v3.24.3
Cover Document - $ / shares
9 Months Ended
Sep. 30, 2024
Oct. 29, 2024
Entity Information [Line Items]    
Document Type 10-Q  
Document Quarterly Report true  
Document Period End Date Sep. 30, 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   1,473,827,485
Entity Central Index Key 0000885725  
Current Fiscal Year End Date --12-31  
Document Fiscal Year Focus 2024  
Document Fiscal Period Focus Q3  
Amendment Flag false  
Common Stock, par value $0.01 per share    
Entity Information [Line Items]    
Title of 12(b) Security Common Stock, par value $0.01 per share  
Trading Symbol BSX  
Security Exchange Name NYSE  
0.625% Senior Notes due 2027    
Entity Information [Line Items]    
Title of 12(b) Security 0.625% Senior Notes due 2027  
Trading Symbol BSX27  
Security Exchange Name NYSE  
v3.24.3
Consolidated Statements of Operations (Unaudited) - USD ($)
shares in Millions, $ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Income Statement [Abstract]        
Net sales $ 4,209 $ 3,527 $ 12,186 $ 10,515
Cost of products sold 1,312 1,101 3,791 3,198
Gross profit 2,897 2,426 8,395 7,317
Operating expenses:        
Selling, general and administrative expenses 1,562 1,242 4,372 3,811
Research and development expenses 407 356 1,156 1,051
Royalty expense 5 11 24 35
Amortization expense 205 208 631 620
Intangible asset impairment charges 0 1 276 58
Contingent consideration net expense (benefit) (23) 12 (4) 43
Restructuring net charges (credits) 8 15 12 51
Litigation-related net charges (credits) 0 (111) 0 (111)
Operating expenses 2,164 1,733 6,467 5,558
Operating income (loss) 733 693 1,928 1,759
Other income (expense):        
Interest expense (79) (66) (225) (200)
Other, net 14 (18) (7) (78)
Income (loss) before income taxes 669 610 1,697 1,480
Income tax expense (benefit) 200 105 413 392
Net income (loss) 468 504 1,284 1,088
Preferred stock dividends 0 0 0 (23)
Net income (loss) attributable to noncontrolling interests 0 0 (4) 0
Net income (loss) attributable to Boston Scientific common stockholders $ 469 $ 505 $ 1,288 $ 1,065
Net income (loss) per common share — basic $ 0.32 $ 0.34 $ 0.88 $ 0.74
Net income (loss) per common share — diluted $ 0.32 $ 0.34 $ 0.87 $ 0.73
Weighted-average shares outstanding        
Basic 1,472.7 1,464.5 1,470.6 1,448.8
Diluted 1,487.4 1,475.0 1,484.5 1,459.1
v3.24.3
Consolidated Statements of Comprehensive Income (Loss) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Statement of Comprehensive Income [Abstract]        
Net income (loss) $ 468 $ 504 $ 1,284 $ 1,088
Other comprehensive income (loss), net of tax:        
Foreign currency translation adjustment (181) 21 (79) (7)
Net change in derivative financial instruments (100) 3 (95) (25)
Net change in defined benefit pensions and other items 0 0 0 (5)
Other comprehensive income (loss) (282) 23 (173) (37)
Comprehensive income (loss) 187 528 1,110 1,051
Net income (loss) attributable to noncontrolling interests 0 0 (4) 0
Other comprehensive income (loss) attributable to noncontrolling interests 10 (16) 4 (16)
Comprehensive income (loss) attributable to noncontrolling interests 10 (16) 0 (16)
Comprehensive income attributable to Boston Scientific common stockholders $ 177 $ 511 $ 1,110 $ 1,035
v3.24.3
Consolidated Balance Sheets (Unaudited) - USD ($)
$ in Millions
Sep. 30, 2024
Dec. 31, 2023
Current assets:    
Cash and cash equivalents $ 2,502 $ 865
Trade accounts receivable, net 2,501 2,228
Inventories 2,753 2,484
Prepaid income taxes 332 315
Other current assets 674 621
Total current assets 8,761 6,514
Property, plant and equipment, net 3,072 2,859
Goodwill 15,033 14,387
Other intangible assets, net 5,754 6,003
Deferred tax assets 3,816 3,841
Other long-term assets 1,642 1,531
TOTAL ASSETS 38,078 35,136
Current liabilities:    
Current debt obligations 1,652 531
Accounts payable 907 942
Accrued expenses 2,460 2,646
Other current liabilities 891 814
Total current liabilities 5,910 4,933
Long-term debt 9,233 8,571
Deferred income taxes 138 134
Other long-term liabilities 1,841 1,967
Commitments and contingencies
Stockholders’ equity    
Preferred stock, $0.01 par value - authorized 50,000,000 shares - 0 shares issued as of September 30, 2024 and December 31, 2023 0 0
Common stock, $0.01 par value - authorized 2,000,000,000 shares - issued 1,736,731,395 shares as of September 30, 2024 and 1,729,000,224 shares as of December 31, 2023 17 17
Treasury stock, at cost - 263,289,848 shares as of September 30, 2024 and December 31, 2023 (2,251) (2,251)
Additional paid-in capital 20,963 20,647
Retained earnings 2,107 819
Accumulated other comprehensive income (loss), net of tax (128) 49
Total stockholders’ equity 20,708 19,282
Noncontrolling interests 248 248
Total equity 20,956 19,530
TOTAL LIABILITIES AND EQUITY $ 38,078 $ 35,136
v3.24.3
Consolidated Balance Sheets (Parenthetical) - $ / shares
Sep. 30, 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
v3.24.3
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)     7,541,629          
Conversion of mandatory convertible preferred stock to common stock   (10,062,500) 23,982,902          
Conversion of mandatory convertible preferred stock to common stock   $ 0 $ 0          
Repurchase of common stock       0        
Impact of stock-based compensation plans     $ 0   285      
Net income (loss) $ 1,088         1,088    
Preferred stock dividends           (23)    
Net income (loss) attributable to noncontrolling interests 0         0   0
Changes in other comprehensive income (loss) (37)           (37) (16)
Changes to noncontrolling ownership interest               259
Ending Balance (Shares Issued) at Sep. 30, 2023   0            
Ending Balance (Shares) at Sep. 30, 2023     1,728,158,524          
Ending Balance, Equity at Sep. 30, 2023 19,129 $ 0 $ 17 (2,251) 20,573 315 231 243
Increase (Decrease) in Stockholders' Equity [Roll Forward]                
Total stockholders’ equity             208  
Beginning Balance (Shares Issued) at Jun. 30, 2023   0            
Beginning Balance (Shares) at Jun. 30, 2023     1,725,956,141          
Beginning Balance, Equity at Jun. 30, 2023   $ 0 $ 17 (2,251) 20,441 (189) 208 259
Increase (Decrease) in Stockholders' Equity [Roll Forward]                
Stock-based compensation (Shares)     2,202,383          
Conversion of mandatory convertible preferred stock to common stock   0 0          
Conversion of mandatory convertible preferred stock to common stock   $ 0 $ 0          
Repurchase of common stock       0        
Impact of stock-based compensation plans     $ 0   132      
Net income (loss) 504         504    
Preferred stock dividends           0    
Net income (loss) attributable to noncontrolling interests 0         0   0
Changes in other comprehensive income (loss) 23           23 (16)
Changes to noncontrolling ownership interest               0
Ending Balance (Shares Issued) at Sep. 30, 2023   0            
Ending Balance (Shares) at Sep. 30, 2023     1,728,158,524          
Ending Balance, Equity at Sep. 30, 2023 19,129 $ 0 $ 17 (2,251) 20,573 315 231 243
Increase (Decrease) in Stockholders' Equity [Roll Forward]                
Total stockholders’ equity 18,886           231  
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)     7,731,171          
Conversion of mandatory convertible preferred stock to common stock   0 0          
Conversion of mandatory convertible preferred stock to common stock   $ 0 $ 0          
Repurchase of common stock       0        
Impact of stock-based compensation plans     $ 0   316      
Net income (loss) 1,284         1,284    
Preferred stock dividends           0    
Net income (loss) attributable to noncontrolling interests 4         4   (4)
Changes in other comprehensive income (loss) (173)           (178) 4
Changes to noncontrolling ownership interest               0
Ending Balance (Shares Issued) at Sep. 30, 2024   0            
Ending Balance (Shares) at Sep. 30, 2024     1,736,731,395          
Ending Balance, Equity at Sep. 30, 2024 20,956 $ 0 $ 17 (2,251) 20,963 2,107 (128) 248
Increase (Decrease) in Stockholders' Equity [Roll Forward]                
Total stockholders’ equity             164  
Beginning Balance (Shares Issued) at Jun. 30, 2024   0            
Beginning Balance (Shares) at Jun. 30, 2024     1,734,329,744          
Beginning Balance, Equity at Jun. 30, 2024   $ 0 $ 17 (2,251) 20,803 1,639 164 238
Increase (Decrease) in Stockholders' Equity [Roll Forward]                
Stock-based compensation (Shares)     2,401,651          
Conversion of mandatory convertible preferred stock to common stock   0 0          
Conversion of mandatory convertible preferred stock to common stock   $ 0 $ 0          
Repurchase of common stock       0        
Impact of stock-based compensation plans     $ 0   160      
Net income (loss) 468         468    
Preferred stock dividends           0    
Net income (loss) attributable to noncontrolling interests 0         0   0
Changes in other comprehensive income (loss) (282)           (292) 10
Changes to noncontrolling ownership interest               0
Ending Balance (Shares Issued) at Sep. 30, 2024   0            
Ending Balance (Shares) at Sep. 30, 2024     1,736,731,395          
Ending Balance, Equity at Sep. 30, 2024 20,956 $ 0 $ 17 $ (2,251) $ 20,963 $ 2,107 (128) $ 248
Increase (Decrease) in Stockholders' Equity [Roll Forward]                
Total stockholders’ equity $ 20,708           $ (128)  
v3.24.3
Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash provided by (used for) operating activities    
Net income (loss) $ 1,284 $ 1,088
Depreciation and amortization 921 883
Deferred and prepaid income taxes 10 (74)
Stock-based compensation expense 197 174
Goodwill and other intangible asset impairment charges 276 58
Net loss (gain) on investments and notes receivable 60 48
Contingent consideration net expense (benefit) (4) 43
Inventory step-up amortization 0 6
Other, net 22 33
Trade accounts receivable (261) (164)
Inventories (274) (601)
Other assets (109) (43)
Accounts payable, accrued expenses and other liabilities (142) 95
Cash provided by (used for) operating activities 1,979 1,546
Investing activities:    
Purchases of property, plant and equipment and internal use software (513) (444)
Proceeds from sale of property, plant and equipment 1 4
Payments for acquisitions of businesses, net of cash acquired (1,222) (1,018)
Payments for investments and acquisitions of certain technologies, net of investment proceeds (264) (89)
Proceeds from royalty rights 16 23
Proceeds from settlements of hedge contracts 0 2
Cash provided by (used for) investing activities (1,983) (1,521)
Financing activities:    
Payment of contingent consideration previously established in purchase accounting (131) (39)
Payments for royalty rights (26) (50)
Payments for finance leases (25) 0
Payments on short-term borrowings (504) 0
Proceeds from short-term borrowings, net of debt issuance costs 22 0
Net increase (decrease) in commercial paper 0 (4)
Proceeds from long-term borrowings, net of debt issuance costs 2,145 0
Cash dividends paid on preferred stock 0 (28)
Cash used to net share settle employee equity awards (83) (54)
Proceeds from issuances of common stock pursuant to employee stock compensation and purchase plans 202 165
Cash provided by (used for) financing activities 1,600 (10)
Effect of foreign exchange rates on cash (2) (8)
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted cash equivalents 1,594 7
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 2,649 1,132
Supplemental Information    
Stock-based compensation expense 197 174
Fair value of contingent consideration recorded in purchase accounting 29 0
Non-cash impact of transferred royalty rights (16) (23)
Cash and cash equivalents 2,502 952
Restricted cash and restricted cash equivalents included in Other current assets 70 123
Restricted cash equivalents included in Other long-term assets 78 58
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period $ 2,649 $ 1,132
v3.24.3
Basis of Presentation
9 Months Ended
Sep. 30, 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 and nine months ended September 30, 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. In the first quarter of 2023, we acquired a majority stake investment in Acotec Scientific Holdings Limited (Acotec) and have elected to consolidate their financial statements on a one quarter lag.

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.
v3.24.3
Acquisitions, Divestitures and Strategic Investments
9 Months Ended
Sep. 30, 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 have responded to the Second Request and continue to work cooperatively with the FTC in its review. The transaction is expected to be completed in the fourth quarter 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.

2024 Acquisitions

On September 17, 2024, we completed our acquisition of 100 percent of the outstanding equity of Silk Road Medical, Inc. (Silk Road Medical), a publicly traded medical device company that has developed an innovative platform of products to prevent stroke in patients with carotid artery disease through a minimally invasive procedure called transcarotid artery revascularization (TCAR). The transaction consisted of an upfront cash payment of $27.50 per share, or approximately $1.126 billion, net of cash acquired. The Silk Road Medical business is being integrated into our Peripheral Interventions division.

Purchase Price Allocation

We accounted for this transaction 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 preliminary purchase price was comprised of the amount presented below:
(in millions)Silk Road Medical
Payment for acquisition, net of cash acquired$1,126 
$1,126 

We recorded the assets acquired and liabilities assumed at their respective fair values as of the closing date of the transaction. The preliminary purchase price allocation was comprised of the components presented below, which represent the preliminary determination of the fair value of identifiable assets acquired and liabilities assumed, with the excess of the purchase price over the fair value of net assets acquired recorded to goodwill. The final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with FASB ASC Topic 805.

(in millions)Silk Road Medical
Goodwill$563 
Amortizable intangible assets507 
Other assets acquired124 
Liabilities assumed(46)
Net deferred tax liabilities(22)
$1,126 

Goodwill was primarily established due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies, none of which is deductible for tax purposes.

