10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

☑ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2023

OR

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

Commission File No. 1-11083

BOSTON SCIENTIFIC CORPORATION

(Exact name of registrant as specified in its charter)

Delaware	04-2695240
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)

    300 Boston Scientific Way, Marlborough, Massachusetts                    01752-1234

        (Address of Principal Executive Offices)                         (Zip Code)

508 683-4000

(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:

Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock, par value $0.01 per share	BSX	New York Stock Exchange
0.625% Senior Notes due 2027	BSX27	New York Stock Exchange

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☑ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☑ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and "emerging growth company" in Rule 12b-2 of the Exchange Act.

Large accelerated filer	☑	Accelerated filer	☐
Non-accelerated filer	☐	Smaller reporting company	☐
		Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☑

The number of shares outstanding of Common Stock, $0.01 par value per share, as of July 31, 2023 was 1,464,223,263.

TABLE OF CONTENTS

		Page No.
PART I	FINANCIAL INFORMATION	3
ITEM 1.	Consolidated Financial Statements	3
	Consolidated Statements of Operations (Unaudited)	3
	Consolidated Statements of Comprehensive Income (Loss) (Unaudited)	4
	Consolidated Balance Sheets (Unaudited)	5
	Consolidated Statements of Stockholders' Equity (Unaudited)	6
	Consolidated Statements of Cash Flows (Unaudited)	7
	Notes to the Consolidated Financial Statements (Unaudited)	9
ITEM 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	37
ITEM 3.	Quantitative and Qualitative Disclosures About Market Risk	56
ITEM 4.	Controls and Procedures	57
PART II	OTHER INFORMATION	58
ITEM 1.	Legal Proceedings	58
ITEM 1A.	Risk Factors	58
ITEM 5.	Other Information	58
ITEM 6.	Exhibits	58
SIGNATURE		60

2

PART I

FINANCIAL INFORMATION

ITEM 1. CONSOLIDATED FINANCIAL STATEMENTS

BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED)

	Three Months Ended June 30,				Six Months Ended June 30,
(in millions, except per share data)	2023		2022		2023		2022
Net sales	$	3,599	$	3,244	$	6,988	$	6,270
Cost of products sold	1,058		1,011		2,098		1,966
Gross profit	2,542		2,233		4,891		4,304
Operating expenses:
Selling, general and administrative expenses	1,354		1,165		2,570		2,225
Research and development expenses	359		335		695		654
Royalty expense	12		11		23		23
Amortization expense	210		204		412		402
Intangible asset impairment charges	57		7		57		7
Contingent consideration net expense (benefit)	19		36		31		48
Restructuring net charges (credits)	16		11		36		14
Litigation-related net charges (credits)	—		42		—		42
	2,028		1,810		3,825		3,415
Operating income (loss)	514		423		1,066		889
Other income (expense):
Interest expense	(70)		(64)		(135)		(343)
Other, net	(18)		(14)		(61)		(46)
Income (loss) before income taxes	426		345		870		501
Income tax expense (benefit)	156		85		287		131
Net income (loss)	270		260		584		370
Preferred stock dividends	(9)		(14)		(23)		(28)
Net income (loss) attributable to noncontrolling interests	—		—		—		—
Net income (loss) attributable to Boston Scientific common stockholders	$	261	$	246	$	561	$	342
Net income (loss) per common share — basic	$	0.18	$	0.17	$	0.39	$	0.24
Net income (loss) per common share — diluted	$	0.18	$	0.17	$	0.39	$	0.24
Weighted-average shares outstanding
Basic	1,446.2		1,429.7		1,441.0		1,428.8
Diluted	1,456.2		1,437.8		1,451.1		1,438.1

Refer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.

3

BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (UNAUDITED)

	Three Months Ended June 30,				Six Months Ended June 30,
(in millions)	2023		2022		2023		2022
Net income (loss)	$	270	$	260	$	584	$	370
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustment	15		77		(28)		13
Net change in derivative financial instruments	15		134		(28)		157
Net change in defined benefit pensions and other items	0		0		(5)		0
Other comprehensive income (loss)	30		211		(61)		170
Comprehensive income (loss)	$	300	$	471	$	523	$	540
Comprehensive income attributable to noncontrolling interests	—		—		—		—
Comprehensive income attributable to Boston Scientific common stockholders	$	300	$	471	$	523	$	540

Refer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.

