Cardiovascular, each of which generates revenues from the sale of medical devices. 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), and 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 accompanying unaudited consolidated statements of operations and are included in the reconciliation below. Refer to Note L – 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 unaudited consolidated statements of operations is as follows (in millions, except percentages). Prior period amounts have been restated at constant currency to conform to current year presentation. Three Months Ended Net Sales 2024 2023 MedSurg $ 1,402 $ 1,266 Cardiovascular 2,426 2,072 Total net sales of reportable segments 3,827 3,337 Impact of foreign currency fluctuations 29 52 $ 3,856 $ 3,389 Income (loss) before income taxes MedSurg $ 474 $ 409 Cardiovascular 653 553 Total operating income of reportable segments 1,128 963 Unallocated amounts: Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments (115) (98) 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 EU MDR implementation costs (124) (110) Amortization expense (214) (203) Operating income (loss) 675 552 Other income (expense), net (67) (108) Income (loss) before income taxes $ 608 $ 444 Three Months Ended March 31, Operating income margin of reportable segments 2024 2023 MedSurg 33.8 % 32.3 % Cardiovascular 26.9 % 26.7 %

Revenue

Revenue	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenue from Contract with Customer [Text Block]	NOTE L – REVENUE We generate revenue primarily from the sale of single-use medical devices and present revenue net of sales taxes within our accompanying unaudited 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. Three Months Ended March 31, 2024 2023 Businesses U.S. Int'l Total U.S. Int'l Total Endoscopy $ 395 $ 247 $ 642 $ 351 $ 226 $ 577 Urology 356 157 513 326 143 469 Neuromodulation 190 66 256 172 62 234 MedSurg 941 470 1,412 850 430 1,280 Interventional Cardiology Therapies 195 457 652 183 408 591 Watchman 311 33 344 265 25 291 Cardiac Rhythm Management 354 221 575 345 203 548 Electrophysiology 158 143 300 85 91 177 Cardiology 1,017 854 1,872 879 727 1,606 Peripheral Interventions 299 274 573 275 229 503 Cardiovascular 1,316 1,129 2,445 1,154 956 2,110 Total Net Sales $ 2,258 $ 1,599 $ 3,856 $ 2,003 $ 1,386 $ 3,389 Refer to Note K - Segment Reporting for information on our reportable segments. Three Months Ended March 31, Geographic Regions 2024 2023 U.S. $ 2,258 $ 2,003 Europe, Middle East and Africa 803 712 Asia-Pacific 647 548 Latin America and Canada 149 126 Total Net Sales $ 3,856 $ 3,389 Emerging Markets (1) $ 648 $ 529 (1) 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. Deferred Revenue Contract liabilities are classified within Other current liabilities and Other long-term liabilities within our accompanying unaudited consolidated balance sheets. Our deferred revenue balance was $593 million as of March 31, 2024 and $577 million as of December 31, 2023. 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 $62 million in the first quarter that was included in the above contract liability balance as of December 31, 2023. 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 For additional information on variable consideration, refer to Note A – Significant Accounting Policies to our audited financial statements contained in Item 8. Financial Statements and Supplementary Data of our most recent Annual Report on Form 10-K.

Changes in Other Comprehensive

Changes in Other Comprehensive Income	3 Months Ended
	Mar. 31, 2024
Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]
Comprehensive Income (Loss) Note [Text Block]	NOTE M – CHANGES IN OTHER COMPREHENSIVE INCOME The following tables provide the reclassifications out of Other comprehensive income (loss), 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, 2023 $ (96) $ 154 $ (8) $ 49 Other comprehensive income (loss) before reclassifications 65 59 — 124 (Income) loss amounts reclassified from accumulated other comprehensive income (3) (38) (0) (41) Total other comprehensive income (loss) 62 22 (0) 83 Balance as of March 31, 2024 $ (34) $ 175 $ (8) $ 132 (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 (40) 10 (5) (35) (Income) loss amounts reclassified from accumulated other comprehensive income (2) (53) (0) (56) Total other comprehensive income (loss) (42) (43) (5) (91) Balance as of March 31, 2023 $ (43) $ 225 $ (4) $ 178 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 .

New Accounting Pronouncements

New Accounting Pronouncements	3 Months Ended
	Mar. 31, 2024
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	NOTE N – 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 accompanying unaudited consolidated financial statements. During the first quarter of 2024, we implemented the following standard on a prospective basis, which did not have a material impact on our unaudited consolidated financial statements: ASC Update No. 2022-03 ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions 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. Standards to be Implemented 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. As this accounting standard update only impacts disclosures, we do not expect the adoption to have a material impact on our unaudited consolidated financial statements. 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. As this accounting standard update only impacts disclosures, we do not expect the adoption to have a material impact on our unaudited consolidated financial statements. No other new accounting pronouncements issued or effective in the period had or are expected to have a material impact on our accompanying unaudited consolidated financial statements.