We allocated a portion of the purchase price to the specific intangible asset categories as follows:

Amount Assigned
(in millions)
Weighted Average Amortization Period
(in years)
Risk-Adjusted Discount
Rates used in Purchase Price Allocation
Amortizable intangible assets:
Technology-related$447 1213%
Customer relationships61 1213%
$507 

2023 Acquisitions

On April 4, 2023, we completed our acquisition of 100 percent of the outstanding equity of Apollo Endosurgery, Inc. (Apollo), a public company which offers a portfolio of devices used during endoluminal procedures to close gastrointestinal defects, manage gastrointestinal complications and aid in weight loss for patients suffering from obesity. The transaction consisted of an upfront cash payment of $636 million, net of cash acquired. The Apollo business is being integrated into our Endoscopy division.

On 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 these transactions as business combinations in accordance with FASB ASC Topic 805. The final purchase prices were comprised of the amounts presented below:
(in millions)
Acotec(1)
Apollo
Payment for acquisition, net of cash acquired(2)
$381 $636 
$381 $636 
(1) Excludes approximately $140 million of cash on hand at the closing of the transaction
(2) Related to Acotec, represents our majority stake investment

We recorded the assets acquired, liabilities assumed and specific to Acotec, the noncontrolling interest, at their respective fair values as of the closing date of the transaction. The final purchase price allocations were 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)AcotecApollo
Goodwill$337 $378 
Amortizable intangible assets334 248 
Other assets acquired93 50 
Liabilities assumed(48)(33)
Net deferred tax liabilities(76)(5)
Fair value of noncontrolling interest(259)— 
$381 $636 

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 for Apollo, due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies, none of which is deductible for tax purposes.

We allocated a portion of the purchase price to the specific intangible asset categories as follows:

Amount Assigned
(in millions)
Weighted Average Amortization Period
(in years)
Risk-Adjusted Discount
Rates used in Purchase Price Allocation
Acotec:
Amortizable intangible assets:
Technology-related$308 1114%
Customer relationships15 1114%
Other intangible assets11 1314%
$334 
Apollo:
Amortizable intangible assets:
Technology-related$222 1112%
Customer relationships26 1112%
$248 
Contingent Consideration
Changes in the fair value of our contingent consideration liability during the first nine months of 2024 associated with prior period acquisitions were as follows:

(in millions)
Balance as of December 31, 2023$404 
Amount recorded related to current year acquisitions29 
Contingent consideration net expense (benefit)(4)
Contingent consideration payments and other adjustments(258)
Balance as of September 30, 2024$171 

The payments made during the first nine months of 2024 primarily related to our acquisition of Farapulse, Inc. (Farapulse) and Relievant Medsystems, Inc. (Relievant) following the achievement of revenue-based earnouts and sales milestones, respectively. 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 September 30, 2024, the fair value of such uncapped contingent consideration is estimated at $139 million. As of September 30, 2024, the maximum amount that we could be required to pay under our other contingent consideration arrangements (undiscounted) is approximately $220 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 LiabilityFair Value as of September 30, 2024Valuation TechniqueUnobservable InputRange
Weighted Average(1)
Revenue-based Payments and Milestones$171 millionDiscounted Cash FlowDiscount Rate6%-15%7%
Probability of Payment90%-100%98%
Projected Year of Payment2025-20292027
(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 September 30, 2024.

Strategic Investments

The aggregate carrying amount of our strategic investments was comprised of the following:

As of
(in millions)September 30, 2024December 31, 2023
Equity method investments$256 $219 
Measurement alternative investments(1, 2)
276 194 
$532 $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.
As of September 30, 2024, the cost of our aggregated equity method investments exceeded our share of the underlying equity in net assets by $255 million, which represents amortizable intangible assets, in-process research and development (IPR&D), goodwill and deferred tax liabilities.
v3.24.3
Goodwill and Other Intangible Assets
9 Months Ended
Sep. 30, 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 September 30, 2024As of December 31, 2023
(in millions)Gross Carrying AmountAccumulated Amortization/ Write-offsGross Carrying AmountAccumulated Amortization/ Write-offs
Technology-related$13,431 $(8,555)$13,207 $(8,101)
Patents480 (381)480 (387)
Other intangible assets2,270 (1,584)2,130 (1,500)
Amortizable intangible assets$16,181 $(10,521)$15,817 $(9,988)
    
Goodwill$24,933 $(9,900)$24,287 $(9,900)
IPR&D$94 $54 
Technology-related— 120 
Indefinite-lived intangible assets$94 $174 
The increase in our balance of goodwill and amortizable intangible assets is related primarily to our acquisition of Silk Road Medical in the third quarter of 2024.


The following represents a roll-forward of our goodwill balance by reportable segment:
(in millions)MedSurgCardiovascularTotal
As of December 31, 2023$5,347 $9,041 $14,387 
Goodwill acquired24 609 633 
Impact of foreign currency fluctuations and purchase price and other adjustments(22)34 12 
As of September 30, 2024$5,349 $9,684 $15,033 

Goodwill and Other Intangible Asset Impairments

We did not record any goodwill impairment charges in the first nine months of 2024 or 2023. We test our goodwill balances in the second quarter of each year as of April 1 for impairment, or more frequently if impairment indicators are present or changes in circumstances suggest an impairment may exist.

We assess goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment, referred to as a component. We identified the following reporting units for purposes of our annual goodwill impairment test: Interventional Cardiology, Rhythm Management, Peripheral Interventions, Endoscopy, Urology and Neuromodulation. Based on the criteria prescribed in FASB ASC Topic 350, Intangibles - Goodwill and Other (FASB ASC Topic 350), we aggregated the Interventional Cardiology Therapies and Watchman components of our Cardiology operating segment into a single Interventional Cardiology reporting unit and aggregated the Cardiac Rhythm Management and Electrophysiology components of our Cardiology operating segment into a single Rhythm Management reporting unit.
In the second quarter of 2024, we performed our annual goodwill impairment test utilizing both the qualitative and quantitative approach described in FASB ASC Topic 350. The qualitative approach was used for testing certain reporting units where fair value has historically exceeded carrying value by greater than 100 percent, and all other reporting units were tested using the quantitative approach. For the reporting units tested using the qualitative approach, after assessing the totality of events, it was determined that it was not more likely than not that the fair value of the reporting units was less than their carrying value, and it was not deemed necessary to proceed to the quantitative test. For the reporting units tested using the quantitative approach, we determined that the fair value of the reporting units exceeded the carrying value and concluded that goodwill was not impaired or at risk of impairment. There were no impairment indicators in the third quarter of 2024 that necessitated an interim impairment test.
In 2024, we did not record any Intangible asset impairment charges in the third quarter and recorded $276 million in the first nine months. The impairment charges recorded in 2024 were associated with amortizable intangible assets established in connection with our acquisitions of Cryterion Medical, Inc. (Cryterion) and Devoro Medical, Inc. (Devoro), which were integrated into our Electrophysiology and Peripheral Interventions business units, respectively. Intangible assets acquired from Cryterion were impaired due to strong commercial adoption of our Farapulse™ Pulsed Field Ablation System and the resulting lower revenue projections and cannibalization of our cryoablation business in major markets like the U.S. Intangible assets acquired from Devoro were impaired following management's decision to cancel the related program in the second quarter of 2024. We calculated the fair value of our Cryterion and Devoro intangible assets as the present value of estimated future cash flows we expect to generate from the assets based on estimates and assumptions about future revenue contributions, cost structures and the remaining useful lives of the assets.
In 2023, we recorded Intangible asset impairment charges of less than $1 million in the third quarter and $58 million in the first nine months. The impairment charges recorded in 2023 were primarily associated with the cancellation of an IPR&D program due to the incremental time and cost to complete the program and bring the technology to market.
We review intangible assets subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may indicate impairment include, but are not limited to, a significant adverse change in legal factors or business climate that could affect the value of an asset, a product recall or an adverse action or assessment by a regulator. If we determine it is more likely than not that the asset is impaired based on our qualitative assessment of impairment indicators, we test the intangible asset for recoverability. If the carrying value of the intangible asset or asset group exceeds the undiscounted cash flows expected to result from the use and eventual disposition of the intangible asset or asset group, we will write the carrying value down to fair value in the period impairment is identified. We test our indefinite-lived intangible assets at least annually during the third quarter for impairment and reassess their classification as indefinite-lived assets. In addition, we review our indefinite-lived intangible assets for classification and impairment more frequently if impairment indicators exist.
During the third quarter of 2024, we performed our annual IPR&D impairment test and evaluated our indefinite-lived core technology assets for impairment and concluded the assets were not impaired. We also reclassified our indefinite-lived core technology assets to amortizable intangible assets after determining the intangibles no longer have an indefinite useful life and verified that the classification of IPR&D projects recognized within our unaudited consolidated balance sheets continues to be appropriate.
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 for further discussion of our annual goodwill and intangible asset impairment testing.
v3.24.3
Hedging Activities and Fair Value Measurements
9 Months Ended
Sep. 30, 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 September 30, 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 September 30, 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 September 30, 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 DesignationAs of
September 30, 2024December 31, 2023
Forward currency contractsCash flow hedge$2,763 $2,284 
Forward currency contractsNet investment hedge645 333 
Foreign currency-denominated debt(1)
Net investment hedge997 997 
Forward currency contractsNon-designated3,072 3,282 
Total Notional Outstanding$7,477 $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 September 30, 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 TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended September 30, 2024
Forward currency contracts
Cash flow hedges$(86)$19 $(66)Cost of products sold$1,312 $(44)$10 $(34)
Net investment hedges(2)
(35)(27)Interest expense79 (4)(3)
Foreign currency-denominated debt
Net investment hedges(3)
(44)10 (34)Other, net(14)— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense79 (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 TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended September 30, 2023
Forward currency contracts
Cash flow hedges$54 $(12)$42 Cost of products sold$1,101 $(51)$11 $(39)
Net investment hedges(2)
12 (3)Interest expense66 (2)(2)
Foreign currency-denominated debt
Net investment hedges(3)
26 (6)20 Other, net18 — — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest Expense66 (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 TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Nine Months Ended September 30, 2024
Forward currency contracts
Cash flow hedges$22 $(5)$17 Cost of products sold$3,791 $(146)$33 $(113)
Net investment hedges(2)
12 (3)Interest expense225 (12)(10)
Foreign currency-denominated debt
Net investment hedges(3)
(12)(10)Other, net— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense225 (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 TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Nine Months Ended September 30, 2023
Forward currency contracts
Cash flow hedges$141 $(32)$109 Cost of products sold$3,198 $(176)$40 $(136)
Net investment hedges(2)
40 (9)31 Interest expense200 (7)(6)
Foreign currency-denominated debt
Net investment hedges(3)
(2)Other, net78 — — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense200 (0)
(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 September 30, 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 DesignationLocation on Unaudited Consolidated Statements of OperationsAmount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings
Designated Hedging Instrument
Forward currency contractsCash flow hedgeCost of products sold$72 
Forward currency contractsNet investment hedgeInterest expense
Interest rate derivative contractsCash flow hedgeInterest 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 OperationsThree Months Ended September 30,Nine Months Ended September 30,
(in millions)2024202320242023
Net gain (loss) on currency hedge contractsOther, net$(48)$10 $(4)$13 
Net gain (loss) on currency transaction exposuresOther, net44 (16)(7)(42)
Net currency exchange gain (loss)$(4)$(6)$(11)$(30)
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)September 30, 2024December 31, 2023
Derivative and Nonderivative Assets:   
Designated Hedging Instruments  
Forward currency contractsOther current assets$146 $140 
Forward currency contractsOther long-term assets20 107 
  166 246 
Non-Designated Hedging Instruments   
Forward currency contractsOther current assets22 20 
Total Derivative and Nonderivative Assets $188 $266 
Derivative and Nonderivative Liabilities:   
Designated Hedging Instruments  
Forward currency contractsOther current liabilities$36 $15 
Forward currency contractsOther long-term liabilities13 
Foreign currency-denominated debt(2)
Long-term debt1,002 988 
  1,052 1,012 
Non-Designated Hedging Instruments   
Forward currency contractsOther current liabilities36 38 
Total Derivative and Nonderivative Liabilities $1,087 $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
 September 30, 2024December 31, 2023
(in millions)Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Assets        
Money market funds and time deposits$1,733 $— $— $1,733 $454 $— $— $454 
Publicly-held equity securities19 — — 19 18 — — 18 
Hedging instruments— 188 — 188 — 266 — 266 
Licensing arrangements— — 37 37 — — 77 77 
 $1,752 $188 $37 $1,977 $472 $266 $77 $816 
Liabilities        
Hedging instruments$— $1,087 $— $1,087 $— $1,050 $— $1,050 
Contingent consideration liability— — 171 171 — — 404 404 
Licensing arrangements— — 41 41 — — 90 90 
 $ $1,087 $212 $1,300 $ $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 $1.733 billion invested in money market funds and time deposits as of September 30, 2024 and $454 million as of December 31, 2023, we held $803 million in interest-bearing and non-interest-bearing bank accounts as of September 30, 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 sheet as of September 30, 2024 include the following significant unobservable inputs:
Licensing ArrangementsFair Value as of September 30, 2024Valuation TechniqueUnobservable InputRange
Weighted Average (1)
Financial Asset$37 millionDiscounted Cash FlowDiscount Rate15%15%
Projected Year of Payment2024-20252025
Financial Liability$41 millionDiscounted Cash FlowDiscount Rate12 %-15%13%
Projected Year of Payment2024-20262025
(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(31)
Fair value adjustment (expense) benefit(9)
Balance as of September 30, 2024$37 

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(41)
Fair value adjustment expense (benefit)(8)
Balance as of September 30, 2024$41 

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 $10.734 billion as of September 30, 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.
v3.24.3
Contractual Obligations and Commitments
9 Months Ended
Sep. 30, 2024
Debt Disclosure [Abstract]  
CONTRACTUAL OBLIGATIONS AND COMMITMENTS
NOTE E – CONTRACTUAL OBLIGATIONS AND COMMITMENTS

Borrowings and Credit Arrangements

We had total debt outstanding of $10.885 billion as of September 30, 2024 and $9.102 billion as of December 31, 2023, with current obligations of $1.652 billion as of September 30, 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 DateMaturity DateAs of
Coupon Rate(1)
September 30,
2024
December 31,
2023
March 2025 Senior Notes(3)
March 2022March 2025— 1,105 0.750%
June 2025 Senior NotesMay 2020June 2025— 500 1.900%
March 2026 Senior NotesFebruary 2019March 2026255 255 3.750%
December 2027 Senior Notes(3)
November 2019December 20271,007 995 0.625%
March 2028 Senior Notes(3)
March 2022March 2028839 829 1.375%
March 2028 Senior NotesFebruary 2018March 2028344 344 4.000%
March 2029 Senior NotesFebruary 2019March 2029272 272 4.000%
March 2029 Senior Notes(3)
February 2024March 2029839 — 3.375%
June 2030 Senior NotesMay 2020June 20301,200 1,200 2.650%
March 2031 Senior Notes(3)
March 2022March 2031839 829 1.625%
March 2032 Senior Notes(3)
February 2024March 20321,399 — 3.500%
March 2034 Senior Notes(3)
March 2022March 2034560 553 1.875%
November 2035 Senior Notes(2)
November 2005November 2035350 350 6.500%
March 2039 Senior NotesFebruary 2019March 2039450 450 4.550%
January 2040 Senior NotesDecember 2009January 2040300 300 7.375%
March 2049 Senior NotesFebruary 2019March 2049650 650 4.700%
Unamortized Debt Issuance Discount and Deferred Financing Costs2024 - 2049(75)(65)
Finance Lease ObligationVarious
Long-term debt$9,233 $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 September 30, 2024 and December 31, 2023, respectively.