4

BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS (UNAUDITED)

	As of
(in millions, except share and per share data)	June 30, 2023		December 31, 2022
ASSETS
Current assets:
Cash and cash equivalents	$	426	$	928
Trade accounts receivable, net	2,134		1,970
Inventories	2,250		1,867
Prepaid income taxes	303		264
Other current assets	773		731
Total current assets	5,886		5,760
Property, plant and equipment, net	2,534		2,446
Goodwill	13,659		12,920
Other intangible assets, net	6,063		5,902
Deferred tax assets	3,865		3,942
Other long-term assets	1,595		1,500
TOTAL ASSETS	$	33,601	$	32,469
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Current debt obligations	$	559	$	20
Accounts payable	899		862
Accrued expenses	2,164		2,160
Other current liabilities	940		761
Total current liabilities	4,562		3,803
Long-term debt	8,494		8,915
Deferred income taxes	135		144
Other long-term liabilities	1,926		2,035
Commitments and contingencies
Stockholders’ equity
Preferred stock, $0.01 par value - authorized 50,000,000 shares - 0 shares issued as of June 30, 2023 and 10,062,500 shares as of December 31, 2022	—		—
Common stock, $0.01 par value - authorized 2,000,000,000 shares - issued 1,725,956,141 shares as of June 30, 2023 and 1,696,633,993 shares as of December 31, 2022	17		17
Treasury stock, at cost - 263,289,848 shares as of June 30, 2023 and December 31, 2022	(2,251)		(2,251)
Additional paid-in capital	20,441		20,289
Accumulated deficit	(189)		(750)
Accumulated other comprehensive income (loss), net of tax	208		269
Total stockholders’ equity	18,226		17,573
Noncontrolling interests	259		—
Total equity	18,485		17,573
TOTAL LIABILITIES AND EQUITY	$	33,601	$	32,469

Refer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.

5

BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (UNAUDITED)

	Three Months Ended June 30,					Six Months Ended June 30,
(in millions, except share data)	2023		2022			2023		2022
Preferred stock shares issued
Beginning	10,062,500		10,062,500			10,062,500		10,062,500
Conversion of mandatory convertible preferred stock to common stock	(10,062,500)		—			(10,062,500)		—
Ending	—		10,062,500			—		10,062,500
Common stock shares issued
Beginning	1,700,828,873		1,692,828,987			1,696,633,993		1,688,810,052
Impact of stock-based compensation plans	1,144,366		363,798			5,339,246		4,382,733
Conversion of mandatory convertible preferred stock to common stock	23,982,902		—			23,982,902		—
Ending	1,725,956,141		1,693,192,785			1,725,956,141		1,693,192,785
Preferred stock
Beginning	$	—	$	—		$	—	$	—
Conversion of mandatory convertible preferred stock to common stock	—		—		—	—		$	—
Ending	$	—	$	—		—		$	—
Common stock
Beginning	$	17	$	17		$	17	$	17
Conversion of mandatory convertible preferred stock to common stock	0		—			0		—
Ending	$	17	$	17		$	17	$	17
Treasury Stock
Beginning	$	(2,251)	$	(2,251)		$	(2,251)	$	(2,251)
Repurchase of common stock	—		—			—		—
Ending	$	(2,251)	$	(2,251)		$	(2,251)	$	(2,251)
Additional Paid-In Capital
Beginning	$	20,356	$	20,043		$	20,289	$	19,986
Impact of stock-based compensation plans	85		60			153		117
Ending	$	20,441	$	20,103		$	20,441	$	20,103
Accumulated Deficit
Beginning	$	(450)	$	(1,296)		$	(750)	$	(1,392)
Net income (loss)	270		260			584		370
Preferred stock dividends	(9)		(14)			(23)		(28)
Ending	$	(189)	$	(1,050)		$	(189)	$	(1,050)
Accumulated Other Comprehensive Income (Loss), Net of Tax
Beginning	$	178	$	222		$	269	$	263
Changes in other comprehensive income (loss)	30		211			(61)		170
Ending	$	208	$	433		$	208	$	433
Total stockholders' equity	$	18,226	$	17,251		18,226		17,251
Noncontrolling interests
Beginning	$	259	$	—		—		—
Net income (loss) attributable to noncontrolling interests	—		—			—		—
Changes in other comprehensive income (loss)	—		—			—		—
Changes to noncontrolling ownership interest	—		—			259		—
Ending	$	259	$	—		259		—
Total equity	$	18,485	$	17,251		18,485		17,251

Refer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.

