REVENUE RECOGNITION

On January 1, 2018 we adopted ASU 2014-09 Revenue from Contracts with Customers (ASC 606) using the modified retrospective method for contracts that were not completed as of January 1, 2018. The cumulative effect of initially applying ASC 606 was an adjustment to decrease the opening balance of retained earnings by $64 as of January 1, 2018.

With the adoption of ASC 606, we elected to apply certain permitted practical expedients. In evaluating the cumulative-effect adjustment to retained earnings, we adopted the standard only for contracts that were not complete as of the date of adoption. For contracts containing elements of variable consideration, we have elected to use the transaction price at the date the contract was deemed complete. For contracts that were modified prior to the adoption date, we have elected to present the aggregate effect of all contract modifications in determining the transaction price and for the allocation to the satisfied and unsatisfied performance obligations.

The impact of ASC 606 on our results of operations for the three and nine months 2018 was not material and related primarily to the reclassification of certain costs previously presented as selling, general and administrative expenses to net sales.

Sales are recognized as the performance obligations to deliver products or services are satisfied and are recorded based on the amount of consideration we expect to receive in exchange for satisfying the performance obligations. In the United States most of our products and services are marketed directly to doctors, hospitals and other healthcare facilities through company-owned subsidiaries and branches. Our products are also sold in over 85 countries through company-owned sales subsidiaries and branches as well as third-party dealers and distributors.

Sales represent the amount of consideration we expect to receive from customers in exchange for transferring products and services. Net sales exclude sales, value added and other taxes we collect from customers. Other costs to obtain and fulfill contracts are expensed as incurred due to the short-term nature of most of our sales. We extend terms of payment to our customers based on commercially reasonable terms for the markets of our customers, while also considering their credit quality. A provision for estimated sales returns, discounts and rebates is recognized as a reduction of sales in the same period that the sales are recognized. Our estimate of the provision for sales returns has been established based on contract terms with our customers and historical business practices. Shipping and handling costs charged to customers are included in net sales.

Our sales continue to be recognized primarily when title to the product, ownership and risk of loss transfer to the customer, which can be on the date of shipment, the date of receipt by the customer or, for most Orthopaedics products, when we have received a purchase order and appropriate notification the product has been used or implanted. Products and services are primarily transferred to customers at a point in time, with some transfers of services taking place over time. In the three and nine months 2018 less than 10% of our sales were recognized as services transferred over time.

We disaggregate our net sales by product line and geographic location for each of our segments as we believe it best depicts how the nature, amount, timing and certainty of our net sales and cash flows are affected by economic factors.



	Three Months				Nine Months
	2018		2017		2018		2017
Orthopaedics:
Knees	$	395	$	369	$	1,236	$	1,149
Hips	316		313		983		955
Trauma and Extremities	376		367		1,152		1,070
Other	84		83		244		234
	$	1,171	$	1,132	$	3,615	$	3,408
MedSurg:
Instruments	$	442	$	404	$	1,292	$	1,190
Endoscopy	443		404		1,335		1,183
Medical	492		464		1,508		1,413
Sustainability	66		64		190		191
	$	1,443	$	1,336	$	4,325	$	3,977
Neurotechnology and Spine:
Neurotechnology	$	435	$	353	$	1,282	$	1,036
Spine	193		185		583		552
	$	628	$	538	$	1,865	$	1,588
Total	$	3,242	$	3,006	$	9,805	$	8,973



	Three Months 2018				Three Months 2017
	United States		International		United States		International
Orthopaedics:
Knees	$	291	$	104	$	270	$	99
Hips	198		118		194		119
Trauma and Extremities	242		134		237		130
Other	67		17		68		15
	$	798	$	373	$	769	$	363
MedSurg:
Instruments	$	352	$	90	$	316	$	88
Endoscopy	346		97		316		88
Medical	393		99		357		108
Sustainability	66		—		63		—
	$	1,157	$	286	$	1,052	$	284
Neurotechnology and Spine:
Neurotechnology	$	284	$	150	$	222	$	131
Spine	142		52		139		46
	$	426	$	202	$	361	$	177
Total	$	2,381	$	861	$	2,182	$	824



	Nine Months 2018				Nine Months 2017
	United States		International		United States		International
Orthopaedics:
Knees	$	896	$	340	$	838	$	311
Hips	610		373		601		354
Trauma and Extremities	729		423		693		377
Other	198		46		190		44
	$	2,433	$	1,182	$	2,322	$	1,086
MedSurg:
Instruments	$	1,007	$	285	$	927	$	263
Endoscopy	1,049		286		927		256
Medical	1,158		350		1,099		314
Sustainability	189		1		190		1
	$	3,403	$	922	$	3,143	$	834
Neurotechnology and Spine:
Neurotechnology	$	820	$	462	$	660	$	376
Spine	424		159		421		131
	$	1,244	$	621	$	1,081	$	507
Total	$	7,080	$	2,725	$	6,546	$	2,427

Orthopaedics

Orthopaedics products consist primarily of implants used in hip and knee joint replacements and trauma and extremity surgeries. Substantially all Orthopaedics sales are recognized when we have received a purchase order and appropriate notification the product has been used or implanted. For certain Orthopaedic products in the "other" category, we recognize sales at a point in time, as well as over time for performance obligations that may include an obligation to complete installation, provide training and ongoing services. These performance obligations are satisfied within one year.

MedSurg

MedSurg products include surgical equipment and surgical navigation systems (Instruments), endoscopic and communications systems (Endoscopy), patient handling, emergency medical equipment and intensive care disposable products (Medical), reprocessed and remanufactured medical devices (Sustainability) and other medical device products used in a variety of medical specialties. Substantially all MedSurg sales are recognized when a purchase order has been received and control has transferred. For certain Endoscopy, Instruments and Medical services, we may recognize sales over time as we satisfy performance obligations that may include an obligation to complete installation, provide training and perform ongoing services and are generally performed within one year.

Neurotechnology and Spine

Neurotechnology and Spine products include both neurosurgical and neurovascular devices. Our spinal implant products include cervical, thoracolumbar and interbody systems used in spinal injury, deformity and degenerative therapies. Substantially all Neurotechnology and Spine sales are recognized when a purchase order has been received and control has transferred.

Contract Assets and Liabilities

The nature of our products and services do not generally give rise to contract assets as we typically do not incur costs to fulfill a contract before a product or service is provided to a customer. Our costs to obtain contracts are typically in the form of sales commissions paid to employees of Stryker or third-party agents. We have elected to expense sales commissions associated with obtaining a contract as incurred as the amortization period is generally less than one year. These costs have been presented within selling, general and administrative expenses. On September 30, 2018 there were no contract assets recorded in our Consolidated Balance Sheets.

Our contract liabilities arise as a result of unearned revenue received from customers at inception of contracts for certain businesses or where the timing of billing for services precedes satisfaction of our performance obligations. We generally satisfy performance obligations within one year from the contract inception date. On January 1, 2018 our contract liabilities were $381, which were reported in accrued expenses and other liabilities and other noncurrent liabilities in our Consolidated Balance Sheets, $43 of which were recognized in sales in the three months 2018 and $201 in the nine months 2018. On September 30, 2018 our contract liabilities were $281.