Revolving Credit Facility

On May 10, 2021, we entered into a $2.750 billion revolving credit facility (as amended, supplemented or otherwise modified from time to time, the 2021 Revolving Credit Facility) with a global syndicate of commercial banks. On May 10, 2024, we entered into a third amendment to the 2021 Revolving Credit Facility credit agreement, which provided for, among other things, an extension of the scheduled maturity date to May 10, 2029, an amendment of the Ratings based pricing grid of the Applicable Margin, each as defined in the credit agreement, and reset the applicable date for purposes of determining the amounts of restructuring charges and restructuring-related expenses that may be excluded from consolidated Earnings Before Interest, Taxes, Depreciation and Amortization (EBITDA), as defined by the credit agreement, for purposes of our maximum leverage ratio covenant, from December 31, 2022 to March 31, 2024, as further discussed 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 September 30, 2024 or December 31, 2023.
Financial Covenant

As of September 30, 2024, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility.
Covenant RequirementActual
 as of September 30, 2024as of September 30, 2024
Maximum permitted leverage ratio(1)
3.75 times1.95 times
(1) Ratio of total debt to deemed consolidated 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 September 30, 2024, we excluded from our leverage ratio calculation $2.218 billion of debt incurred in connection with the Axonics acquisition.

The financial covenant requirement, as amended on May 10, 2024, 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 related to restructuring charges and restructuring-related expenses from December 31, 2022 to March 31, 2024. Permitted exclusions include up to $500 million in cash and non-cash restructuring charges and restructuring-related expenses associated with our current or future restructuring plans. As of September 30, 2024, we had $401 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 September 30, 2024, we had $1.442 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 September 30, 2024 or December 31, 2023.

Senior Notes

We had senior notes outstanding of $10.924 billion as of September 30, 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 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, in addition to all of AMS Europe's obligations under the euro-denominated senior notes that were
previously issued by AMS Europe in 2022, 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 fourth quarter 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, Transfers and Servicing. 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 ArrangementsAs of September 30, 2024As of December 31, 2023
Amount
De-recognized
Weighted Average
Interest Rate
Amount
De-recognized
Weighted Average
Interest Rate
Euro denominated$211 5.5 %$206 5.1 %
Yen denominated199 0.9 %214 0.6 %
Renminbi denominated
27 2.2 %14 2.9 %

Other Contractual Obligations and Commitments

We had outstanding letters of credit of $216 million as of September 30, 2024 and $174 million as of December 31, 2023, which consisted primarily of bank guarantees and collateral for workers' compensation insurance arrangements. As of September 30, 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 $137 million as of September 30, 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.
v3.24.3
Supplemental Balance Sheet Information
9 Months Ended
Sep. 30, 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)September 30, 2024December 31, 2023
Trade accounts receivable$2,610 $2,338 
Allowance for credit losses(109)(110)
 $2,501 $2,228 

The following is a roll forward of our Allowance for credit losses:
Three Months Ended September 30,Nine Months Ended
September 30,
(in millions)2024202320242023
Beginning balance$105 $127 $110 $109 
Credit loss expense10 10 30 44 
Write-offs(6)(11)(32)(27)
Ending balance$109 $126 $109 $126 

Inventories
 As of
(in millions)September 30, 2024December 31, 2023
Finished goods$1,687 $1,537 
Work-in-process206 174 
Raw materials860 773 
 $2,753 $2,484 
Other current assets
 As of
(in millions)September 30, 2024December 31, 2023
Restricted cash and restricted cash equivalents$70 $130 
Derivative assets168 159 
Licensing arrangements33 47 
Other403 285 
 $674 $621 
Property, plant and equipment, net
 As of
(in millions)September 30, 2024December 31, 2023
Land$143 $140 
Buildings and improvements1,912 1,843 
Equipment, furniture and fixtures3,673 3,503 
Capital in progress966 857 
 6,694 6,343 
Less: accumulated depreciation3,622 3,484 
 $3,072 $2,859 

Depreciation expense was $102 million for the third quarter of 2024, $93 million for the third quarter of 2023, $290 million for the first nine months of 2024 and $263 million for the first nine months of 2023.

Other long-term assets

 As of
(in millions)September 30, 2024December 31, 2023
Restricted cash equivalents$78 $60 
Operating lease right-of-use assets426 439 
Derivative assets20 107 
Investments532 413 
Licensing arrangements30 
Indemnification asset183 176 
Other400 306 
 $1,642 $1,531 
Accrued expenses
 As of
(in millions)September 30, 2024December 31, 2023
Legal reserves$126 $206 
Payroll and related liabilities1,111 1,051 
Rebates460 389 
Contingent consideration62 304 
Other701 696 
 $2,460 $2,646 

Other current liabilities
 As of
(in millions)September 30, 2024December 31, 2023
Deferred revenue$290 $266 
Licensing arrangements33 49 
Taxes payable286 220 
Other282 278 
 $891 $814 
Other long-term liabilities
 As of
(in millions)September 30, 2024December 31, 2023
Accrued income taxes$364 $470 
Legal reserves124 172 
Contingent consideration109 100 
Licensing arrangements41 
Operating lease liabilities373 390 
Deferred revenue328 311 
Other535 484 
 $1,841 $1,967 
v3.24.3
Income Taxes
9 Months Ended
Sep. 30, 2024
Income Tax Disclosure [Abstract]  
INCOME TAXES
NOTE G – INCOME TAXES

The following table provides a reconciliation of our reported tax rate to the rate from continuing operations:
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
Reported tax rate30.0 %17.3 %24.4 %26.5 %
Impact of certain receipts/charges(1)
(12.3)%(0.2)%(6.0)%(7.3)%
Rate from continuing operations17.7 %17.1 %18.3 %19.2 %
(1)These receipts/charges are taxed at different rates than our rate from continuing operations.

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 rate from continuing operations.

In the third quarter of 2024, the primary difference between the rate from continuing operations and our reported tax rate relates to certain acquisition-related net charges. In the first nine months of 2024, the primary difference between the rate from continuing operations and our reported tax rate relates to certain acquisition-related net charges, benefits for intangible asset impairment charges, and discrete tax benefits primarily related to stock-based compensation.

In the third quarter of 2023, the primary difference between the rate from continuing operations and our reported tax rate relates to litigation-related charges. In the first nine months of 2023, the primary difference between the rate from continuing operations and our reported tax rate relates to certain acquisition-related net charges, litigation-related charges and discrete tax benefits related to unrecognized tax benefits and stock-based compensation.

As of September 30, 2024, we had $493 million of gross unrecognized tax benefits, of which a net $417 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 gross unrecognized tax benefit is primarily related to current year accruals for reserves and audits.

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 $9 million.
v3.24.3
Commitments and Contingencies
9 Months Ended
Sep. 30, 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. Our accrual for legal matters that are probable and estimable was $250 million as of September 30, 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 $70 million as of September 30, 2024 and $130 million as of December 31, 2023. Refer to Note F – Supplemental Balance Sheet Information for additional information.

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. We did not record any litigation-related net charges (credits) during the third quarter and first nine months of 2024, and recorded litigation-related net credits of $111 million during the third quarter and first nine months of 2023 related to the settlement of offensive patent litigation. 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.

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 required by our credit arrangements.

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 filed a motion seeking prejudgment interest and enhanced damages. The Company filed a motion seeking judgment as a matter of law in its favor or alternatively a new trial. On June 5, 2024, the Court granted the Company’s motion for judgment as a matter of law of no willful infringement, but otherwise denied the Company’s motions. The Court also denied UT’s motion for enhanced damages, awarded approximately $7 million in pre-judgment interest, and awarded post-judgment interest. On July 3, 2024, UT and the Company each filed a notice of appeal.

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

Like many healthcare companies, the Company receives inquiries and has ongoing discussions with governmental agencies with respect to the Company’s operations, such as the Securities and Exchange Commission (SEC), the Department of Justice (DOJ) and foreign regulators, including its operations in Vietnam with respect to alleged Foreign Corrupt Practices Act (FCPA) violations the Company received in March 2022. The Company has received related subpoenas for documents from the DOJ and the SEC with respect to the Vietnam matter, and is cooperating with the government while investigating these allegations. From time to time, the Company also self-discloses potential concerns to regulators. In the course of Vietnam-related discussions with the DOJ and SEC, the Company has disclosed that it is investigating other potential concerns in Vietnam and other countries.

From time to time, the Company also receives U.S.-based subpoenas and DOJ Civil Investigative Demands (CID), including the following matters: in April 2023, the Company received a DOJ subpoena that seeks documents and information related to its ambulatory electrocardiography monitoring business; in December 2023, the Company received a DOJ CID related to the provision of peripheral intervention services through office-based labs. The Company is cooperating with the DOJ in these matters.
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 and dismissed the case on April 23, 2024.

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.
v3.24.3
Stockholders' Equity
9 Months Ended
Sep. 30, 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.
v3.24.3
Weighted Average Shares Outstanding
9 Months Ended
Sep. 30, 2024
Earnings Per Share [Abstract]  
WEIGHTED AVERAGE SHARES OUTSTANDING
NOTE J – WEIGHTED AVERAGE SHARES OUTSTANDING

Three Months Ended September 30,Nine Months Ended September 30,
(in millions)2024202320242023
Weighted average shares outstanding — basic1,472.7 1,464.5 1,470.6 1,448.8 
Net effect of common stock equivalents14.8 10.5 13.9 10.2 
Weighted average shares outstanding - diluted1,487.4 1,475.0 1,484.5 1,459.1 

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 September 30,Nine Months Ended September 30,
(in millions)2024202320242023
Stock options outstanding(1)
00
MCPS(2)
— 13
(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 third quarter and first nine months 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 two million shares of our common stock in the third quarter of 2024, approximately eight million shares in the first nine months of 2024, approximately two million shares in the third quarter of 2023 and approximately 32 million shares in the first nine months of 2023. Shares were issued following the exercise of stock options, vesting of restricted stock units or purchases under our employee stock purchase plan and, specific to the first nine months of 2023, following the automatic conversion of the MCPS. We did not repurchase any shares of our common stock in the first nine months 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 September 30, 2024, we had the full amount remaining available under the authorization.
v3.24.3
Segment Reporting
9 Months Ended
Sep. 30, 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
September 30,
Nine Months Ended
September 30,
Net Sales2024202320242023
MedSurg$1,470 $1,332$4,352 $3,943
Cardiovascular2,709 2,1677,767 6,442
Total net sales of reportable segments4,179 3,49812,118 10,385
Impact of foreign currency fluctuations30 2868 130
$4,209 $3,527$12,186 $10,515
Income (loss) before income taxes
MedSurg$509 $455$1,494 $1,322
Cardiovascular842 5792,256 1,714
Total operating income of reportable segments1,350 1,0343,750 3,036
Unallocated amounts:
Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments(203)(115)(472)(288)
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(209)(19)(719)(370)
Amortization expense(205)(208)(631)(620)
Operating income (loss)733 6931,928 1,759
Other income (expense), net(65)(83)(231)(279)
Income (loss) before income taxes$669 $610$1,697 $1,480

Three Months Ended September 30,Nine Months Ended
September 30,
Operating income margin of reportable segments2024202320242023
MedSurg34.6 %34.2 %34.3 %33.5 %
Cardiovascular31.1 %26.7 %29.0 %26.6 %
v3.24.3
Revenue
9 Months Ended
Sep. 30, 2024
Revenue from Contract with Customer [Abstract]  
REVENUE
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 September 30,
20242023
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$417 $261 $678 $382 $247 $629 
Urology379 153 532 341 142 483 
Neuromodulation211 57 268 175 55 229 
MedSurg1,007 472 1,479 898 443 1,341 
   Interventional Cardiology Therapies212 449 661 182 401 583 
   Watchman342 38 380 291 31 323 
   Cardiac Rhythm Management349 213 561 355 197 552 
    Electrophysiology366 160 527 89 101 190 
Cardiology1,269 859 2,129 918 730 1,647 
Peripheral Interventions316 285 602 283 255 538 
Cardiovascular1,586 1,145 2,731 1,201 984 2,185 
Total Net Sales$2,593 $1,616 $4,209 $2,099 $1,427 $3,527 