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024 shares
Vance R. Brown [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 20, 2024, Vance R. Brown, our Senior Vice President, General Counsel and Corporate Secretary entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Brown’s plan covers the sale of 33,043 shares to be acquired upon exercise of stock options. Transactions under Mr. Brown’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. Brown’s plan will terminate on the earlier of December 31, 2024, or the date all shares subject to the plan have been sold.
Name	Vance R. Brown
Title	Senior Vice President, General Counsel and Corporate Secretary
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 20, 2024
Arrangement Duration	315 days
Aggregate Available	33,043
Daniel Brennan [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 21, 2024, Daniel Brennan, our Executive Vice President and Chief Financial Officer, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Brennan’s plan covers the sale of 112,075 shares of our common stock, including 64,454 shares to be acquired upon exercise of stock options. Transactions under Mr. Brennan’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. Brennan’s plan will terminate on the earlier of December 31, 2024, or the date all shares subject to the plan have been sold.
Name	Daniel Brennan
Title	Executive Vice President and Chief Financial Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 21, 2024
Arrangement Duration	314 days
Jonathan Monson [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 26, 2024, Jonathan Monson, our prior Senior Vice President, Global Controller and Chief Accounting Officer until March 1, 2024, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Monson’s plan covers the sale of 16,082 shares of our common stock, including 10,000 shares to be acquired upon exercise of stock options. Transactions under Mr. Monson’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. Monson’s plan will terminate on the earlier of February 1, 2025, or the date all shares subject to the plan have been sold.
Name	Jonathan Monson
Title	prior Senior Vice President, Global Controller and Chief Accounting Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 26, 2024
Arrangement Duration	341 days
Jeffrey B. Mirviss [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 28, 2024, Jeffrey B. Mirviss, our Senior Vice President and President, Peripheral Interventions, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Mirviss’ plan covers the sale of up to 88,888 shares of our common stock, including up to 25,086 shares to be acquired upon determination and/or vesting of performance share units and restricted share units and 33,726 shares to be acquired upon exercise of stock options. Transactions under Mr. Mirviss’ 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. Mirviss’ plan will terminate on the earlier of February 21, 2025, or the date all shares subject to the plan have been sold.
Name	Jeffrey B. Mirviss
Title	Senior Vice President and President, Peripheral Interventions
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 28, 2024
Arrangement Duration	359 days
Michael F. Mahoney [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 28, 2024, Michael F. Mahoney, our Chairman and Chief Executive Officer, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Mahoney’s plan covers the sale of 488,332 shares of our common stock, including 335,659 shares to be acquired upon exercise of stock options. Transactions under Mr. Mahoney’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. Mahoney’s plan will terminate on the earlier of November 8, 2024, or the date all shares subject to the plan have been sold.
Name	Michael F. Mahoney
Title	Chairman and Chief Executive Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 28, 2024
Arrangement Duration	254 days
Daniel Brennan Rule Trading Arrangement, Common Stock [Member] | Daniel Brennan [Member]
Trading Arrangements, by Individual
Aggregate Available	112,075
Daniel Brennan Rule Trading Arrangement, Stock Options [Member] | Daniel Brennan [Member]
Trading Arrangements, by Individual
Aggregate Available	64,454
Jonathan Monson Rule Trading Arrangement, Common Stock [Member] | Jonathan Monson [Member]
Trading Arrangements, by Individual
Aggregate Available	16,082
Jonathan Monson Rule Trading Arrangement, Stock Options [Member] | Jonathan Monson [Member]
Trading Arrangements, by Individual
Aggregate Available	10,000
Jeffrey B. Mirviss Rule Trading Arrangement, Common Stock [Member] | Jeffrey B. Mirviss [Member]
Trading Arrangements, by Individual
Aggregate Available	88,888
Jeffrey B. Mirviss Rule Trading Arrangement, Vesting of Performance Units And Restricted Units [Member] | Jeffrey B. Mirviss [Member]
Trading Arrangements, by Individual
Aggregate Available	25,086
Jeffrey B. Mirviss Rule Trading Arrangement, Stock Options [Member] | Jeffrey B. Mirviss [Member]
Trading Arrangements, by Individual
Aggregate Available	33,726
Michael F. Mahoney Rule Trading Arrangement, Common Stock [Member] | Michael F. Mahoney [Member]
Trading Arrangements, by Individual
Aggregate Available	488,332
Michael F. MahoneyRule Trading Arrangement, Stock Options [Member] | Michael F. Mahoney [Member]
Trading Arrangements, by Individual
Aggregate Available	335,659

Basis of Presentation Basis of

Basis of Presentation Basis of Presentation (Policies)	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Subsequent Events	Subsequent Events We evaluate events occurring after the date of our accompanying unaudited consolidated balance sheet for potential recognition or disclosure within our 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 H – Commitments and Contingencies for further details.

Hedging Activities and Fair V_2

Hedging Activities and Fair Value Measurements (Policies)	3 Months Ended
	Mar. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Fair Value Measurement, Policy [Policy Text Block]	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

Commitments and Contingencies (

Commitments and Contingencies (Policies)	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Legal Costs, Policy [Policy Text Block]	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 unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses

New Accounting Pronouncements (

New Accounting Pronouncements (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	NOTE N – 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 accompanying unaudited consolidated financial statements. During the first quarter of 2024, we implemented the following standard on a prospective basis, which did not have a material impact on our unaudited consolidated financial statements: ASC Update No. 2022-03 ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions 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. Standards to be Implemented 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. As this accounting standard update only impacts disclosures, we do not expect the adoption to have a material impact on our unaudited consolidated financial statements. 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. As this accounting standard update only impacts disclosures, we do not expect the adoption to have a material impact on our unaudited consolidated financial statements. No other new accounting pronouncements issued or effective in the period had or are expected to have a material impact on our accompanying unaudited consolidated financial statements.

Acquisitions, Divestitures an_2

Acquisitions, Divestitures and Strategic Investments (Tables)	3 Months Ended
	Mar. 31, 2024
Business Acquisition [Line Items]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	Changes in the fair value of our contingent consideration liability during the first quarter of 2024 associated with prior period acquisitions were as follows: (in millions) Balance as of December 31, 2023 $ 404 Contingent consideration net expense (benefit) 17 Contingent consideration payments and other adjustments (148) Balance as of March 31, 2024 $ 273
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 March 31, 2024 Valuation Technique Unobservable Input Range Weighted Average (1) Revenue-based Payments and Milestones $273 million Discounted Cash Flow Discount Rate 6% - 11% 6% Probability of Payment 100% 100% 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 (in millions) March 31, 2024 December 31, 2023 Equity method investments $ 211 $ 219 Measurement alternative investments (1, 2) 218 194 $ 429 $ 413 (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 unaudited consolidated statements of operations. (2) Includes publicly-held securities and convertible notes measured at fair value with changes in fair value recognized in Other, net within our accompanying unaudited consolidated statements of operations.
Acotec
Business Acquisition [Line Items]
Schedule of Business Acquisitions, by Acquisition	(in millions) Acotec (1) Payment for majority stake investment $ 381 $ 381 (1) Excludes approximately $140 million of cash on hand at the closing of the transaction
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	(in millions) Acotec Goodwill $ 337 Amortizable intangible assets 334 Other assets acquired 93 Liabilities assumed (48) Net deferred tax liabilities (76) Fair value of noncontrolling interest (259) $ 381
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 Amortizable intangible assets: Technology-related $ 308 11 14% Customer relationships 15 11 14% Other intangible assets 11 13 14% $ 334

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets Goodwill (Tables)	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024 As of December 31, 2023 (in millions) Gross Carrying Amount Accumulated Amortization/ Write-offs Gross Carrying Amount Accumulated Amortization/ Write-offs Technology-related $ 13,223 $ (8,287) $ 13,207 $ (8,101) Patents 480 (385) 480 (387) Other intangible assets 2,159 (1,527) 2,130 (1,500) Amortizable intangible assets $ 15,863 $ (10,198) $ 15,817 $ (9,988) Goodwill $ 24,261 $ (9,900) $ 24,287 $ (9,900) IPR&D $ 54 $ 54 Technology-related 120 120 Indefinite-lived intangible assets $ 174 $ 174
Schedule of Goodwill	The following represents a roll-forward of our goodwill balance by reportable segment: (in millions) MedSurg Cardiovascular Total As of December 31, 2023 $ 5,347 $ 9,041 $ 14,387 Goodwill acquired 24 — 24 Impact of foreign currency fluctuations and purchase price and other adjustments (29) (22) (51) As of March 31, 2024 $ 5,342 $ 9,019 $ 14,361