6

BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)

	Six Months Ended June 30,
(in millions)	2023		2022
Net income (loss)	$	584	$	370
Adjustments to reconcile net income (loss) to cash provided by (used for) operating activities
Depreciation and amortization	583		558
Deferred and prepaid income taxes	(45)		(93)
Stock-based compensation expense	115		107
Goodwill and other intangible asset impairment charges	57		7
Net loss (gain) on investments and notes receivable	35		36
Contingent consideration net expense (benefit)	31		48
Inventory step-up amortization	3		25
Debt extinguishment costs	—		194
Other, net	23		31
Increase (decrease) in operating assets and liabilities, excluding purchase accounting:
Trade accounts receivable	(161)		(162)
Inventories	(399)		(180)
Other assets	(55)		(244)
Accounts payable, accrued expenses and other liabilities	78		(449)
Cash provided by (used for) operating activities	848		249
Investing activities:
Purchases of property, plant and equipment and internal use software	(254)		(226)
Proceeds from sale of property, plant and equipment	3		9
Payments for acquisitions of businesses, net of cash acquired	(1,018)		(1,471)
Proceeds from (payments for) investments and acquisitions of certain technologies	(73)		(10)
Proceeds from royalty rights	16		36
Proceeds from (payments for) settlements of hedge contracts	2		56
Cash provided by (used for) investing activities	(1,324)		(1,603)
Financing activities:
Payment of contingent consideration previously established in purchase accounting	(39)		(283)
Payments for royalty rights	(34)		(39)
Payments on short-term borrowings	—		(250)
Net increase (decrease) in commercial paper	37		154
Payments on long-term borrowings and debt extinguishment costs	—		(3,184)
Proceeds from long-term borrowings, net of debt issuance costs	—		3,270
Cash dividends paid on preferred stock	(28)		(28)
Cash used to net share settle employee equity awards	(52)		(47)
Proceeds from issuances of common stock pursuant to employee stock compensation and purchase plans	90		58
Cash provided by (used for) financing activities	(26)		(350)
Effect of foreign exchange rates on cash	(3)		(6)
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted cash equivalents	(506)		(1,710)
Cash, cash equivalents, restricted cash and restricted cash equivalents at beginning of period	1,126		2,168
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period	$	620	$	458

Refer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.

7

BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)

(SUPPLEMENTAL INFORMATION)

	Six Months Ended June 30,
(in millions)	2023		2022
Supplemental Information
Stock-based compensation expense	$	115	$	107
Non-cash impact of transferred royalty rights	(16)		(36)

	As of June 30,
Reconciliation to amounts within the unaudited consolidated balance sheets:	2023		2022
Cash and cash equivalents	$	426	$	276
Restricted cash and restricted cash equivalents included in Other current assets	135		132
Restricted cash equivalents included in Other long-term assets	60		50
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period	$	620	$	458

Refer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.

8

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

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 six months ended June 30, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. 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.

Subsequent Events

We evaluate events occurring after the date of our accompanying unaudited consolidated balance sheet for potential recognition or disclosure in our financial statements. Those items requiring recognition in the financial statements have been recorded and disclosed accordingly.

Those items requiring disclosure (non-recognized subsequent events) in the financial statements have been disclosed accordingly. Refer to Note H – Commitments and Contingencies for further details.

NOTE B – ACQUISITIONS, DIVESTITURES 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 June 15, 2022, we announced our entry into a definitive agreement with Synergy Innovation Co, Ltd, to purchase its majority stake in M.I. Tech Co., Ltd., (M.I. Tech), a publicly traded Korean manufacturer and distributor of medical devices for endoscopic and urological procedures. The agreement required global regulatory approvals that we were not able to obtain in some countries. As a result, the original agreement was terminated, and on June 15, 2023, we purchased a 9.9 percent minority stake in M.I. Tech.

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, a publicly traded Chinese manufacturer of drug-coated balloons used in the treatment of vascular and other diseases. We acquired approximately 65

9

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 Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 805, Business Combinations (FASB ASC Topic 805). The preliminary purchase prices were comprised of the amounts presented below:

(in millions)	Acotec(1)		Apollo
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) Represents majority stake investment in Acotec

We recorded the assets acquired, liabilities assumed and specific to Acotec, the noncontrolling interest, at their respective fair values as of the closing of the transaction. The preliminary purchase price allocations were comprised of the following components and the final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with FASB ASC Topic 805:

(in millions)	Acotec		Apollo
Goodwill	$	340	$	374
Amortizable intangible assets	334		248
Other assets acquired	93		50
Liabilities assumed	(48)		(26)
Net deferred tax liabilities	(79)		(9)
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 within 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.