Nine Months Ended September 30,
20242023
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$1,227 $769 $1,996 $1,118 $719 $1,836 
Urology1,098 473 1,570 1,007 430 1,437 
Neuromodulation616 191 807 530 177 708 
MedSurg2,941 1,433 4,373 2,655 1,326 3,981 
   Interventional Cardiology Therapies608 1,370 1,977 554 1,248 1,803 
   Watchman996 107 1,103 843 87 930 
   Cardiac Rhythm Management1,054 658 1,713 1,057 609 1,665 
    Electrophysiology795 460 1,255 259 300 560 
Cardiology3,452 2,595 6,048 2,714 2,244 4,958 
Peripheral Interventions924 841 1,765 844 733 1,577 
Cardiovascular4,377 3,436 7,813 3,557 2,977 6,534 
Total Net Sales$7,317 $4,869 $12,186 $6,212 $4,303 $10,515 

Refer to Note K - Segment Reporting for information on our reportable segments.
Three Months Ended September 30,Nine Months Ended September 30,
Geographic Regions2024202320242023
U.S.$2,593 $2,099 $7,317 $6,212 
Europe, Middle East and Africa773 671 2,398 2,107 
Asia-Pacific684 611 2,002 1,784 
Latin America and Canada159 146 469 412 
Total Net Sales$4,209 $3,527 $12,186 $10,515 
Emerging Markets(1)
$684 $594 $2,012 $1,715 
(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 $618 million as of September 30, 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 $57 million in the third quarter and $177 million in the first nine months of 2024 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.
v3.24.3
Changes in Other Comprehensive Income
9 Months Ended
Sep. 30, 2024
Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]  
CHANGES IN OTHER COMPREHENSIVE INCOME
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 AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of June 30, 2024$13 $159 $(8)$164 
Other comprehensive income (loss) before reclassifications(188)(66)— (255)
(Income) loss amounts reclassified from accumulated other comprehensive income(3)(34)(0)(37)
Total other comprehensive income (loss)(191)(100)(0)(292)
Balance as of September 30, 2024$(179)$59 $(8)$(128)
(in millions)Foreign Currency Translation AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of June 30, 2023$(28)$241 $(4)$208 
Other comprehensive income (loss) before reclassifications23 42 — 64 
(Income) loss amounts reclassified from accumulated other comprehensive income(2)(39)(0)(41)
Total other comprehensive income (loss)21 (0)23 
Balance as of September 30, 2023$(8)$243 $(4)$231 

(in millions)Foreign Currency Translation AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of December 31, 2023$(96)$154 $(8)$49 
Other comprehensive income (loss) before reclassifications(73)17 (56)
(Income) loss amounts reclassified from accumulated other comprehensive income(10)(112)$(0)(122)
Total other comprehensive income (loss)(83)(95)(178)
Balance as of September 30, 2024$(179)$59 $(8)$(128)

(in millions)Foreign Currency Translation AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of December 31, 2022$(1)$269 $1 $269 
Other comprehensive income (loss) before reclassifications(1)109 (5)103 
(Income) loss amounts reclassified from accumulated other comprehensive income(6)(134)(1)(141)
Total other comprehensive income (loss)(7)(25)(5)(37)
Balance as of September 30, 2023$(8)$243 $(4)$231 

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.
v3.24.3
New Accounting Pronouncements
9 Months Ended
Sep. 30, 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 nine months 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 impacts disclosures only, 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 impacts disclosures only, 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.
v3.24.3
Insider Trading Arrangements
3 Months Ended 9 Months Ended
Sep. 30, 2024
shares
Sep. 30, 2024
shares
Trading Arrangements, by Individual    
Non-Rule 10b5-1 Arrangement Adopted false  
Rule 10b5-1 Arrangement Terminated false  
Non-Rule 10b5-1 Arrangement Terminated false  
John B. "Brad" Sorenson [Member]    
Trading Arrangements, by Individual    
Material Terms of Trading Arrangement  
On August 9, 2024, John B. "Brad" Sorenson, our Executive Vice President, Global Operations, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Sorenson’s plan covers the sale of up to 67,198 shares of our common stock including up to 20,383 shares to be acquired upon determination and/or vesting of performance share units and restricted share units and 17,362 shares to be acquired upon exercise of stock options. Transactions under Mr. Sorenson’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. Sorenson’s plan will terminate on the earlier of May 16, 2025, or the date all shares subject to the plan have been sold.
Name John B. "Brad" Sorenson  
Title Executive Vice President, Global Operations  
Rule 10b5-1 Arrangement Adopted true  
Adoption Date August 9, 2024  
Arrangement Duration 280 days  
Arthur C. Butcher [Member]    
Trading Arrangements, by Individual    
Material Terms of Trading Arrangement  
On August 9, 2024, Arthur C. Butcher, our Executive Vice President and Group President, MedSurg and Asia Pacific, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Butcher’s plan covers the sale of 69,253 shares of our common stock to be acquired upon exercise of stock options. Transactions under Mr. Butcher’s plan are based upon pre-established dates and stock price thresholds and will only occur upon the expiration of the applicable mandatory cooling-off period. Mr. Butcher’s plan will terminate on the earlier of January 30, 2026, or the date all shares subject to the plan have been sold.
Name Arthur C. Butcher  
Title Executive Vice President and Group President, MedSurg and Asia Pacific  
Rule 10b5-1 Arrangement Adopted true  
Adoption Date August 9, 2024  
Arrangement Duration 539 days  
Aggregate Available 69,253 69,253
Daniel J. Brennan [Member]    
Trading Arrangements, by Individual    
Material Terms of Trading Arrangement  
On August 26, 2024, Daniel J. 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 up to 120,672 shares of our common stock including up to 45,062 shares to be acquired upon determination and/or vesting of performance share units and restricted share units and 75,610 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 June 2, 2025, or the date all shares subject to the plan have been sold.
Name Daniel J. Brennan  
Title Executive Vice President and Chief Financial Officer  
Rule 10b5-1 Arrangement Adopted true  
Adoption Date August 26, 2024  
Arrangement Duration 280 days  
Rule Trading Arrangement, Common Stock [Member] | John B. "Brad" Sorenson [Member]    
Trading Arrangements, by Individual    
Aggregate Available 67,198 67,198
Rule Trading Arrangement, Common Stock [Member] | Daniel J. Brennan [Member]    
Trading Arrangements, by Individual    
Aggregate Available 120,672 120,672
Rule Trading Arrangement Performance And Restricted Share Units [Member] | John B. "Brad" Sorenson [Member]    
Trading Arrangements, by Individual    
Aggregate Available 20,383 20,383
Rule Trading Arrangement Performance And Restricted Share Units [Member] | Daniel J. Brennan [Member]    
Trading Arrangements, by Individual    
Aggregate Available 45,062 45,062
Rule Trading Arrangement Stock, Stock Options [Member] | John B. "Brad" Sorenson [Member]    
Trading Arrangements, by Individual    
Aggregate Available 17,362 17,362
Rule Trading Arrangement Stock, Stock Options [Member] | Daniel J. Brennan [Member]    
Trading Arrangements, by Individual    
Aggregate Available 75,610 75,610
v3.24.3
Basis of Presentation Basis of Presentation (Policies)
9 Months Ended
Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Fair Value Measurement FASB ASC Topic 815 requires all derivative and nonderivative instruments to be recognized at their fair values as either assets or liabilities on the balance sheet. We determine the fair value of our derivative and nonderivative instruments using the framework prescribed by FASB ASC Topic 820, Fair Value Measurements and Disclosures
Legal Costs
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. Our accrual for legal matters that are probable and estimable was $250 million as of September 30, 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 $70 million as of September 30, 2024 and $130 million as of December 31, 2023. Refer to Note F – Supplemental Balance Sheet Information for additional information.
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.
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 nine months 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 impacts disclosures only, 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 impacts disclosures only, 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.
v3.24.3
Acquisitions, Divestitures and Strategic Investments (Tables)
9 Months Ended
Sep. 30, 2024
Business Combinations [Abstract]  
Schedule of Business Acquisitions, by Acquisition The preliminary purchase price was comprised of the amount presented below:
(in millions)Silk Road Medical
Payment for acquisition, net of cash acquired$1,126 
$1,126 
(in millions)
Acotec(1)
Apollo
Payment for acquisition, net of cash acquired(2)
$381 $636 
$381 $636 
(1) Excludes approximately $140 million of cash on hand at the closing of the transaction
(2) Related to Acotec, represents our majority stake investment
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed The final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with FASB ASC Topic 805.
(in millions)Silk Road Medical
Goodwill$563 
Amortizable intangible assets507 
Other assets acquired124 
Liabilities assumed(46)
Net deferred tax liabilities(22)
$1,126 
The final purchase price allocations were 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)AcotecApollo
Goodwill$337 $378 
Amortizable intangible assets334 248 
Other assets acquired93 50 
Liabilities assumed(48)(33)
Net deferred tax liabilities(76)(5)
Fair value of noncontrolling interest(259)— 
$381 $636 
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
Rates used in Purchase Price Allocation
Amortizable intangible assets:
Technology-related$447 1213%
Customer relationships61 1213%
$507 
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
Rates used in Purchase Price Allocation
Acotec:
Amortizable intangible assets:
Technology-related$308 1114%
Customer relationships15 1114%
Other intangible assets11 1314%
$334 
Apollo:
Amortizable intangible assets:
Technology-related$222 1112%
Customer relationships26 1112%
$248 
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation
Changes in the fair value of our contingent consideration liability during the first nine months of 2024 associated with prior period acquisitions were as follows:

(in millions)
Balance as of December 31, 2023$404 
Amount recorded related to current year acquisitions29 
Contingent consideration net expense (benefit)(4)
Contingent consideration payments and other adjustments(258)
Balance as of September 30, 2024$171 
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 LiabilityFair Value as of September 30, 2024Valuation TechniqueUnobservable InputRange
Weighted Average(1)
Revenue-based Payments and Milestones$171 millionDiscounted Cash FlowDiscount Rate6%-15%7%
Probability of Payment90%-100%98%
Projected Year of Payment2025-20292027
(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)September 30, 2024December 31, 2023
Equity method investments$256 $219 
Measurement alternative investments(1, 2)
276 194 
$532 $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.
v3.24.3
Goodwill and Other Intangible Assets Goodwill (Tables)
9 Months Ended
Sep. 30, 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 September 30, 2024As of December 31, 2023
(in millions)Gross Carrying AmountAccumulated Amortization/ Write-offsGross Carrying AmountAccumulated Amortization/ Write-offs
Technology-related$13,431 $(8,555)$13,207 $(8,101)
Patents480 (381)480 (387)
Other intangible assets2,270 (1,584)2,130 (1,500)
Amortizable intangible assets$16,181 $(10,521)$15,817 $(9,988)
    
Goodwill$24,933 $(9,900)$24,287 $(9,900)
IPR&D$94 $54 
Technology-related— 120 
Indefinite-lived intangible assets$94 $174 
The increase in our balance of goodwill and amortizable intangible assets is related primarily to our acquisition of Silk Road Medical in the third quarter of 2024.
Schedule of Goodwill
The following represents a roll-forward of our goodwill balance by reportable segment:
(in millions)MedSurgCardiovascularTotal
As of December 31, 2023$5,347 $9,041 $14,387 
Goodwill acquired24 609 633 
Impact of foreign currency fluctuations and purchase price and other adjustments(22)34 12 
As of September 30, 2024$5,349 $9,684 $15,033 
v3.24.3
Hedging Activities and Fair Value Measurements (Tables)
9 Months Ended
Sep. 30, 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 DesignationAs of
September 30, 2024December 31, 2023
Forward currency contractsCash flow hedge$2,763 $2,284 
Forward currency contractsNet investment hedge645 333 
Foreign currency-denominated debt(1)
Net investment hedge997 997 
Forward currency contractsNon-designated3,072 3,282 
Total Notional Outstanding$7,477 $6,896 
(1) Foreign currency-denominated debt is the €900 million debt principal associated with our 2027 Notes designated as a net investment hedge.
Derivative Instruments, Gain (Loss)
Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended September 30, 2024
Forward currency contracts
Cash flow hedges$(86)$19 $(66)Cost of products sold$1,312 $(44)$10 $(34)
Net investment hedges(2)
(35)(27)Interest expense79 (4)(3)
Foreign currency-denominated debt
Net investment hedges(3)
(44)10 (34)Other, net(14)— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense79 (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 TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended September 30, 2023
Forward currency contracts
Cash flow hedges$54 $(12)$42 Cost of products sold$1,101 $(51)$11 $(39)
Net investment hedges(2)
12 (3)Interest expense66 (2)(2)
Foreign currency-denominated debt
Net investment hedges(3)
26 (6)20 Other, net18 — — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest Expense66 (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 TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Nine Months Ended September 30, 2024
Forward currency contracts
Cash flow hedges$22 $(5)$17 Cost of products sold$3,791 $(146)$33 $(113)
Net investment hedges(2)
12 (3)Interest expense225 (12)(10)
Foreign currency-denominated debt
Net investment hedges(3)
(12)(10)Other, net— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense225 (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 TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Nine Months Ended September 30, 2023
Forward currency contracts
Cash flow hedges$141 $(32)$109 Cost of products sold$3,198 $(176)$40 $(136)
Net investment hedges(2)
40 (9)31 Interest expense200 (7)(6)
Foreign currency-denominated debt
Net investment hedges(3)
(2)Other, net78 — — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense200 (0)
(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 September 30, 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 DesignationLocation on Unaudited Consolidated Statements of OperationsAmount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings
Designated Hedging Instrument
Forward currency contractsCash flow hedgeCost of products sold$72 
Forward currency contractsNet investment hedgeInterest expense
Interest rate derivative contractsCash flow hedgeInterest expense(1)
Derivatives Not Designated as Hedging
Net gains and losses on currency hedge contracts not designated as hedging instruments offset by net gains and losses from currency transaction exposures are presented below:
Location on Unaudited Consolidated Statements of OperationsThree Months Ended September 30,Nine Months Ended September 30,
(in millions)2024202320242023
Net gain (loss) on currency hedge contractsOther, net$(48)$10 $(4)$13 
Net gain (loss) on currency transaction exposuresOther, net44 (16)(7)(42)
Net currency exchange gain (loss)$(4)$(6)$(11)$(30)
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)September 30, 2024December 31, 2023
Derivative and Nonderivative Assets:   
Designated Hedging Instruments  
Forward currency contractsOther current assets$146 $140 
Forward currency contractsOther long-term assets20 107 
  166 246 
Non-Designated Hedging Instruments   
Forward currency contractsOther current assets22 20 
Total Derivative and Nonderivative Assets $188 $266 
Derivative and Nonderivative Liabilities:   
Designated Hedging Instruments  
Forward currency contractsOther current liabilities$36 $15 
Forward currency contractsOther long-term liabilities13 
Foreign currency-denominated debt(2)
Long-term debt1,002 988 
  1,052 1,012 
Non-Designated Hedging Instruments   
Forward currency contractsOther current liabilities36 38 
Total Derivative and Nonderivative Liabilities $1,087 $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
 September 30, 2024December 31, 2023
(in millions)Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Assets        
Money market funds and time deposits$1,733 $— $— $1,733 $454 $— $— $454 
Publicly-held equity securities19 — — 19 18 — — 18 
Hedging instruments— 188 — 188 — 266 — 266 
Licensing arrangements— — 37 37 — — 77 77 
 $1,752 $188 $37 $1,977 $472 $266 $77 $816 
Liabilities        
Hedging instruments$— $1,087 $— $1,087 $— $1,050 $— $1,050 
Contingent consideration liability— — 171 171 — — 404 404 
Licensing arrangements— — 41 41 — — 90 90 
 $ $1,087 $212 $1,300 $ $1,050 $494 $1,545 
The recurring Level 3 fair value measurements of our licensing arrangements recognized within our accompanying unaudited consolidated balance sheet as of September 30, 2024 include the following significant unobservable inputs:
Licensing ArrangementsFair Value as of September 30, 2024Valuation TechniqueUnobservable InputRange
Weighted Average (1)
Financial Asset$37 millionDiscounted Cash FlowDiscount Rate15%15%
Projected Year of Payment2024-20252025
Financial Liability$41 millionDiscounted Cash FlowDiscount Rate12 %-15%13%
Projected Year of Payment2024-20262025
(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(31)
Fair value adjustment (expense) benefit(9)
Balance as of September 30, 2024$37 