Hedging Activities and Fair V_3

Hedging Activities and Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024 December 31, 2023 Forward currency contracts Cash flow hedge $ 2,242 $ 2,284 Forward currency contracts Net investment hedge 645 333 Foreign currency-denominated debt (1) Net investment hedge 997 997 Forward currency contracts Non-designated 3,070 3,282 Total Notional Outstanding $ 6,954 $ 6,896 (1) Foreign currency-denominated debt is the €900 million debt principal associated with our 2027 Notes designated as a net investment hedge.
Derivative Instruments, Gain (Loss)	Effect of Hedging Relationships on Accumulated Other Comprehensive Income Amount Recognized in OCI on Hedges Unaudited 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 Three Months Ended March 31, 2024 Forward currency contracts Cash flow hedges $ 76 $ (17) $ 59 Cost of products sold $ 1,209 $ (49) $ 11 $ (38) Net investment hedges (2) 27 (6) 21 Interest expense 69 (4) 1 (3) Foreign currency-denominated debt Net investment hedges (3) 23 (5) 18 Other, net (2) — — — Interest rate derivative contracts Cash flow hedges — — — Interest expense 69 1 (0) 0 Effect of Hedging Relationships on Accumulated Other Comprehensive Income Amount Recognized in OCI on Hedges Unaudited 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 Three Months Ended March 31, 2023 Forward currency contracts Cash flow hedges $ 13 $ (3) $ 10 Cost of products sold $ 1,040 $ (69) $ 16 $ (54) Net investment hedges (2) 6 (1) 4 Interest expense 65 (3) 1 (2) Foreign currency-denominated debt Net investment hedges (3) (19) 4 (14) Other, net 43 — — — Interest rate derivative contracts Cash flow hedges — — — Interest Expense 65 1 — 1 (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 March 31, 2024, 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): FASB ASC Topic 815 Designation Location on Unaudited Consolidated Statements of Operations Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings Designated Hedging Instrument Forward currency contracts Cash flow hedge Cost of products sold $ 173 Forward currency contracts Net investment hedge Interest expense 15 Interest rate derivative contracts Cash flow hedge Interest expense (1)
Derivatives Not Designated as Hedging	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: Location on Unaudited Consolidated Statements of Operations Three Months Ended March 31, (in millions) 2024 2023 Net gain (loss) on currency hedge contracts Other, net $ 15 $ (8) Net gain (loss) on currency transaction exposures Other, net (20) (6) Net currency exchange gain (loss) $ (5) $ (14)
Schedule of Derivative Instruments in Statement of Financial Position, Fair Value	The following are the balances of our derivative and nonderivative assets and liabilities: Location on Unaudited Consolidated Balance Sheets (1) As of (in millions) March 31, 2024 December 31, 2023 Derivative and Nonderivative Assets: Designated Hedging Instruments Forward currency contracts Other current assets $ 160 $ 140 Forward currency contracts Other long-term assets 125 107 285 246 Non-Designated Hedging Instruments Forward currency contracts Other current assets 17 20 Total Derivative and Nonderivative Assets $ 302 $ 266 Derivative and Nonderivative Liabilities: Designated Hedging Instruments Forward currency contracts Other current liabilities $ 3 $ 15 Forward currency contracts Other long-term liabilities 1 9 Foreign currency-denominated debt (2) Long-term debt 966 988 969 1,012 Non-Designated Hedging Instruments Forward currency contracts Other current liabilities 17 38 Total Derivative and Nonderivative Liabilities $ 986 $ 1,050 (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 associated with our 2027 Notes 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 March 31, 2024 December 31, 2023 (in millions) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Assets Money market funds and time deposits $ 1,979 $ — $ — $ 1,979 $ 454 $ — $ — $ 454 Publicly-held equity securities 20 — — 20 18 — — 18 Hedging instruments — 302 — 302 — 266 — 266 Licensing arrangements — — 66 66 — — 77 77 $ 1,999 $ 302 $ 66 $ 2,367 $ 472 $ 266 $ 77 $ 816 Liabilities Hedging instruments $ — $ 986 $ — $ 986 $ — $ 1,050 $ — $ 1,050 Contingent consideration liability — — 273 273 — — 404 404 Licensing arrangements — — 71 71 — — 90 90 $ — $ 986 $ 344 $ 1,330 $ — $ 1,050 $ 494 $ 1,545 The recurring Level 3 fair value measurements of our licensing arrangements recognized within our accompanying unaudited consolidated balance sheets as of March 31, 2024 include the following significant unobservable inputs: Licensing Arrangements Fair Value as of March 31, 2024 Valuation Technique Unobservable Input Range Weighted Average (1) Financial Asset $66 million Discounted Cash Flow Discount Rate 15% 15% Projected Year of Payment 2024 - 2025 2025 Financial Liability $71 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, 2023 $ 77 Proceeds from royalty rights (14) Fair value adjustment (expense) benefit 2 Balance as of March 31, 2024 $ 66 Changes in the fair value of our licensing arrangements' financial liability were as follows: (in millions) Balance as of December 31, 2023 $ 90 Payments for royalty rights (22) Fair value adjustment expense (benefit) 2 Balance as of March 31, 2024 $ 71

Contractual Obligations and C_2

Contractual Obligations and Commitments (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	The debt maturity schedule for our long-term debt obligations is presented below: (in millions, except interest rates) Issuance Date Maturity Date As of Coupon Rate (1) March 31, December 31, March 2025 Senior Notes (3) March 2022 March 2025 — 1,105 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 972 995 0.625% March 2028 Senior Notes (3) March 2022 March 2028 810 829 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% March 2029 Senior Notes (3) February 2024 March 2029 810 — 3.375% June 2030 Senior Notes May 2020 June 2030 1,200 1,200 2.650% March 2031 Senior Notes (3) March 2022 March 2031 810 829 1.625% March 2032 Senior Notes (3) February 2024 March 2032 1,349 — 3.500% March 2034 Senior Notes (3) March 2022 March 2034 540 553 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 (81) (65) Finance Lease Obligation Various 4 5 Long-term debt $ 9,534 $ 8,571 (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 March 31, 2024 and December 31, 2023, respectively.
Summary Of Term Loan And Revolving Credit Facility Agreement Compliance With Debt Covenants	As of March 31, 2024, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility. Covenant Requirement Actual as of March 31, 2024 as of March 31, 2024 Maximum permitted leverage ratio (1) 3.75 times 2.08 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 within our accompanying unaudited consolidated balance sheets, are aggregated by contract denominated currency below (in millions): Factoring Arrangements As of March 31, 2024 As of December 31, 2023 Amount Weighted Average Amount Weighted Average Euro denominated $ 175 5.5 % $ 206 5.1 % Yen denominated 191 0.6 % 214 0.6 % Renminbi denominated 21 1.8 % 14 2.9 %