10

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	11	14%
Customer relationships	15		11	14%
Other intangible assets	11		13	14%
	$	334
Apollo:
Amortizable intangible assets:
Technology-related	$	222	11	12%
Customer relationships	26		11	12%
	$	248

2022 Acquisition

On February 14, 2022, we completed our acquisition of Baylis Medical Company Inc. (Baylis Medical), a privately-held company which developed the radiofrequency (RF) NRG™ and VersaCross™ Transseptal Platforms as well as a family of guidewires, sheaths and dilators used to support left heart access, which expanded our electrophysiology and structural heart product portfolios. The transaction consisted of an upfront cash payment of $1.463 billion, net of cash acquired, subject to closing adjustments. We are integrating the Baylis Medical business into our Cardiology division.

Purchase Price Allocation

We accounted for the acquisition of Baylis Medical as a business combination in accordance with FASB ASC Topic 805. The final purchase price was comprised of the amount presented below:

(in millions)
Payment for acquisition, net of cash acquired	$	1,463
	$	1,463

We recorded the assets acquired and liabilities assumed at their respective fair values as of the acquisition date. The final purchase price allocation was comprised of the following components:

(in millions)
Goodwill	$	988
Amortizable intangible assets	657
Other assets acquired	112
Liabilities assumed	(287)
Net deferred tax liabilities	(7)
	$	1,463

Goodwill was primarily established due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies, and was deductible for tax purposes.

11

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	$	622	11	11%
Other intangible assets	36		11	11%
	$	657

Contingent Consideration

None of our acquisitions that closed during 2023 or 2022 contained contingent consideration arrangements. Changes in the fair value of our contingent consideration liability during the first six months of 2023 associated with prior period acquisitions were as follows:

(in millions)
Balance as of December 31, 2022	$	149
Contingent consideration net expense (benefit)	31
Contingent consideration payments	(73)
Balance as of June 30, 2023	$	107

The payments made during the first six months of 2023 primarily related to our 2021 acquisition of Farapulse, Inc. As of June 30, 2023, the maximum amount of future contingent consideration (undiscounted) that we could be required to pay associated with our completed acquisitions was approximately $364 million. Refer to Note B – Acquisitions and Strategic Investments to our audited financial statements contained in Item 8. Financial Statements and Supplementary Data of our most recent Annual Report on Form 10-K for additional information.

The recurring Level 3 fair value measurements of our contingent consideration liability that we expect to be required to settle include the following significant unobservable inputs:

Contingent Consideration Liability	Fair Value as of June 30, 2023	Valuation Technique	Unobservable Input	Range			Weighted Average(1)
R&D, Regulatory and Commercialization-based Milestones	$13 million	Discounted Cash Flow	Discount Rate	1%	-	2%	1%
			Probability of Payment	10%	-	25%	22%
			Projected Year of Payment	2023	-	2025	2024
Revenue-based Payments	$94 million	Discounted Cash Flow	Discount Rate	6%	-	14%	6%
			Probability of Payment	100%			100%
			Projected Year of Payment	2023	-	2024	2023

(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 research and development (R&D), regulatory and commercialization-based milestones and revenue-based payments 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 June 30, 2023.

12

Strategic Investments

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

	As of
(in millions)	June 30, 2023		December 31, 2022
Equity method investments	$	206	$	188
Measurement alternative investments(1, 2)	215		219
	$	422	$	407

(1)    Measurement alternative investments are privately-held equity securities without readily determinable fair values that are measured at cost less impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer, recognized in Other, net within our accompanying 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 June 30, 2023, the cost of our aggregated equity method investments exceeded our share of the underlying equity in net assets by $230 million, which represents amortizable intangible assets, in-process research and development (IPR&D), goodwill and deferred tax liabilities.

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 June 30, 2023				As of December 31, 2022
(in millions)	Gross Carrying Amount		Accumulated Amortization/ Write-offs		Gross Carrying Amount		Accumulated Amortization/ Write-offs
Technology-related	$	12,932	$	(7,737)	$	12,397	$	(7,378)
Patents	478		(385)		486		(394)
Other intangible assets	2,050		(1,448)		1,960		(1,400)
Amortizable intangible assets	$	15,459	$	(9,571)	$	14,843	$	(9,173)
Goodwill	$	23,559	$	(9,900)	$	22,820	$	(9,900)
IPR&D	$	54			$	112
Technology-related	120				120
Indefinite-lived intangible assets	$	174			$	232

The increase in our balance of goodwill and amortizable intangible assets is related primarily to our majority stake investment in Acotec completed in the first quarter of 2023 and our acquisition of Apollo completed in the second quarter of 2023.