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(41)
Fair value adjustment expense (benefit)(8)
Balance as of September 30, 2024$41 
v3.24.3
Contractual Obligations and Commitments (Tables)
9 Months Ended
Sep. 30, 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 DateMaturity DateAs of
Coupon Rate(1)
September 30,
2024
December 31,
2023
March 2025 Senior Notes(3)
March 2022March 2025— 1,105 0.750%
June 2025 Senior NotesMay 2020June 2025— 500 1.900%
March 2026 Senior NotesFebruary 2019March 2026255 255 3.750%
December 2027 Senior Notes(3)
November 2019December 20271,007 995 0.625%
March 2028 Senior Notes(3)
March 2022March 2028839 829 1.375%
March 2028 Senior NotesFebruary 2018March 2028344 344 4.000%
March 2029 Senior NotesFebruary 2019March 2029272 272 4.000%
March 2029 Senior Notes(3)
February 2024March 2029839 — 3.375%
June 2030 Senior NotesMay 2020June 20301,200 1,200 2.650%
March 2031 Senior Notes(3)
March 2022March 2031839 829 1.625%
March 2032 Senior Notes(3)
February 2024March 20321,399 — 3.500%
March 2034 Senior Notes(3)
March 2022March 2034560 553 1.875%
November 2035 Senior Notes(2)
November 2005November 2035350 350 6.500%
March 2039 Senior NotesFebruary 2019March 2039450 450 4.550%
January 2040 Senior NotesDecember 2009January 2040300 300 7.375%
March 2049 Senior NotesFebruary 2019March 2049650 650 4.700%
Unamortized Debt Issuance Discount and Deferred Financing Costs2024 - 2049(75)(65)
Finance Lease ObligationVarious
Long-term debt$9,233 $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 September 30, 2024 and December 31, 2023, respectively.
Summary Of Term Loan And Revolving Credit Facility Agreement Compliance With Debt Covenants
As of September 30, 2024, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility.
Covenant RequirementActual
 as of September 30, 2024as of September 30, 2024
Maximum permitted leverage ratio(1)
3.75 times1.95 times
(1) Ratio of total debt to deemed consolidated 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 ArrangementsAs of September 30, 2024As of December 31, 2023
Amount
De-recognized
Weighted Average
Interest Rate
Amount
De-recognized
Weighted Average
Interest Rate
Euro denominated$211 5.5 %$206 5.1 %
Yen denominated199 0.9 %214 0.6 %
Renminbi denominated
27 2.2 %14 2.9 %
v3.24.3
Supplemental Balance Sheet Information (Tables)
9 Months Ended
Sep. 30, 2024
Supplemental Balance Sheet Information [Abstract]  
Trade accounts receivable, net
Trade accounts receivable, net
 As of
(in millions)September 30, 2024December 31, 2023
Trade accounts receivable$2,610 $2,338 
Allowance for credit losses(109)(110)
 $2,501 $2,228 

The following is a roll forward of our Allowance for credit losses:
Three Months Ended September 30,Nine Months Ended
September 30,
(in millions)2024202320242023
Beginning balance$105 $127 $110 $109 
Credit loss expense10 10 30 44 
Write-offs(6)(11)(32)(27)
Ending balance$109 $126 $109 $126 
Inventory Disclosure
Inventories
 As of
(in millions)September 30, 2024December 31, 2023
Finished goods$1,687 $1,537 
Work-in-process206 174 
Raw materials860 773 
 $2,753 $2,484 
Schedule of Other Current Assets
Other current assets
 As of
(in millions)September 30, 2024December 31, 2023
Restricted cash and restricted cash equivalents$70 $130 
Derivative assets168 159 
Licensing arrangements33 47 
Other403 285 
 $674 $621 
Property, plant and equipment, net
Property, plant and equipment, net
 As of
(in millions)September 30, 2024December 31, 2023
Land$143 $140 
Buildings and improvements1,912 1,843 
Equipment, furniture and fixtures3,673 3,503 
Capital in progress966 857 
 6,694 6,343 
Less: accumulated depreciation3,622 3,484 
 $3,072 $2,859 
Schedule of Other Assets
Other long-term assets

 As of
(in millions)September 30, 2024December 31, 2023
Restricted cash equivalents$78 $60 
Operating lease right-of-use assets426 439 
Derivative assets20 107 
Investments532 413 
Licensing arrangements30 
Indemnification asset183 176 
Other400 306 
 $1,642 $1,531 
Schedule of Accrued Liabilities
Accrued expenses
 As of
(in millions)September 30, 2024December 31, 2023
Legal reserves$126 $206 
Payroll and related liabilities1,111 1,051 
Rebates460 389 
Contingent consideration62 304 
Other701 696 
 $2,460 $2,646 
Other Current Liabilities
Other current liabilities
 As of
(in millions)September 30, 2024December 31, 2023
Deferred revenue$290 $266 
Licensing arrangements33 49 
Taxes payable286 220 
Other282 278 
 $891 $814 
Other long-term liabilities
Other long-term liabilities
 As of
(in millions)September 30, 2024December 31, 2023
Accrued income taxes$364 $470 
Legal reserves124 172 
Contingent consideration109 100 
Licensing arrangements41 
Operating lease liabilities373 390 
Deferred revenue328 311 
Other535 484 
 $1,841 $1,967 
v3.24.3
Income Taxes (Tables)
9 Months Ended
Sep. 30, 2024
Income Tax Disclosure [Abstract]  
Schedule of Effective Income Tax Rate from Continuing Operations
Three Months Ended September 30,Nine Months Ended September 30,
2024202320242023
Reported tax rate30.0 %17.3 %24.4 %26.5 %
Impact of certain receipts/charges(1)
(12.3)%(0.2)%(6.0)%(7.3)%
Rate from continuing operations17.7 %17.1 %18.3 %19.2 %
(1)These receipts/charges are taxed at different rates than our rate from continuing operations.
v3.24.3
Weighted Average Shares Outstanding (Tables)
9 Months Ended
Sep. 30, 2024
Earnings Per Share [Abstract]  
Schedule of Weighted Average Number of Shares
NOTE J – WEIGHTED AVERAGE SHARES OUTSTANDING

Three Months Ended September 30,Nine Months Ended September 30,
(in millions)2024202320242023
Weighted average shares outstanding — basic1,472.7 1,464.5 1,470.6 1,448.8 
Net effect of common stock equivalents14.8 10.5 13.9 10.2 
Weighted average shares outstanding - diluted1,487.4 1,475.0 1,484.5 1,459.1 
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 September 30,Nine Months Ended September 30,
(in millions)2024202320242023
Stock options outstanding(1)
00
MCPS(2)
— 13
(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.
v3.24.3
Segment Reporting (Tables)
9 Months Ended
Sep. 30, 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
September 30,
Nine Months Ended
September 30,
Net Sales2024202320242023
MedSurg$1,470 $1,332$4,352 $3,943
Cardiovascular2,709 2,1677,767 6,442
Total net sales of reportable segments4,179 3,49812,118 10,385
Impact of foreign currency fluctuations30 2868 130
$4,209 $3,527$12,186 $10,515
Income (loss) before income taxes
MedSurg$509 $455$1,494 $1,322
Cardiovascular842 5792,256 1,714
Total operating income of reportable segments1,350 1,0343,750 3,036
Unallocated amounts:
Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments(203)(115)(472)(288)
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(209)(19)(719)(370)
Amortization expense(205)(208)(631)(620)
Operating income (loss)733 6931,928 1,759
Other income (expense), net(65)(83)(231)(279)
Income (loss) before income taxes$669 $610$1,697 $1,480

Three Months Ended September 30,Nine Months Ended
September 30,
Operating income margin of reportable segments2024202320242023
MedSurg34.6 %34.2 %34.3 %33.5 %
Cardiovascular31.1 %26.7 %29.0 %26.6 %
v3.24.3
Revenue (Tables)
9 Months Ended
Sep. 30, 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 September 30,
20242023
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$417 $261 $678 $382 $247 $629 
Urology379 153 532 341 142 483 
Neuromodulation211 57 268 175 55 229 
MedSurg1,007 472 1,479 898 443 1,341 
   Interventional Cardiology Therapies212 449 661 182 401 583 
   Watchman342 38 380 291 31 323 
   Cardiac Rhythm Management349 213 561 355 197 552 
    Electrophysiology366 160 527 89 101 190 
Cardiology1,269 859 2,129 918 730 1,647 
Peripheral Interventions316 285 602 283 255 538 
Cardiovascular1,586 1,145 2,731 1,201 984 2,185 
Total Net Sales$2,593 $1,616 $4,209 $2,099 $1,427 $3,527 

Nine Months Ended September 30,
20242023
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$1,227 $769 $1,996 $1,118 $719 $1,836 
Urology1,098 473 1,570 1,007 430 1,437 
Neuromodulation616 191 807 530 177 708 
MedSurg2,941 1,433 4,373 2,655 1,326 3,981 
   Interventional Cardiology Therapies608 1,370 1,977 554 1,248 1,803 
   Watchman996 107 1,103 843 87 930 
   Cardiac Rhythm Management1,054 658 1,713 1,057 609 1,665 
    Electrophysiology795 460 1,255 259 300 560 
Cardiology3,452 2,595 6,048 2,714 2,244 4,958 
Peripheral Interventions924 841 1,765 844 733 1,577 
Cardiovascular4,377 3,436 7,813 3,557 2,977 6,534 
Total Net Sales$7,317 $4,869 $12,186 $6,212 $4,303 $10,515 

Refer to Note K - Segment Reporting for information on our reportable segments.
Three Months Ended September 30,Nine Months Ended September 30,
Geographic Regions2024202320242023
U.S.$2,593 $2,099 $7,317 $6,212 
Europe, Middle East and Africa773 671 2,398 2,107 
Asia-Pacific684 611 2,002 1,784 
Latin America and Canada159 146 469 412 
Total Net Sales$4,209 $3,527 $12,186 $10,515 
Emerging Markets(1)
$684 $594 $2,012 $1,715 
v3.24.3
Changes in Other Comprehensive Income (Tables)
9 Months Ended
Sep. 30, 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 AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of June 30, 2024$13 $159 $(8)$164 
Other comprehensive income (loss) before reclassifications(188)(66)— (255)
(Income) loss amounts reclassified from accumulated other comprehensive income(3)(34)(0)(37)
Total other comprehensive income (loss)(191)(100)(0)(292)
Balance as of September 30, 2024$(179)$59 $(8)$(128)
(in millions)Foreign Currency Translation AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of June 30, 2023$(28)$241 $(4)$208 
Other comprehensive income (loss) before reclassifications23 42 — 64 
(Income) loss amounts reclassified from accumulated other comprehensive income(2)(39)(0)(41)
Total other comprehensive income (loss)21 (0)23 
Balance as of September 30, 2023$(8)$243 $(4)$231 

(in millions)Foreign Currency Translation AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of December 31, 2023$(96)$154 $(8)$49 
Other comprehensive income (loss) before reclassifications(73)17 (56)
(Income) loss amounts reclassified from accumulated other comprehensive income(10)(112)$(0)(122)
Total other comprehensive income (loss)(83)(95)(178)
Balance as of September 30, 2024$(179)$59 $(8)$(128)