Supplemental Balance Sheet In_2

Supplemental Balance Sheet Information (Tables)	3 Months Ended
	Mar. 31, 2024
Supplemental Balance Sheet Information [Abstract]
Trade accounts receivable, net	Trade accounts receivable, net As of (in millions) March 31, 2024 December 31, 2023 Trade accounts receivable $ 2,413 $ 2,338 Allowance for credit losses (109) (110) $ 2,304 $ 2,228 The following is a roll forward of our Allowance for credit losses : Three Months Ended March 31, (in millions) 2024 2023 Beginning balance $ 110 $ 109 Credit loss expense 9 16 Write-offs (10) (6) Ending balance $ 109 $ 118
Inventory Disclosure	Inventories As of (in millions) March 31, 2024 December 31, 2023 Finished goods $ 1,555 $ 1,537 Work-in-process 188 174 Raw materials 818 773 $ 2,561 $ 2,484
Schedule of Other Current Assets	Other current assets As of (in millions) March 31, 2024 December 31, 2023 Restricted cash and restricted cash equivalents $ 93 $ 130 Derivative assets 177 159 Licensing arrangements 44 47 Other 357 285 $ 671 $ 621
Property, plant and equipment, net	Property, plant and equipment, net As of (in millions) March 31, 2024 December 31, 2023 Land $ 141 $ 140 Buildings and improvements 1,856 1,843 Equipment, furniture and fixtures 3,550 3,503 Capital in progress 880 857 6,427 6,343 Less: accumulated depreciation 3,530 3,484 $ 2,897 $ 2,859
Schedule of Other Assets	Other long-term assets As of (in millions) March 31, 2024 December 31, 2023 Restricted cash equivalents $ 74 $ 60 Operating lease right-of-use assets 430 439 Derivative assets 125 107 Investments 429 413 Licensing arrangements 22 30 Indemnification asset 175 176 Other 341 306 $ 1,596 $ 1,531
Schedule of Accrued Liabilities	Accrued expenses As of (in millions) March 31, 2024 December 31, 2023 Legal reserves $ 129 $ 206 Payroll and related liabilities 749 1,051 Rebates 384 389 Contingent consideration 182 304 Other 639 696 $ 2,083 $ 2,646
Other Current Liabilities	Other current liabilities As of (in millions) March 31, 2024 December 31, 2023 Deferred revenue $ 280 $ 266 Licensing arrangements 45 49 Taxes payable 257 220 Other 246 278 $ 827 $ 814
Other long-term liabilities	Other long-term liabilities As of (in millions) March 31, 2024 December 31, 2023 Accrued income taxes $ 466 $ 470 Legal reserves 154 172 Contingent consideration 90 100 Licensing arrangements 26 41 Operating lease liabilities 382 390 Deferred revenue 314 311 Other 486 484 $ 1,919 $ 1,967

Income Taxes (Tables)

Income Taxes (Tables)	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Schedule of Effective Income Tax Rate from Continuing Operations	Our effective tax rate from continuing operations is presented below: Three Months Ended March 31, 2024 2023 Effective tax rate from continuing operations 18.9 % 29.4 %

Weighted Average Shares Outst_2

Weighted Average Shares Outstanding (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Schedule of Weighted Average Number of Shares	NOTE J – WEIGHTED AVERAGE SHARES OUTSTANDING Three Months Ended March 31, (in millions) 2024 2023 Weighted average shares outstanding — basic 1,468.4 1,435.8 Net effect of common stock equivalents 13.4 10.2 Weighted average shares outstanding - diluted 1,481.7 1,446.0
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: Three Months Ended March 31, (in millions) 2024 2023 Stock options outstanding (1) 2 3 MCPS (2) — 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 I – Stockholders' Equity for additional information.

Segment Reporting (Tables)

Segment Reporting (Tables)	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated	A reconciliation of the totals reported for the reportable segments to the applicable line items within our accompanying unaudited consolidated statements of operations is as follows (in millions, except percentages). Prior period amounts have been restated at constant currency to conform to current year presentation. Three Months Ended Net Sales 2024 2023 MedSurg $ 1,402 $ 1,266 Cardiovascular 2,426 2,072 Total net sales of reportable segments 3,827 3,337 Impact of foreign currency fluctuations 29 52 $ 3,856 $ 3,389 Income (loss) before income taxes MedSurg $ 474 $ 409 Cardiovascular 653 553 Total operating income of reportable segments 1,128 963 Unallocated amounts: Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments (115) (98) 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 EU MDR implementation costs (124) (110) Amortization expense (214) (203) Operating income (loss) 675 552 Other income (expense), net (67) (108) Income (loss) before income taxes $ 608 $ 444 Three Months Ended March 31, Operating income margin of reportable segments 2024 2023 MedSurg 33.8 % 32.3 % Cardiovascular 26.9 % 26.7 %

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2024
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. Three Months Ended March 31, 2024 2023 Businesses U.S. Int'l Total U.S. Int'l Total Endoscopy $ 395 $ 247 $ 642 $ 351 $ 226 $ 577 Urology 356 157 513 326 143 469 Neuromodulation 190 66 256 172 62 234 MedSurg 941 470 1,412 850 430 1,280 Interventional Cardiology Therapies 195 457 652 183 408 591 Watchman 311 33 344 265 25 291 Cardiac Rhythm Management 354 221 575 345 203 548 Electrophysiology 158 143 300 85 91 177 Cardiology 1,017 854 1,872 879 727 1,606 Peripheral Interventions 299 274 573 275 229 503 Cardiovascular 1,316 1,129 2,445 1,154 956 2,110 Total Net Sales $ 2,258 $ 1,599 $ 3,856 $ 2,003 $ 1,386 $ 3,389 Refer to Note K - Segment Reporting for information on our reportable segments. Three Months Ended March 31, Geographic Regions 2024 2023 U.S. $ 2,258 $ 2,003 Europe, Middle East and Africa 803 712 Asia-Pacific 647 548 Latin America and Canada 149 126 Total Net Sales $ 3,856 $ 3,389 Emerging Markets (1) $ 648 $ 529

Changes in Other Comprehensiv_2

Changes in Other Comprehensive Income (Tables)	3 Months Ended
	Mar. 31, 2024
Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]
Changes in Other Comprehensive Income	The following tables provide the reclassifications out of Other comprehensive income (loss), 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, 2023 $ (96) $ 154 $ (8) $ 49 Other comprehensive income (loss) before reclassifications 65 59 — 124 (Income) loss amounts reclassified from accumulated other comprehensive income (3) (38) (0) (41) Total other comprehensive income (loss) 62 22 (0) 83 Balance as of March 31, 2024 $ (34) $ 175 $ (8) $ 132 (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 (40) 10 (5) (35) (Income) loss amounts reclassified from accumulated other comprehensive income (2) (53) (0) (56) Total other comprehensive income (loss) (42) (43) (5) (91) Balance as of March 31, 2023 $ (43) $ 225 $ (4) $ 178