(in millions)Foreign Currency Translation AdjustmentNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of December 31, 2022$(1)$269 $1 $269 
Other comprehensive income (loss) before reclassifications(1)109 (5)103 
(Income) loss amounts reclassified from accumulated other comprehensive income(6)(134)(1)(141)
Total other comprehensive income (loss)(7)(25)(5)(37)
Balance as of September 30, 2023$(8)$243 $(4)$231 
v3.24.3
Acquisitions, Divestitures and Strategic Investments - Narrative (Details)
$ / shares in Units, $ in Millions
9 Months Ended
Sep. 17, 2024
USD ($)
$ / shares
Jan. 08, 2024
USD ($)
$ / shares
Apr. 04, 2023
USD ($)
Feb. 20, 2023
USD ($)
Sep. 30, 2024
USD ($)
Sep. 30, 2023
USD ($)
Feb. 20, 2023
$ / shares
Business Acquisition [Line Items]              
Payment for acquisition, net of cash acquired         $ 1,222 $ 1,018  
Uncapped Contingent Considertation         139    
Equity Method Investment, Difference Between Carrying Amount and Underlying Equity         $ 255    
Acotec              
Business Acquisition [Line Items]              
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners         35.00%    
Axonics              
Business Acquisition [Line Items]              
Business Acquisition, Percentage of Voting Interests Acquired   100.00%          
Business Acquisition, Share Price | $ / shares   $ 71.00          
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value   $ 3,670          
Silk Road Medical              
Business Acquisition [Line Items]              
Business Acquisition, Percentage of Voting Interests Acquired 100.00%            
Business Acquisition, Share Price | $ / shares $ 27.50            
Payment for acquisition, net of cash acquired $ 1,126            
Apollo              
Business Acquisition [Line Items]              
Business Acquisition, Percentage of Voting Interests Acquired     100.00%        
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value     $ 636        
Payment for acquisition, net of cash acquired         $ 636    
Acotec              
Business Acquisition [Line Items]              
Business Acquisition, Percentage of Voting Interests Acquired             65.00%
Business Acquisition, Share Price | $ / shares             $ 20.00
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value       $ 519      
Payment for acquisition, net of cash acquired         381    
All Business Acquisitions              
Business Acquisition [Line Items]              
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High         $ 220    
v3.24.3
Acquisitions, Divestitures and Strategic Investments - Price Allocation (Details) - USD ($)
$ in Millions
9 Months Ended
Sep. 17, 2024
Sep. 30, 2024
Sep. 30, 2023
Dec. 31, 2023
Feb. 20, 2023
Business Acquisition [Line Items]          
Payment for acquisition, net of cash acquired   $ 1,222 $ 1,018    
Cash   803   $ 411 $ 140
Silk Road Medical          
Business Acquisition [Line Items]          
Payment for acquisition, net of cash acquired $ 1,126        
Net assets acquired $ 1,126 1,126      
Acotec          
Business Acquisition [Line Items]          
Payment for acquisition, net of cash acquired   381      
Net assets acquired   381      
Apollo          
Business Acquisition [Line Items]          
Payment for acquisition, net of cash acquired   636      
Net assets acquired   $ 636      
v3.24.3
Acquisitions, Divestitures and Strategic Investments - Assets and Liabilities Assumed (Details) - USD ($)
$ in Millions
Sep. 30, 2024
Sep. 17, 2024
Dec. 31, 2023
Business Acquisition [Line Items]      
Goodwill $ 15,033   $ 14,387
Silk Road Medical      
Business Acquisition [Line Items]      
Goodwill   $ 563  
Amortizable intangible assets   507  
Other assets acquired   124  
Liabilities assumed   (46)  
Net deferred tax liabilities   (22)  
Net assets acquired 1,126 $ 1,126  
Acotec      
Business Acquisition [Line Items]      
Goodwill 337    
Amortizable intangible assets 334    
Other assets acquired 93    
Liabilities assumed (48)    
Net deferred tax liabilities (76)    
Fair value of noncontrolling interest (259)    
Net assets acquired 381    
Apollo      
Business Acquisition [Line Items]      
Goodwill 378    
Amortizable intangible assets 248    
Other assets acquired 50    
Liabilities assumed (33)    
Net deferred tax liabilities (5)    
Fair value of noncontrolling interest 0    
Net assets acquired $ 636    
v3.24.3
Acquisitions, Divestitures and Strategic Investments - Intangible Assets Acquired (Details) - USD ($)
$ in Millions
9 Months Ended
Sep. 17, 2024
Sep. 30, 2024
Acotec    
Business Acquisition [Line Items]    
Amortizable intangible assets   $ 334
Acotec | Technology-related    
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 | Technology-related | Weighted Average    
Business Acquisition [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation   14.00%
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 | Customer relationships | Weighted Average    
Business Acquisition [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation   14.00%
Acotec | Other intangible assets    
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 | Other intangible assets | Weighted Average    
Business Acquisition [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation   14.00%
Apollo    
Business Acquisition [Line Items]    
Amortizable intangible assets   $ 248
Apollo | Technology-related    
Business Acquisition [Line Items]    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles   $ 222
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life   11 years
Apollo | Technology-related | Weighted Average    
Business Acquisition [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation   12.00%
Apollo | Customer relationships    
Business Acquisition [Line Items]    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles   $ 26
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life   11 years
Apollo | Customer relationships | Weighted Average    
Business Acquisition [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation   12.00%
Silk Road Medical    
Business Acquisition [Line Items]    
Amortizable intangible assets $ 507  
Silk Road Medical | Technology-related    
Business Acquisition [Line Items]    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles $ 447  
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life 12 years  
Silk Road Medical | Technology-related | Weighted Average    
Business Acquisition [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation 13.00%  
Silk Road Medical | Customer relationships    
Business Acquisition [Line Items]    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles $ 61  
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life 12 years  
Silk Road Medical | Customer relationships | Weighted Average    
Business Acquisition [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation 13.00%  
v3.24.3
Acquisitions, Divestitures and Strategic Investments - Contingent Consideration (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Business Combination, Contingent Consideration, Liability [Roll Forward]        
Balance as of December 31, 2023     $ 404  
Fair value of contingent consideration recorded in purchase accounting     29  
Contingent consideration net expense (benefit) $ (23) $ 12 (4) $ 43
Contingent consideration payments and other adjustments     (258)  
Balance as of September 30, 2024 $ 171   $ 171  
v3.24.3
Acquisitions, Divestitures and Strategic Investments - Level 3 Contingent Consideration (Details) - USD ($)
$ in Millions
Sep. 30, 2024
Dec. 31, 2023
Business Acquisition [Line Items]    
Contingent Consideration Liability $ 171 $ 404
Revenue-based Payments and Milestones | Discount Rate    
Business Acquisition [Line Items]    
Contingent Consideration Liability $ 171  
Revenue-based Payments and Milestones | Discount Rate | Minimum    
Business Acquisition [Line Items]    
contingent consideration liability, probability of payment 90.00%  
Risk-Adjusted Discount Rates used in Purchase Price Allocation 6.00%  
Revenue-based Payments and Milestones | Discount Rate | Maximum    
Business Acquisition [Line Items]    
contingent consideration liability, probability of payment 100.00%  
Risk-Adjusted Discount Rates used in Purchase Price Allocation 15.00%  
Revenue-based Payments and Milestones | Discount Rate | Weighted Average    
Business Acquisition [Line Items]    
contingent consideration liability, probability of payment 98.00%  
Risk-Adjusted Discount Rates used in Purchase Price Allocation 7.00%  
v3.24.3
Acquisitions, Divestitures and Strategic Investments - Strategic Investments (Details) - USD ($)
$ in Millions
Sep. 30, 2024
Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]    
Equity method investments $ 256 $ 219
Measurement alternative investments(1, 2) 276 194
Investments $ 532 $ 413
v3.24.3
Goodwill and Other Intangible Assets (Details) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2024
Dec. 31, 2023
Intangible Assets and Goodwill [Line Items]    
Gross Carrying Amount $ 16,181 $ 15,817
Accumulated Amortization/ Write-offs (10,521) (9,988)
Indefinite-lived Intangible Assets (Excluding Goodwill) 94 174
Goodwill [Roll Forward]    
Goodwill Beginning Balance 14,387  
Goodwill acquired 633  
Impact of foreign currency fluctuations and purchase price and other adjustments 12  
Goodwill Ending Balance 15,033  
MedSurg    
Goodwill [Roll Forward]    
Goodwill Beginning Balance 5,347  
Goodwill acquired 24  
Impact of foreign currency fluctuations and purchase price and other adjustments (22)  
Goodwill Ending Balance 5,349  
Cardiovascular    
Goodwill [Roll Forward]    
Goodwill Beginning Balance 9,041  
Goodwill acquired 609  
Impact of foreign currency fluctuations and purchase price and other adjustments 34  
Goodwill Ending Balance 9,684  
Goodwill    
Intangible Assets and Goodwill [Line Items]    
Goodwill, Gross 24,933 24,287
Goodwill, Impaired, Accumulated Impairment Loss (9,900) (9,900)
IPR&D    
Intangible Assets and Goodwill [Line Items]    
Indefinite-lived Intangible Assets (Excluding Goodwill) 94 54
Technology-related    
Intangible Assets and Goodwill [Line Items]    
Indefinite-lived Intangible Assets (Excluding Goodwill) 0 120
Technology-related    
Intangible Assets and Goodwill [Line Items]    
Gross Carrying Amount 13,431 13,207
Accumulated Amortization/ Write-offs (8,555) (8,101)
Patents    
Intangible Assets and Goodwill [Line Items]    
Gross Carrying Amount 480 480
Accumulated Amortization/ Write-offs (381) (387)
Other intangible assets    
Intangible Assets and Goodwill [Line Items]    
Gross Carrying Amount 2,270 2,130
Accumulated Amortization/ Write-offs $ (1,584) $ (1,500)
v3.24.3
Goodwill and Other Intangible Assets - Narrative (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]        
Intangible asset impairment charges $ 0 $ 1 $ 276 $ 58
v3.24.3
Hedging Activities and Fair Value Measurements - Narrative (Details)
€ in Millions, $ in Millions
9 Months Ended
Sep. 30, 2024
USD ($)
derivative_instrument
Rate
Sep. 30, 2024
EUR (€)
derivative_instrument
Rate
Dec. 31, 2023
USD ($)
derivative_instrument
Dec. 31, 2023
EUR (€)
derivative_instrument
Feb. 20, 2023
USD ($)
Derivative [Line Items]          
Cash $ 803   $ 411   $ 140
Debt Instrument, Fair Value Disclosure 10,734   8,735    
Fair Value, Measurements, Recurring [Member]          
Derivative [Line Items]          
Money Market Funds, at Carrying Value 1,733   454    
Fair Value, Inputs, Level 1 [Member] | Fair Value, Measurements, Recurring [Member]          
Derivative [Line Items]          
Money Market Funds, at Carrying Value $ 1,733   $ 454    
Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member]          
Derivative [Line Items]          
Number of Interest Rate Derivatives Held | derivative_instrument 0 0 0 0  
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | Minimum          
Derivative [Line Items]          
Forward Currency Contracts, Time to Maturity 1 year        
Designated as Hedging Instrument [Member] | Net Investment Hedging [Member] | Maximum          
Derivative [Line Items]          
Forward Currency Contracts, Time to Maturity 2 years        
Designated as Hedging Instrument [Member] | Fair Value Hedging          
Derivative [Line Items]          
Number of Interest Rate Derivatives Held | derivative_instrument 0 0 0 0  
Foreign Exchange Forward | Not Designated as Hedging Instrument [Member]          
Derivative [Line Items]          
Derivative, Term of Contract (less than) 1 year        
Derivative, Remaining Maturity 1 year 1 year      
Foreign Exchange Contract [Member] | Designated as Hedging Instrument [Member] | Cash Flow Hedging [Member]          
Derivative [Line Items]          
Forward Currency Contracts, Time to Maturity 36 months        
December 2027 Notes [Member]          
Derivative [Line Items]          
Long-term Debt $ 1,007 € 900 $ 995 € 900  
Debt Instrument, Interest Rate, Stated Percentage | Rate 0.625% 0.625%      
v3.24.3
Hedging Activities and Fair Value Measurements - Notional Amounts (Details)
€ in Millions, $ in Millions
Sep. 30, 2024
USD ($)
Sep. 30, 2024
EUR (€)
Dec. 31, 2023
USD ($)
Dec. 31, 2023
EUR (€)
Derivative [Line Items]        
Derivative, Notional Amount $ 7,477   $ 6,896  
December 2027 Notes [Member]        
Derivative [Line Items]        
Long-term Debt 1,007 € 900 995 € 900
Foreign Exchange Contract [Member] | Not Designated as Hedging Instrument [Member]        
Derivative [Line Items]        
Derivative, Notional Amount 3,072   3,282  
Foreign Exchange Contract [Member] | Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member]        
Derivative [Line Items]        
Derivative, Notional Amount 2,763   2,284  
Foreign Exchange Contract [Member] | Net Investment Hedging [Member] | Designated as Hedging Instrument [Member]        
Derivative [Line Items]        
Derivative, Notional Amount 645   333  
foreign currency denominated in debt [Member] | Net Investment Hedging [Member] | Designated as Hedging Instrument [Member]        
Derivative [Line Items]        
Derivative, Notional Amount $ 997   $ 997  
v3.24.3
Hedging Activities and Fair Value Measurements - Effect of Hedging Relationships on Accumulated Other Comprehensive Income (Details) - USD ($)
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]        
Cost of products sold $ 1,312,000,000 $ 1,101,000,000 $ 3,791,000,000 $ 3,198,000,000
Interest Expense 79,000,000 66,000,000 225,000,000 200,000,000
Other Operating Income (Expense), Net (14,000,000) 18,000,000 7,000,000 78,000,000
Foreign Currency Translation Adjustment        
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]        
Reclassification from AOCI, Current Period, Net of Tax, Attributable to Parent 0 0 0 0
Foreign Exchange Contract [Member] | Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Cost of Sales [Member]        
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]        
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax (86,000,000) 54,000,000 22,000,000 141,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax 19,000,000 (12,000,000) (5,000,000) (32,000,000)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax (66,000,000) 42,000,000 17,000,000 109,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax (44,000,000) (51,000,000) (146,000,000) (176,000,000)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax 10,000,000 11,000,000 33,000,000 40,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax (34,000,000) (39,000,000) (113,000,000) (136,000,000)
Foreign Exchange Contract [Member] | Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | Interest Expense [Member]        
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]        
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax (35,000,000) 12,000,000 12,000,000 40,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax 8,000,000 (3,000,000) (3,000,000) (9,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax (27,000,000) 9,000,000 9,000,000 31,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, before Tax (4,000,000) (2,000,000) (12,000,000) (7,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, Tax 1,000,000 1,000,000 3,000,000 2,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, after Tax (3,000,000) (2,000,000) (10,000,000) (6,000,000)
foreign currency denominated in debt [Member] | Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | Interest Expense [Member]        
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]        
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax (44,000,000) 26,000,000 (12,000,000) 8,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax 10,000,000 (6,000,000) 3,000,000 (2,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax (34,000,000) 20,000,000 (10,000,000) 6,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, before Tax 0 0 0 0
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, Tax 0 0 0 0
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, after Tax 0 0 0 0
Interest Rate Contract [Member] | Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Interest Expense [Member]        
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]        
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax 0 0 0 0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax 0 0 0 0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax 0 0 0 0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax 0 1,000,000 1,000,000 2,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax 0 0 0 0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax $ 0 $ 1,000,000 $ 1,000,000 $ 2,000,000
v3.24.3
Hedging Activities and Fair Value Measurements - Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings (Details)
$ in Millions
Sep. 30, 2024
USD ($)
Foreign Exchange Contract [Member] | Cash Flow Hedging [Member] | Cost of Sales [Member]  
Derivative Instruments and Hedging Activities Disclosures [Line Items]  
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months $ 72
Foreign Exchange Contract [Member] | Net Investment Hedging [Member] | Interest Expense [Member]  
Derivative Instruments and Hedging Activities Disclosures [Line Items]  
Derivative Used in Net Investment Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net 6
Interest Rate Contract [Member] | Cash Flow Hedging [Member] | Interest Expense [Member]  
Derivative Instruments and Hedging Activities Disclosures [Line Items]  
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net $ (1)
v3.24.3
Hedging Activities and Fair Value Measurements - Location on Unaudited Consolidated Statements of Operations (Details) - Not Designated as Hedging Instrument [Member] - Other Nonoperating Income (Expense) [Member] - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Derivative Instruments and Hedging Activities Disclosures [Line Items]        
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments $ (48) $ 10 $ (4) $ 13
Foreign Currency Transaction Gain (Loss), before Tax 44 (16) (7) (42)
Net currency exchange gain (loss) $ (4) $ (6) $ (11) $ (30)
v3.24.3
Hedging Activities and Fair Value Measurements - Balance Sheet Location (Details)
€ in Millions, $ in Millions
Sep. 30, 2024
EUR (€)
Sep. 30, 2024
USD ($)
Dec. 31, 2023
EUR (€)
Dec. 31, 2023
USD ($)
Derivatives, Fair Value [Line Items]        
Derivative Asset, Fair Value, Gross Asset   $ 188   $ 266
Derivative Liability, Fair Value, Gross Liability   1,087   1,050
December 2027 Notes [Member]        
Derivatives, Fair Value [Line Items]        
Long-term Debt € 900 1,007 € 900 995
Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments in Hedges, Assets, at Fair Value   166   246
Derivative Instruments in Hedges, Liabilities, at Fair Value   1,052   1,012
Prepaid Expenses and Other Current Assets [Member] | Foreign Exchange Contract [Member] | Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments in Hedges, Assets, at Fair Value   146   140
Prepaid Expenses and Other Current Assets [Member] | Foreign Exchange Contract [Member] | Not Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments Not Designated as Hedging Instruments, Asset, at Fair Value   22   20
Other Noncurrent Assets [Member] | Foreign Exchange Contract [Member] | Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments in Hedges, Assets, at Fair Value   20   107
Other Current Liabilities [Member] | Foreign Exchange Contract [Member] | Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments in Hedges, Liabilities, at Fair Value   36   15
Other Current Liabilities [Member] | Foreign Exchange Contract [Member] | Not Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments Not Designated as Hedging Instruments, Liability, at Fair Value   36   38
Other Noncurrent Liabilities [Member] | Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments in Hedges, Liabilities, at Fair Value   1,002   988
Other Noncurrent Liabilities [Member] | Foreign Exchange Contract [Member] | Designated as Hedging Instrument [Member]        
Derivatives, Fair Value [Line Items]        
Derivative Instruments in Hedges, Liabilities, at Fair Value   $ 13   $ 9
v3.24.3
Hedging Activities and Fair Value Measurements - Fair Value (Details) - USD ($)
$ in Millions
Sep. 30, 2024
Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Derivative Asset $ 20 $ 107
Licensing arrangements, asset 4 30
Contingent Consideration Liability 171 404
Licensing arrangements, liability 8 41
Fair Value, Measurements, Recurring [Member]    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Money Market Funds, at Carrying Value 1,733 454
Equity Securities, FV-NI 19 18
Derivative Asset 188 266
Licensing arrangements, asset 37 77
Assets, Fair Value Disclosure 1,977 816
Derivative Liability 1,087 1,050
Contingent Consideration Liability 171 404
Licensing arrangements, liability 41 90
Financial and Nonfinancial Liabilities, Fair Value Disclosure 1,300 1,545
Fair Value, Inputs, Level 1 [Member] | Fair Value, Measurements, Recurring [Member]    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Money Market Funds, at Carrying Value 1,733 454
Equity Securities, FV-NI 19 18
Derivative Asset 0 0
Licensing arrangements, asset 0 0
Assets, Fair Value Disclosure 1,752 472
Derivative Liability 0 0
Contingent Consideration Liability 0 0
Licensing arrangements, liability 0 0
Financial and Nonfinancial Liabilities, Fair Value Disclosure 0 0
Fair Value, Inputs, Level 2 [Member] | Fair Value, Measurements, Recurring [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 188 266
Licensing arrangements, asset 0 0
Assets, Fair Value Disclosure 188 266
Derivative Liability 1,087 1,050
Contingent Consideration Liability 0 0
Licensing arrangements, liability 0 0
Financial and Nonfinancial Liabilities, Fair Value Disclosure 1,087 1,050
Fair Value, Inputs, Level 3 [Member]    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Licensing arrangements, asset 37  
Licensing arrangements, liability 41  
Fair Value, Inputs, Level 3 [Member] | Fair Value, Measurements, Recurring [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 37 77
Assets, Fair Value Disclosure 37 77
Derivative Liability 0 0
Contingent Consideration Liability 171 404
Licensing arrangements, liability 41 90
Financial and Nonfinancial Liabilities, Fair Value Disclosure $ 212 $ 494
v3.24.3
Hedging Activities and Fair Value Measurements - Licensing Arrangements (Details) - USD ($)
$ in Millions
Sep. 30, 2024
Dec. 31, 2023
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]    
Licensing arrangements, asset $ 4 $ 30
Licensing arrangements, liability $ 8 $ 41
Licensing arrangement assets [Member]    
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation 15.00%  
Licensing arrangement assets [Member] | Weighted Average    
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation 15.00%  
Licensing arrangement liabilities [Member] | Weighted Average    
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation 13.00%  
Licensing arrangement liabilities [Member] | Minimum    
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation 12.00%  
Licensing arrangement liabilities [Member] | Maximum    
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]    
Risk-Adjusted Discount Rates used in Purchase Price Allocation 15.00%  
Fair Value, Inputs, Level 3 [Member]    
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]    
Licensing arrangements, asset $ 37  
Licensing arrangements, liability $ 41  
v3.24.3
Hedging Activities and Fair Value Measurements - Change in Fair Value (Details)
$ in Millions
9 Months Ended
Sep. 30, 2024
USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]  
Licensing arrangements, asset $ 30
Licensing arrangements, liability 41
Licensing arrangements, asset 4
Licensing arrangements, liability 8
Licensing arrangement assets [Member]  
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]  
Proceeds from royalty rights (31)
Fair value adjustment (expense) benefit (9)
Licensing arrangement liabilities [Member]  
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]  
Payments for Royalties (41)
Fair value adjustment (expense) benefit (8)
Fair Value, Measurements, Recurring [Member]  
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]  
Licensing arrangements, asset 77
Licensing arrangements, liability 90
Licensing arrangements, asset 37
Licensing arrangements, liability 41
Fair Value, Inputs, Level 3 [Member]  
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]  
Licensing arrangements, asset 37
Licensing arrangements, liability 41
Fair Value, Inputs, Level 3 [Member] | Fair Value, Measurements, Recurring [Member]  
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]  
Licensing arrangements, asset 77
Licensing arrangements, liability 90
Licensing arrangements, asset 37
Licensing arrangements, liability $ 41
v3.24.3
Contractual Obligations and Commitments (Details)
€ in Millions
9 Months Ended 12 Months Ended
Sep. 30, 2024
USD ($)
Rate
Sep. 30, 2023
USD ($)
Dec. 31, 2023
USD ($)
Rate
Sep. 30, 2024
EUR (€)
Rate
Feb. 22, 2024
EUR (€)
Dec. 31, 2023
EUR (€)
May 10, 2021
USD ($)
Debt Instrument [Line Items]              
Total debt $ 10,885,000,000   $ 9,102,000,000        
Debt, Current 1,652,000,000   531,000,000        
Long-term Debt and Capital Lease Obligations 9,233,000,000   8,571,000,000        
Exclusion from EBITDA for Restructuring Charges 500,000,000            
Restructuring charges remaining to be excluded from calculation of consolidated EBITDA 401,000,000            
Amount excluded from debt in leverage ratio 2,218,000,000            
Legal payments remaining to be excluded from calculation of consolidated EBITDA 1,442,000,000            
Letters of Credit Outstanding, Amount 216,000,000   174,000,000        
Qualified Acquisition Consideration 1,000,000,000.000            
Proceeds from Issuance of Senior Long-Term Debt 2,145,000,000 $ 0          
Supplier Finance Program Obligation. current 137,000,000   152,000,000        
Litigation payment exclusion from EBITDA $ 1,000,000,000.000            
AMS Europe              
Debt Instrument [Line Items]              
Debt Instrument, Redemption Price, Percentage 101.00%            
Commercial Paper [Member]              
Debt Instrument [Line Items]              
Debt, Current $ 0   0        
Current Requirement [Member]              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 3.75     3.75      
Actual, Covenant [Member]              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 1.95     1.95      
Requirement, as of December 31, 2021 and through remaining term of facility              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 3.75     3.75      
Requirement, four succeeding quarters following qualified acquisition              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 4.75     4.75      
Requirement, fifth quarter following qualified acquisition [Member]              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 4.50     4.50      
Requirement, sixth quarter following qualified acquisition              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 4.25     4.25      
Requirement, seventh quarter following qualified acquisition              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 4.00     4.00      
Requirement, eighth quarter following qualified acquisition and through remaining term of facility              
Debt Instrument [Line Items]              
Maximum Leverage Ratio 3.75     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
March 2024 Notes [Member]              
Debt Instrument [Line Items]              
Debt Instrument, Interest Rate, Stated Percentage 3.45%     3.45%      
March 2025 Notes              
Debt Instrument [Line Items]              
Long-term Debt $ 0   1,105,000,000        
Debt Instrument, Interest Rate, Stated Percentage | Rate 0.75%     0.75%      
June 2025 Notes [Member]              
Debt Instrument [Line Items]              
Long-term Debt $ 0   500,000,000        
Debt Instrument, Interest Rate, Stated Percentage | Rate 1.90%     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 | Rate 3.75%     3.75%      
December 2027 Notes [Member]              
Debt Instrument [Line Items]              
Long-term Debt $ 1,007,000,000   995,000,000 € 900   € 900  
Debt Instrument, Interest Rate, Stated Percentage | Rate 0.625%     0.625%      
March 2028 Senior Notes              
Debt Instrument [Line Items]              
Long-term Debt $ 839,000,000   829,000,000        
Debt Instrument, Interest Rate, Stated Percentage | Rate 1.375%     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 | Rate 4.00%     4.00%      
March 2029 Notes [Member]              
Debt Instrument [Line Items]              
Long-term Debt $ 272,000,000   272,000,000        
Debt Instrument, Interest Rate, Stated Percentage | Rate 4.00%     4.00%      
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 | Rate 2.65%     2.65%      
March 2031 Notes              
Debt Instrument [Line Items]              
Long-term Debt $ 839,000,000   829,000,000        
Debt Instrument, Interest Rate, Stated Percentage | Rate 1.625%     1.625%      
March 2034 Notes              
Debt Instrument [Line Items]              
Long-term Debt $ 560,000,000   553,000,000        
Debt Instrument, Interest Rate, Stated Percentage | Rate 1.875%     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 | Rate 6.50%     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%     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 | Rate 4.55%     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 | Rate 7.375%     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 | Rate 4.70%     4.70%      
Senior Notes [Member]              
Debt Instrument [Line Items]              
Long-term Debt $ 10,924,000,000   9,136,000,000        
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net (75,000,000)   (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 $ 839,000,000   0   750    
Debt Instrument, Interest Rate, Stated Percentage | Rate 3.375%     3.375%      
March 2032 Euro Senior Notes              
Debt Instrument [Line Items]              
Long-term Debt $ 1,399,000,000   0   € 1,250    
Debt Instrument, Interest Rate, Stated Percentage | Rate 3.50%     3.50%      