Acquisitions, Divestitures an_3

Acquisitions, Divestitures and Strategic Investments - Acquisitions and Divestitures (Details) $ / shares in Units, $ in Millions				3 Months Ended
	Jan. 08, 2024 USD ($) $ / shares	Feb. 20, 2023 USD ($)	Feb. 20, 2023 HKD ($)	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	Dec. 31, 2023 USD ($)
Business Acquisition [Line Items]
Payments to Acquire Businesses, Net of Cash Acquired				$ 47	$ 375
Goodwill				14,361		$ 14,387
Cash				384		$ 411
Acotec
Business Acquisition [Line Items]
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners		35%
Acotec
Business Acquisition [Line Items]
Business Acquisition, Percentage of Voting Interests Acquired		65%
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value		$ 519	$ 20
Payments to Acquire Businesses, Net of Cash Acquired				381
Business Combination, Consideration Transferred, Including Equity Interest in Acquiree Held Prior to Combination				381
Goodwill				337
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets				93
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities				(48)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Liabilities				(76)
Business Combination, Acquisition of Less than 100 Percent, Noncontrolling Interest, Fair Value				(259)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Intangible Assets, Other than Goodwill				334
Cash		$ 140
Acotec | Technology-Based Intangible Assets [Member]
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles				$ 308
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life				11 years
Acotec | Other Intangible Assets [Member]
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles				$ 11
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life				13 years
Acotec | Customer Relationships
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles				$ 15
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life				11 years
Acotec | Weighted Average [Member] | Technology-Based Intangible Assets [Member]
Business Acquisition [Line Items]
Discount Rate, Fair Value Input				14%
Acotec | Weighted Average [Member] | Other Intangible Assets [Member]
Business Acquisition [Line Items]
Discount Rate, Fair Value Input				14%
Acotec | Weighted Average [Member] | Customer Relationships
Business Acquisition [Line Items]
Discount Rate, Fair Value Input				14%
Axonics
Business Acquisition [Line Items]
Business Acquisition, Percentage of Voting Interests Acquired	100%
Business Acquisition, Share Price | $ / shares	$ 71
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value	$ 3,670

Acquisitions, Divestitures an_4

Acquisitions, Divestitures and Strategic Investments - Contingent Consideration (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability Beginning Balance	$ 404
Contingent consideration net expense (benefit)	17	$ 12
Payment of contingent consideration	(148)
Business Combination, Contingent Consideration, Liability Ending Balance	273
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Business Combination, Contingent Consideration, Liability	273
Uncapped Contingent Considertation	164
All Business Acquisitions
Business Combination, Contingent Consideration Arrangements [Abstract]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	275
Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability Ending Balance	273
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Business Combination, Contingent Consideration, Liability	$ 273
contingent consideration liability, probability of payment	100%
Minimum [Member] | Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Discount Rate, Fair Value Input	6%
Maximum [Member] | Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Discount Rate, Fair Value Input	11%
Weighted Average [Member] | Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
contingent consideration liability, probability of payment	100%
Discount Rate, Fair Value Input	6%

Acquisitions, Divestitures an_5

Acquisitions, Divestitures and Strategic Investments - Strategic Investments (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Business Combinations [Abstract]
Equity method investments	$ 211	$ 219
Measurement alternative investments(1, 2)	218	194
Investments	429	$ 413
Equity Method Investment, Difference Between Carrying Amount and Underlying Equity	$ 237

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	$ 15,863	$ 15,817
Finite-Lived Intangible Assets, Accumulated Amortization	(10,198)	(9,988)
Indefinite-lived Intangible Assets (Excluding Goodwill)	174	174
Goodwill [Roll Forward]
Goodwill Beginning Balance	14,387
Goodwill acquired	24
Impact of foreign currency fluctuations and purchase price and other adjustments	(51)
Goodwill Ending Balance	14,361
MedSurg [Member]
Goodwill [Roll Forward]
Goodwill Beginning Balance	5,347
Goodwill acquired	24
Impact of foreign currency fluctuations and purchase price and other adjustments	(29)
Goodwill Ending Balance	5,342
Cardiovascular [Member]
Goodwill [Roll Forward]
Goodwill Beginning Balance	9,041
Goodwill acquired	0
Impact of foreign currency fluctuations and purchase price and other adjustments	(22)
Goodwill Ending Balance	9,019
Goodwill [Member]
Intangible Assets and Goodwill [Line Items]
Goodwill, Gross	24,261	24,287
Goodwill, Impaired, Accumulated Impairment Loss	(9,900)	(9,900)
In Process Research and Development [Member]
Intangible Assets and Goodwill [Line Items]
Indefinite-lived Intangible Assets (Excluding Goodwill)	54	54
Technology-Based Intangible Assets [Member]
Intangible Assets and Goodwill [Line Items]
Indefinite-lived Intangible Assets (Excluding Goodwill)	120	120
Technology-Based Intangible Assets [Member]
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	13,223	13,207
Finite-Lived Intangible Assets, Accumulated Amortization	(8,287)	(8,101)
Patents [Member]
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	480	480
Finite-Lived Intangible Assets, Accumulated Amortization	(385)	(387)
Other Intangible Assets [Member]
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	2,159	2,130
Finite-Lived Intangible Assets, Accumulated Amortization	$ (1,527)	$ (1,500)

Hedging Activities and Fair V_4

Hedging Activities and Fair Value Measurements (Details) € in Millions	3 Months Ended
	Mar. 31, 2024 USD ($) units derivative_instrument	Mar. 31, 2023 USD ($)	Mar. 31, 2024 EUR (€) units derivative_instrument	Dec. 31, 2023 USD ($) derivative_instrument	Dec. 31, 2023 EUR (€) derivative_instrument
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	$ 6,954,000,000			$ 6,896,000,000
Cost of Goods and Services Sold	1,209,000,000	$ 1,040,000,000
Interest Expense	69,000,000	65,000,000
Other Operating Income (Expense), Net	(2,000,000)	43,000,000
Derivative Asset, Fair Value, Gross Asset	302,000,000			266,000,000
Derivative Liability, Fair Value, Gross Liability	986,000,000			1,050,000,000
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative Asset	125,000,000			107,000,000
Licensing arrangements, asset	22,000,000			30,000,000
Business Combination, Contingent Consideration, Liability	273,000,000			404,000,000
Licensing arrangements, liability	26,000,000			41,000,000
Cash	384,000,000			411,000,000
Debt Instrument, Fair Value Disclosure	10,224,000,000			8,735,000,000
Accumulated Foreign Currency Adjustment Attributable to Parent
Derivative Instruments, Gain (Loss) [Line Items]
Reclassification from AOCI, Current Period, Net of Tax, Attributable to Parent	0	0
December 2027 Notes [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Long-term Debt	$ 972,000,000		€ 900	995,000,000	€ 900
Debt Instrument, Interest Rate, Stated Percentage	0.625%		0.625%
Licensing arrangement assets [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	15%		15%
Proceeds from Royalties Received	$ (14,000,000)
Increase (Decrease) in Fair Value Adjustments on Other Assets (Liabilities) Carried at Fair Value under Fair Value Option	2,000,000
Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Payments for Royalties	(22,000,000)
Increase (Decrease) in Fair Value Adjustments on Other Assets (Liabilities) Carried at Fair Value under Fair Value Option	2,000,000
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Licensing arrangements, asset	66,000,000
Licensing arrangements, liability	71,000,000
Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	1,979,000,000			454,000,000
Equity Securities, FV-NI	20,000,000			18,000,000
Derivative Asset	302,000,000			266,000,000
Licensing arrangements, asset	66,000,000			77,000,000
Assets, Fair Value Disclosure	2,367,000,000			816,000,000
Derivative Liability	986,000,000			1,050,000,000
Business Combination, Contingent Consideration, Liability	273,000,000			404,000,000
Licensing arrangements, liability	71,000,000			90,000,000
Financial and Nonfinancial Liabilities, Fair Value Disclosure	1,330,000,000			1,545,000,000
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	1,979,000,000			454,000,000
Equity Securities, FV-NI	20,000,000			18,000,000
Derivative Asset	0			0
Licensing arrangements, asset	0			0
Assets, Fair Value Disclosure	1,999,000,000			472,000,000
Derivative Liability	0			0
Business Combination, Contingent Consideration, Liability	0			0
Licensing arrangements, liability	0			0
Financial and Nonfinancial Liabilities, Fair Value Disclosure	0			0
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member]
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 Asset	302,000,000			266,000,000
Licensing arrangements, asset	0			0
Assets, Fair Value Disclosure	302,000,000			266,000,000
Derivative Liability	986,000,000			1,050,000,000
Business Combination, Contingent Consideration, Liability	0			0
Licensing arrangements, liability	0			0
Financial and Nonfinancial Liabilities, Fair Value Disclosure	986,000,000			1,050,000,000
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 3 [Member]
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 Asset	0			0
Licensing arrangements, asset	66,000,000			77,000,000
Assets, Fair Value Disclosure	66,000,000			77,000,000
Derivative Liability	0			0
Business Combination, Contingent Consideration, Liability	273,000,000			404,000,000
Licensing arrangements, liability	71,000,000			90,000,000
Financial and Nonfinancial Liabilities, Fair Value Disclosure	344,000,000			494,000,000
Designated as Hedging Instrument [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	285,000,000			246,000,000
Derivative Instruments in Hedges, Liabilities, at Fair Value	969,000,000			1,012,000,000
Designated as Hedging Instrument [Member] | Other Noncurrent Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	$ 966,000,000			988,000,000
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Forward Currency Contracts, Time to Maturity | units	36		36
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Prepaid Expenses and Other Current Assets [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	$ 160,000,000			140,000,000
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Noncurrent Assets [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	125,000,000			107,000,000
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Current Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	3,000,000			15,000,000
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Noncurrent Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	1,000,000			9,000,000
Not Designated as Hedging Instrument [Member] | Other Nonoperating Income (Expense) [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	15,000,000	(8,000,000)
Foreign Currency Transaction Gain (Loss), before Tax	(20,000,000)	(6,000,000)
Net currency exchange gain (loss)	(5,000,000)	(14,000,000)
Not Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	3,070,000,000			3,282,000,000
Not Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Prepaid Expenses and Other Current Assets [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments Not Designated as Hedging Instruments, Asset, at Fair Value	17,000,000			20,000,000
Not Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Current Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments Not Designated as Hedging Instruments, Liability, at Fair Value	$ 17,000,000			$ 38,000,000
Not Designated as Hedging Instrument [Member] | Foreign Exchange Forward
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Term of Contract (less than)	1 year
Derivative, Remaining Maturity	1 year		1 year
Weighted Average [Member] | Licensing arrangement assets [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	15%		15%
Weighted Average [Member] | Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	13%		13%
Minimum [Member] | Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	12%		12%
Maximum [Member] | Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	15%		15%
Cash Flow Hedging [Member] | Foreign Exchange Contract [Member] | Cost of Sales [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 173,000,000
Cash Flow Hedging [Member] | Interest Rate Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	$ (1,000,000)
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Number of Interest Rate Derivatives Held | derivative_instrument	0		0	0	0
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	$ 2,242,000,000			$ 2,284,000,000
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Cost of Sales [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	76,000,000	13,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	(17,000,000)	(3,000,000)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	59,000,000	10,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	(49,000,000)	(69,000,000)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	11,000,000	16,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	(38,000,000)	(54,000,000)
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Interest Rate Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	1,000,000	1,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	0	1,000,000
Net Investment Hedging [Member] | Foreign Exchange Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Used in Net Investment Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	15,000,000
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	645,000,000			333,000,000
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax	27,000,000	6,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax	(6,000,000)	(1,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax	21,000,000	4,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, before Tax	(4,000,000)	(3,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, Tax	1,000,000	1,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, after Tax	(3,000,000)	(2,000,000)
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | foreign currency denominated in debt [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	997,000,000			$ 997,000,000
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | foreign currency denominated in debt [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax	23,000,000	(19,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax	(5,000,000)	4,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax	18,000,000	(14,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, before Tax	0	0
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, Tax	0	0
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, after Tax	$ 0	$ 0