Euro Denominated Factoring Arrangements [Member]              
Debt Instrument [Line Items]              
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized $ 211,000,000   $ 206,000,000        
Average interest rate of de-recognized receivables | Rate 5.50%   5.10%        
Yen Denominated Factoring Arrangements [Member]              
Debt Instrument [Line Items]              
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized $ 199,000,000   $ 214,000,000        
Average interest rate of de-recognized receivables | Rate 0.90%   0.60%        
Renminbi Denominated Factoring Arrangements [Member]              
Debt Instrument [Line Items]              
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized $ 27,000,000   $ 14,000,000        
Average interest rate of de-recognized receivables | Rate 2.20%   2.90%        
v3.24.3
Supplemental Balance Sheet Information (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Dec. 31, 2023
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Line Items]          
Depreciation $ 102 $ 93 $ 290 $ 263  
Trade accounts receivable, net          
Accounts receivable 2,610   2,610   $ 2,338
Less: allowance for doubtful accounts (109)   (109)   (110)
Trade accounts receivable, net 2,501   2,501   2,228
Allowance for doubtful accounts          
Beginning balance 105 127 110 109  
Charges to expenses 10 10 30 44  
Utilization of allowances (6) (11) (32) (27)  
Ending balance 109 126 109 126  
Inventories          
Inventory, Finished Goods, Net of Reserves 1,687   1,687   1,537
Inventory, Work in Process, Net of Reserves 206   206   174
Inventory, Raw Materials, Net of Reserves 860   860   773
Inventories 2,753   2,753   2,484
Other Current Assets [Abstract]          
Restricted Cash and Cash Equivalents in Other current assets 70 123 70 123 130
Derivative Asset, Current 168   168   159
Licensing arrangements 33   33   47
Other Assets, Miscellaneous, Current 403   403   285
Other Assets, Current 674   674   621
Property, plant and equipment, net          
Land 143   143   140
Buildings and improvements 1,912   1,912   1,843
Equipment, furniture and fixtures 3,673   3,673   3,503
Capital in progress 966   966   857
Property, plant and equipment 6,694   6,694   6,343
Less: accumulated depreciation 3,622   3,622   3,484
Property, plant and equipment, net 3,072   3,072   2,859
Other Assets, Noncurrent [Abstract]          
Restricted cash equivalents included in Other long-term assets 78 $ 58 78 $ 58 60
Operating Lease, Right-of-Use Asset 426   426   439
Derivative Asset 20   20   107
Investments 532   532   413
Licensing arrangements, asset 4   4   30
Indemnification asset 183   183   176
Other, Other Long-term Assets 400   400   306
Other Assets, Noncurrent 1,642   1,642   1,531
Accrued expenses          
Legal reserves, current 126   126   206
Payroll and related liabilities 1,111   1,111   1,051
Accrued Rebates, Current 460   460   389
Business Combination, Contingent Consideration, Liability, Current 62   62   304
Other 701   701   696
Accrued Liabilities, Current 2,460   2,460   2,646
Other Liabilities, Current [Abstract]          
Deferred Revenue, Current 290   290   266
Licensing Arrangements 33   33   49
Taxes Payable, Current 286   286   220
Other 282   282   278
Other Liabilities, Current 891   891   814
Other long-term liabilities          
Accrued income taxes 364   364   470
Estimated Litigation Liability, Noncurrent 124   124   172
Business Combination, Contingent Consideration, Liability, Noncurrent 109   109   100
Licensing arrangements, liability 8   8   41
Operating Lease, Liability, Noncurrent 373   373   390
Deferred Revenue 328   328   311
Other Accrued Liabilities, Noncurrent 535   535   484
Other long-term liabilities $ 1,841   $ 1,841   $ 1,967
v3.24.3
Income Taxes - Tax Rate Schedule (Details)
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Effective Income Tax Rate Reconciliation, Percent [Abstract]        
Reported tax rate 30.00% 17.30% 24.40% 26.50%
Impact of certain receipts/charges (12.30%) (0.20%) (6.00%) (7.30%)
Rate from continuing operations 17.70% 17.10% 18.30% 19.20%
v3.24.3
Income Taxes - Narrative (Details) - USD ($)
$ in Millions
Sep. 30, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]    
Unrecognized Tax Benefits $ 493 $ 467
Unrecognized Tax Benefits that Would Impact Effective Tax Rate 417 $ 395
Decrease in Unrecognized Tax Benefits is Reasonably Possible $ 9  
v3.24.3
Commitments and Contingencies (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Jan. 31, 2023
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Jun. 05, 2024
Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]              
Accrual for legal matters that are probable and estimable   $ 250.0   $ 250.0     $ 377.0
Restricted Cash and Cash Equivalents in Other current assets   70.0 $ 123.0 70.0 $ 123.0   $ 130.0
Litigation Settlement, Amount Awarded to Other Party $ 42.0            
Pre-Judgement Interest           $ 7.0  
Litigation-related net charges (credits)   $ 0.0 $ (111.0) $ 0.0 $ (111.0)    
v3.24.3
Stockholders' Equity (Details)
$ / shares in Units, $ in Millions
9 Months Ended
May 27, 2020
USD ($)
$ / shares
shares
Sep. 30, 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 $0.01 per share        
Class of Stock [Line Items]        
Conversion of Stock, Shares Converted   24,000,000    
v3.24.3
Weighted Average Shares Outstanding (Details) - shares
shares in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]        
Weighted average shares outstanding — basic 1,472.7 1,464.5 1,470.6 1,448.8
Net effect of common stock equivalents 14.8 10.5 13.9 10.2
Weighted average shares outstanding - diluted 1,487.4 1,475.0 1,484.5 1,459.1
Share-based Payment Arrangement, Option        
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]        
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount 0.0 0.0 0.0 0.0
5.50% MCPS, Series A [Member]        
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]        
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount 0.0 0.0 0.0 13.0
v3.24.3
Weighted Average Shares Outstanding - Narrative (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Dec. 14, 2020
Earnings Per Share [Abstract]          
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture 2,000,000 2,000,000 8,000,000 32,000,000  
Stock Repurchased During Period, Shares     0 0  
Stock Repurchase Program, Authorized Amount         $ 1,000
v3.24.3
Segment Reporting (Details)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
USD ($)
Sep. 30, 2023
USD ($)
Sep. 30, 2024
USD ($)
reportablesegments
Sep. 30, 2023
USD ($)
Segment Reporting [Abstract]        
Number of reportable segments | reportablesegments     2  
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]        
Amortization expense $ (205) $ (208) $ (631) $ (620)
Operating income (loss) 733 693 1,928 1,759
Other expense, net (65) (83) (231) (279)
Income (loss) before income taxes 669 610 1,697 1,480
Impact of Foreign Currency Fluctuations on Net Sales 30 28 68 130
Net sales 4,209 3,527 12,186 10,515
MedSurg        
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]        
Operating Income Allocated to Reportable Segments 509 455 1,494 1,322
Revenues from contracts with customers, disaggregated - performance measurement $ 1,470 $ 1,332 $ 4,352 $ 3,943
Segment operating income as percentage of net sales 34.60% 34.20% 34.30% 33.50%
Net sales $ 1,479 $ 1,341 $ 4,373 $ 3,981
Cardiovascular        
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]        
Operating Income Allocated to Reportable Segments 842 579 2,256 1,714
Revenues from contracts with customers, disaggregated - performance measurement $ 2,709 $ 2,167 $ 7,767 $ 6,442
Segment operating income as percentage of net sales 31.10% 26.70% 29.00% 26.60%
Net sales $ 2,731 $ 2,185 $ 7,813 $ 6,534
BSX Reportable Segments [Member]        
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]        
Revenues from contracts with customers, disaggregated - performance measurement 4,179 3,498 12,118 10,385
Total allocated to reportable segments [Member]        
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]        
Operating income (loss) 1,350 1,034 3,750 3,036
Corporate expenses and currency exchange [Member]        
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]        
Operating Income Unallocated to Segment (203) (115) (472) (288)
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 $ (209) $ (19) $ (719) $ (370)
v3.24.3
Revenue - Narrative (Details)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
USD ($)
Sep. 30, 2024
USD ($)
business
Dec. 31, 2023
USD ($)
Revenue from Contract with Customer [Abstract]      
Contract with Customer, Liability $ 618 $ 618 $ 577
Contract with Customer, Liability, Revenue Recognized $ 57 $ 177  
Number of Operating Segments | business   5  
v3.24.3
Revenue - Disaggregation of Revenue (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Disaggregation of Revenue [Line Items]        
Net sales $ 4,209 $ 3,527 $ 12,186 $ 10,515
MedSurg        
Disaggregation of Revenue [Line Items]        
Net sales 1,479 1,341 4,373 3,981
Cardiovascular        
Disaggregation of Revenue [Line Items]        
Net sales 2,731 2,185 7,813 6,534
United States        
Disaggregation of Revenue [Line Items]        
Net sales 2,593 2,099 7,317 6,212
United States | MedSurg        
Disaggregation of Revenue [Line Items]        
Net sales 1,007 898 2,941 2,655
United States | Cardiovascular        
Disaggregation of Revenue [Line Items]        
Net sales 1,586 1,201 4,377 3,557
International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 1,616 1,427 4,869 4,303
International [Member] | MedSurg        
Disaggregation of Revenue [Line Items]        
Net sales 472 443 1,433 1,326
International [Member] | Cardiovascular        
Disaggregation of Revenue [Line Items]        
Net sales 1,145 984 3,436 2,977
Endoscopy [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 678 629 1,996 1,836
Endoscopy [Member] | United States        
Disaggregation of Revenue [Line Items]        
Net sales 417 382 1,227 1,118
Endoscopy [Member] | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 261 247 769 719
Urology [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 532 483 1,570 1,437
Urology [Member] | United States        
Disaggregation of Revenue [Line Items]        
Net sales 379 341 1,098 1,007
Urology [Member] | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 153 142 473 430
Neuromodulation [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 268 229 807 708
Neuromodulation [Member] | United States        
Disaggregation of Revenue [Line Items]        
Net sales 211 175 616 530
Neuromodulation [Member] | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 57 55 191 177
Interventional Cardiology Therapies        
Disaggregation of Revenue [Line Items]        
Net sales 661 583 1,977 1,803
Interventional Cardiology Therapies | United States        
Disaggregation of Revenue [Line Items]        
Net sales 212 182 608 554
Interventional Cardiology Therapies | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 449 401 1,370 1,248
Watchman        
Disaggregation of Revenue [Line Items]        
Net sales 380 323 1,103 930
Watchman | United States        
Disaggregation of Revenue [Line Items]        
Net sales 342 291 996 843
Watchman | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 38 31 107 87
Cardiac Rhythm Management [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 561 552 1,713 1,665
Cardiac Rhythm Management [Member] | United States        
Disaggregation of Revenue [Line Items]        
Net sales 349 355 1,054 1,057
Cardiac Rhythm Management [Member] | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 213 197 658 609
Electrophysiology [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 527 190 1,255 560
Electrophysiology [Member] | United States        
Disaggregation of Revenue [Line Items]        
Net sales 366 89 795 259
Electrophysiology [Member] | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 160 101 460 300
Cardiology [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 2,129 1,647 6,048 4,958
Cardiology [Member] | United States        
Disaggregation of Revenue [Line Items]        
Net sales 1,269 918 3,452 2,714
Cardiology [Member] | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 859 730 2,595 2,244
Peripheral Interventions [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 602 538 1,765 1,577
Peripheral Interventions [Member] | United States        
Disaggregation of Revenue [Line Items]        
Net sales 316 283 924 844
Peripheral Interventions [Member] | International [Member]        
Disaggregation of Revenue [Line Items]        
Net sales $ 285 $ 255 $ 841 $ 733
v3.24.3
Revenue - Revenue by Geography (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Disaggregation of Revenue [Line Items]        
Net sales $ 4,209 $ 3,527 $ 12,186 $ 10,515
United States        
Disaggregation of Revenue [Line Items]        
Net sales 2,593 2,099 7,317 6,212
United States | BSX Reportable Segments [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 2,593 2,099 7,317 6,212
EMEA [Member] | BSX Reportable Segments [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 773 671 2,398 2,107
APAC [Member] | BSX Reportable Segments [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 684 611 2,002 1,784
Latin America and Canada [Member] | BSX Reportable Segments [Member]        
Disaggregation of Revenue [Line Items]        
Net sales 159 146 469 412
Emerging Markets [Member]        
Disaggregation of Revenue [Line Items]        
Net sales $ 684 $ 594 $ 2,012 $ 1,715
v3.24.3
Changes in Other Comprehensive Income (AOCI Rollforward with Reclassification) (Details) - USD ($)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]        
Beginning Stockholders' Equity     $ 19,282  
Other comprehensive income (loss) $ (282) $ 23 (173) $ (37)
Ending Stockholders' Equity 20,708 18,886 20,708 18,886
Accumulated other comprehensive income (loss), net of tax        
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]        
Beginning Stockholders' Equity 164 208 49 269
Other comprehensive income (loss) before reclassifications (255) 64 (56) 103
(Income) loss amounts reclassified from accumulated other comprehensive income (37) (41) (122) (141)
Other comprehensive income (loss) (292) 23 (178) (37)
Ending Stockholders' Equity (128) 231 (128) 231
Foreign Currency Translation Adjustment        
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]        
Beginning Stockholders' Equity 13 (28) (96) (1)
Other comprehensive income (loss) before reclassifications (188) 23 (73) (1)
(Income) loss amounts reclassified from accumulated other comprehensive income (3) (2) (10) (6)
Other comprehensive income (loss) (191) 21 (83) (7)
Ending Stockholders' Equity (179) (8) (179) (8)
Net Change in Derivative Financial Instruments        
AOCI attributable to Boston Scientific common stockholders, Net of Tax [Roll Forward]        
Beginning Stockholders' Equity 159 241 154 269
Other comprehensive income (loss) before reclassifications (66) 42 17 109
(Income) loss amounts reclassified from accumulated other comprehensive income (34) (39) (112) (134)
Other comprehensive income (loss) (100) 3 (95) (25)
Ending Stockholders' Equity 59 243 59 243
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) (4) (8) 1
Other comprehensive income (loss) before reclassifications 0 0 0 (5)
(Income) loss amounts reclassified from accumulated other comprehensive income 0 0 0 (1)
Other comprehensive income (loss) 0 0 0 (5)
Ending Stockholders' Equity $ (8) $ (4) $ (8) $ (4)