Contractual Obligations and C_3

Contractual Obligations and Commitments (Details) € in Millions		3 Months Ended		12 Months Ended
	May 10, 2021 USD ($)	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	Dec. 31, 2023 USD ($)	Mar. 31, 2024 EUR (€)	Mar. 31, 2024	Mar. 31, 2024 Rate	Feb. 22, 2024 EUR (€)	Dec. 31, 2023 EUR (€)
Debt Instrument [Line Items]
Total debt		$ 10,619,000,000		$ 9,102,000,000
Debt, Current		1,085,000,000		531,000,000
Long-term Debt and Capital Lease Obligations		9,534,000,000		8,571,000,000
Exclusion from EBITDA for Restructuring Charges		500,000,000
Restructuring charges remaining to be excluded from calculation of consolidated EBITDA		273,000,000
Amount excluded from debt in leverage ratio		2,138,000,000
Legal payments remaining to be excluded from calculation of consolidated EBITDA		1,457,000,000
Letters of Credit Outstanding, Amount		174,000,000		174,000,000
Qualified Acquisition Consideration		1,000,000,000
Proceeds from Issuance of Senior Long-Term Debt		2,145,000,000	$ 0
Supplier Finance Program Obligation. current		140,000,000		152,000,000
Litigation payment exclusion from EBITDA		$ 1,000,000,000
AMS Europe
Debt Instrument [Line Items]
Debt Instrument, Redemption Price, Percentage		101%
Commercial Paper [Member]
Debt Instrument [Line Items]
Debt, Current		$ 0		0
Current Requirement [Member]
Debt Instrument [Line Items]
Maximum Leverage Ratio						3.75
Actual, Covenant [Member]
Debt Instrument [Line Items]
Maximum Leverage Ratio						2.08
Requirement, as of December 31, 2021 and through remaining term of facility
Debt Instrument [Line Items]
Maximum Leverage Ratio						3.75
Requirement, four succeeding quarters following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio						4.75
Requirement, fifth quarter following qualified acquisition [Member]
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 following qualified acquisition and through remaining term of facility
Debt Instrument [Line Items]
Maximum Leverage Ratio						3.75
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term Debt		0		0
Line of Credit Facility, Maximum Borrowing Capacity	$ 2,750,000,000
Debt Instrument, Extension Option, Term	1 year
March 2024 Notes [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage						3.45%
March 2025 Notes
Debt Instrument [Line Items]
Long-term Debt		0		1,105,000,000
Debt Instrument, Interest Rate, Stated Percentage						0.75%
June 2025 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		500,000,000		500,000,000
Debt Instrument, Interest Rate, Stated Percentage						1.90%
March 2026 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		255,000,000		255,000,000
Debt Instrument, Interest Rate, Stated Percentage						3.75%
December 2027 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		972,000,000		995,000,000	€ 900				€ 900
Debt Instrument, Interest Rate, Stated Percentage						0.625%
March 2028 Senior Notes
Debt Instrument [Line Items]
Long-term Debt		810,000,000		829,000,000
Debt Instrument, Interest Rate, Stated Percentage						1.375%
March 2028 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		344,000,000		344,000,000
Debt Instrument, Interest Rate, Stated Percentage						4%
March 2029 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		272,000,000		272,000,000
Debt Instrument, Interest Rate, Stated Percentage						4%
June 2030 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		1,200,000,000		1,200,000,000
Debt Instrument, Interest Rate, Stated Percentage						2.65%
March 2031 Notes
Debt Instrument [Line Items]
Long-term Debt		810,000,000		829,000,000
Debt Instrument, Interest Rate, Stated Percentage						1.625%
March 2034 Notes
Debt Instrument [Line Items]
Long-term Debt		540,000,000		553,000,000
Debt Instrument, Interest Rate, Stated Percentage						1.875%
November 2035 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		350,000,000		350,000,000
Debt Instrument, Interest Rate, Stated Percentage						6.50%
November 2035 Notes [Member] | Credit Rating A- or A3 Or Higher
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Stated Percentage						6.25%
March 2039 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		450,000,000		450,000,000
Debt Instrument, Interest Rate, Stated Percentage						4.55%
January 2040 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		300,000,000		300,000,000
Debt Instrument, Interest Rate, Stated Percentage						7.375%
March 2049 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		650,000,000		650,000,000
Debt Instrument, Interest Rate, Stated Percentage						4.70%
Senior Notes [Member]
Debt Instrument [Line Items]
Long-term Debt		10,690,000,000		9,136,000,000
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net		(81,000,000)		(65,000,000)
Finance Lease Obligation
Debt Instrument [Line Items]
Long-term Debt		4,000,000		5,000,000
the Offering
Debt Instrument [Line Items]
Long-term Debt | €								€ 2,000
March 2029 Euro Senior Notes
Debt Instrument [Line Items]
Long-term Debt		810,000,000		0				750
Debt Instrument, Interest Rate, Stated Percentage						3.375%	3.375%
March 2032 Euro Senior Notes
Debt Instrument [Line Items]
Long-term Debt		1,349,000,000		0				€ 1,250
Debt Instrument, Interest Rate, Stated Percentage						3.50%	3.50%
Euro Denominated Factoring Arrangements [Member]
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized		$ 175,000,000		$ 206,000,000
Average interest rate of de-recognized receivables		5.50%		5.10%
Yen Denominated Factoring Arrangements [Member]
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized		$ 191,000,000		$ 214,000,000
Average interest rate of de-recognized receivables		0.60%		0.60%
Renminbi Denominated Factoring Arrangements [Member]
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized		$ 21,000,000		$ 14,000,000
Average interest rate of de-recognized receivables		1.80%		2.90%

Supplemental Balance Sheet In_3

Supplemental Balance Sheet Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Line Items]
Depreciation	$ 90	$ 82
Trade accounts receivable, net
Accounts receivable	2,413		$ 2,338
Less: allowance for doubtful accounts	(109)		(110)
Trade accounts receivable, net	2,304		2,228
Allowance for doubtful accounts
Beginning balance	110	109
Charges to expenses	9	16
Utilization of allowances	(10)	(6)
Ending balance	109	118
Inventories
Inventory, Finished Goods, Net of Reserves	1,555		1,537
Inventory, Work in Process, Net of Reserves	188		174
Inventory, Raw Materials, Net of Reserves	818		773
Inventories	2,561		2,484
Other Current Assets [Abstract]
Restricted Cash and Cash Equivalents in Other current assets	93	135	130
Derivative Asset, Current	177		159
Licensing arrangements	44		47
Other Assets, Miscellaneous, Current	357		285
Other Assets, Current	671		621
Property, plant and equipment, net
Land	141		140
Buildings and improvements	1,856		1,843
Equipment, furniture and fixtures	3,550		3,503
Capital in progress	880		857
Property, plant and equipment	6,427		6,343
Less: accumulated depreciation	3,530		3,484
Property, plant and equipment, net	2,897		2,859
Other Assets, Noncurrent [Abstract]
Restricted cash equivalents included in Other long-term assets	74	$ 57	60
Operating Lease, Right-of-Use Asset	430		439
Derivative Asset	125		107
Investments	429		413
Licensing arrangements, asset	22		30
Indemnification asset	175		176
Other, Other Long-term Assets	341		306
Other Assets, Noncurrent	1,596		1,531
Accrued expenses
Legal reserves, current	129		206
Payroll and related liabilities	749		1,051
Accrued Rebates, Current	384		389
Business Combination, Contingent Consideration, Liability, Current	182		304
Other	639		696
Accrued Liabilities, Current	2,083		2,646
Other Liabilities, Current [Abstract]
Deferred Revenue, Current	280		266
Licensing Arrangements	45		49
Taxes Payable, Current	257		220
Other	246		278
Other Liabilities, Current	827		814
Other long-term liabilities
Accrued income taxes	466		470
Estimated Litigation Liability, Noncurrent	154		172
Business Combination, Contingent Consideration, Liability, Noncurrent	90		100
Licensing arrangements, liability	26		41
Operating Lease, Liability, Noncurrent	382		390
Deferred Revenue	314		311
Other Accrued Liabilities, Noncurrent	486		484
Other long-term liabilities	$ 1,919		$ 1,967

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Effective Income Tax Rate Reconciliation, Percent [Abstract]
Effective tax rate from continuing operations	18.90%	29.40%
Unrecognized Tax Benefits	$ 465		$ 467
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	393		$ 395
Decrease in Unrecognized Tax Benefits is Reasonably Possible	$ 11

Commitments and Contingencies_2

Commitments and Contingencies (Details) $ in Millions	Jan. 31, 2023 USD ($)	Mar. 31, 2024 USD ($) units	Dec. 31, 2023 USD ($)	Mar. 31, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Accrual for legal matters that are probable and estimable		$ 283	$ 377
Restricted Cash and Cash Equivalents in Other current assets		$ 93	$ 130	$ 135
Litigation Settlement, Amount Awarded to Other Party	$ 42
Brazil CADE - # of individuals for alleged anti-competitive behavior | units		29

Stockholders' Equity (Details)

Stockholders' Equity (Details) $ / shares in Units, $ in Millions		3 Months Ended
	May 27, 2020 USD ($) $ / shares shares	Mar. 31, 2024 shares	Dec. 31, 2023 shares	Jun. 01, 2023
Class of Stock [Line Items]
Preferred Stock, Shares Authorized		50,000,000	50,000,000
Preferred Stock, Shares Issued		0	0
5.50% MCPS, Series A [Member]
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 | $ / shares	$ 100
Net proceeds from issuance of preferred stock in connection with public offering | $	$ 975
Preferred Stock, Convertible, Conversion Ratio				2.3834
Common Stock, par value $0.01 per share
Class of Stock [Line Items]
Conversion of Stock, Shares Converted		24,000,000

Weighted Average Shares Outst_3

Weighted Average Shares Outstanding (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Weighted average shares outstanding — basic	1,468.4	1,435.8
Net effect of common stock equivalents	13.4	10.2
Weighted average shares outstanding - diluted	1,481.7	1,446
Share-based Payment Arrangement, Option
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	2	3
5.50% MCPS, Series A [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0	24

Weighted Average Shares Outst_4

Weighted Average Shares Outstanding - Narrative (Details) - USD ($) shares in Millions, $ in Billions	3 Months Ended
	Mar. 31, 2024	Dec. 14, 2020
Earnings Per Share [Abstract]
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	4,000,000
Stock Repurchase Program, Authorized Amount		$ 1

Segment Reporting (Details)

Segment Reporting (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($) reportablesegments	Mar. 31, 2023 USD ($)
Segment Reporting [Abstract]
Number of reportable segments | reportablesegments	2
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Amortization expense	$ (214)	$ (203)
Operating income (loss)	675	552
Other expense, net	(67)	(108)
Income (loss) before income taxes	608	444
Impact of Foreign Currency Fluctuations on Net Sales	29	52
Net sales	3,856	3,389
MedSurg [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating Income Allocated to Reportable Segments	474	409
Revenues from contracts with customers, disaggregated - performance measurement	$ 1,402	$ 1,266
Segment operating income as percentage of net sales	33.80%	32.30%
Net sales	$ 1,412	$ 1,280
Cardiovascular [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating Income Allocated to Reportable Segments	653	553
Revenues from contracts with customers, disaggregated - performance measurement	$ 2,426	$ 2,072
Segment operating income as percentage of net sales	26.90%	26.70%
Net sales	$ 2,445	$ 2,110
BSX Reportable Segments [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Revenues from contracts with customers, disaggregated - performance measurement	3,827	3,337
Total allocated to reportable segments [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating income (loss)	1,128	963
Corporate expenses and currency exchange [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating Income Unallocated to Segment	(115)	(98)
Goodwill and other intangible asset impairment charges, acquisition/divestiture-related net (charges) credits, restructuring- and restructuring-related net (charges) credits, EU MDR implementation costs and litigation-related net (charges) credits
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating Income Unallocated to Segment	$ (124)	$ (110)

Revenue (Details)

Revenue (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($) business	Mar. 31, 2023 USD ($)	Dec. 31, 2023 USD ($)
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	$ 3,856	$ 3,389
Number Of Businesses | business	5
Contract with Customer, Liability [Abstract]
Contract with Customer, Liability	$ 593		$ 577
Change in Contract with Customer, Liability [Abstract]
Contract with Customer, Liability, Revenue Recognized	62
United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	2,258	2,003
International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,599	1,386
Emerging Markets [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	648	529
Endoscopy [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	642	577
Endoscopy [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	395	351
Endoscopy [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	247	226
Urology [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	513	469
Urology [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	356	326
Urology [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	157	143
Neuromodulation [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	256	234
Neuromodulation [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	190	172
Neuromodulation [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	66	62
Interventional Cardiology Therapies
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	652	591
Interventional Cardiology Therapies | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	195	183
Interventional Cardiology Therapies | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	457	408
Watchman
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	344	291
Watchman | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	311	265
Watchman | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	33	25
Cardiac Rhythm Management [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	575	548
Cardiac Rhythm Management [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	354	345
Cardiac Rhythm Management [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	221	203
Electrophysiology [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	300	177
Electrophysiology [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	158	85
Electrophysiology [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	143	91
Cardiology [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,872	1,606
Cardiology [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,017	879
Cardiology [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	854	727
Peripheral Interventions [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	573	503
Peripheral Interventions [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	299	275
Peripheral Interventions [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	274	229
BSX Reportable Segments [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	2,258	2,003
BSX Reportable Segments [Member] | EMEA [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	803	712
BSX Reportable Segments [Member] | APAC [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	647	548
BSX Reportable Segments [Member] | Latin America and Canada [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	149	126
MedSurg [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,412	1,280
MedSurg [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	941	850
MedSurg [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	470	430
Cardiovascular [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	2,445	2,110
Cardiovascular [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,316	1,154
Cardiovascular [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	$ 1,129	$ 956

Changes in Other Comprehensiv_3

Changes in Other Comprehensive Income (AOCI Rollforward with Reclassification) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	$ 19,282
Other comprehensive income (loss)	78	$ (91)
Ending Stockholders' Equity	19,926	17,850
Accumulated other comprehensive income (loss), net of tax
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	49	269
Other comprehensive income (loss) before reclassifications	124	(35)
(Income) loss amounts reclassified from accumulated other comprehensive income	(41)	(56)
Other comprehensive income (loss)	83	(91)
Ending Stockholders' Equity	132	178
Accumulated Foreign Currency Adjustment Attributable to Parent
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	(96)	(1)
Other comprehensive income (loss) before reclassifications	65	(40)
(Income) loss amounts reclassified from accumulated other comprehensive income	(3)	(2)
Other comprehensive income (loss)	62	(42)
Ending Stockholders' Equity	(34)	(43)
Net Change in Derivative Financial Instruments
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	154	269
Other comprehensive income (loss) before reclassifications	59	10
(Income) loss amounts reclassified from accumulated other comprehensive income	(38)	(53)
Other comprehensive income (loss)	22	(43)
Ending Stockholders' Equity	175	225
Net Change in Defined Benefit Pensions and Other Items
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]
Beginning Stockholders' Equity	(8)	1
Other comprehensive income (loss) before reclassifications	0	(5)
(Income) loss amounts reclassified from accumulated other comprehensive income	0	0
Other comprehensive income (loss)	0	(5)
Ending Stockholders' Equity	$ (8)	$ (4)