The following represents a roll-forward of our goodwill balance by global reportable segment:

(in millions)	MedSurg		Cardiovascular		Total
As of December 31, 2022	$	4,237	$	8,684	$	12,920
Goodwill acquired	374		340		714
Impact of foreign currency fluctuations and purchase price adjustments	(3)		28		25
As of June 30, 2023	$	4,607	$	9,052	$	13,659

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Goodwill and Intangible Asset Impairments

We did not record any goodwill impairment charges in the first six months of 2023 or 2022. 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, 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 2023, we performed our annual goodwill impairment test utilizing both the qualitative and quantitative approach described in FASB ASC Topic 350, Intangibles - Goodwill and Other (FASB ASC Topic 350). The qualitative approach was used for testing reporting units where fair value has historically exceeded carrying value by greater than 100 percent, and all other reporting units were tested using the quantitative approach. 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 unit tested using the quantitative approach, we determined that the fair value of the reporting unit exceeded the carrying value and concluded that goodwill was not impaired or at risk of impairment.

We recorded Intangible asset impairment charges of $57 million in the second quarter and first six months of 2023 and $7 million in the second quarter and first six months of 2022. 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. 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.

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.

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 actively monitoring counterparty credit ratings. 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

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.

14

The success of our currency risk management program depends, in part, on forecast transactions denominated primarily in euro, British pound sterling, Swiss franc, Japanese yen, Chinese renminbi and Australian dollar. We may experience unanticipated currency exchange gains or losses to the extent the actual activity is different than forecast. In addition, changes in currency exchange rates related to any unhedged transactions may impact our earnings and cash flows.

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 in 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 in our consolidated statements of cash flows.

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 June 30, 2023 and December 31, 2022, we designated as a net investment hedge our €900 million in aggregate principal amount of 0.625% euro-denominated 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 Foreign currency translation adjustment (CTA) component of Other comprehensive income (loss), net of tax. We reclassify these gains and losses to current period earnings within Other, net in 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

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.

We had no interest rate derivative instruments designated as cash flow hedges outstanding as of June 30, 2023 or December 31, 2022. In the event that we designate outstanding interest rate derivative instruments as cash flow hedges, we record the changes in the fair value of the derivatives within OCI until the underlying hedged transaction occurs.

The following table presents the contractual amounts of our hedging instruments outstanding:

(in millions)	FASB ASC Topic 815 Designation	As of
		June 30, 2023		December 31, 2022
Forward currency contracts	Cash flow hedge	$	2,454	$	2,725
Forward currency contracts	Net investment hedge	333		365
Foreign currency-denominated debt(1)	Net investment hedge	997		997
Forward currency contracts	Non-designated	3,575		4,235
Total Notional Outstanding		$	7,360	$	8,321

(1)    Foreign currency-denominated debt is the €900 million debt principal associated with our 2027 Notes designated as a net investment hedge.

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As of June 30, 2023, the remaining time to maturity 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 three years. The euro-denominated debt principal designated as a net investment hedge has a contractual maturity of December 1, 2027.

The following presents the effect of our derivative and nonderivative instruments designated as cash flow and net investment hedges under FASB ASC Topic 815 in our accompanying unaudited consolidated statements of operations. Refer to Note M – Changes in Other Comprehensive Income for the total amounts relating to derivative and nonderivative instruments presented within our accompanying unaudited consolidated statements of comprehensive income (loss).

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Three Months Ended June 30, 2023
Forward currency contracts
Cash flow hedges	$	74	$	(17)	$	58	Cost of products sold	$	1,058	$	(55)	$	12	$	(43)
Net investment hedges(2)	22		(5)		17		Interest expense	70		(2)		1		(2)
Foreign currency-denominated debt
Net investment hedges(3)	1		—		1		Other, net	18		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest expense	70		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Three Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges	$	213	$	(48)	$	165	Cost of products sold	$	1,011	$	(41)	$	9	$	(32)
Net investment hedges(2)	34		5		39		Interest expense	64		(3)		1		(2)
Foreign currency-denominated debt
Net investment hedges(3)	62		(14)		48		Other, net	14		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest Expense	64		1		—		1

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	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Six Months Ended June 30, 2023
Forward currency contracts
Cash flow hedges	$	87	$	(20)	$	67	Cost of products sold	$	2,098	$	(125)	$	28	$	(97)
Net investment hedges (2)	28		(6)		22		Interest expense	135		(5)		1		(4)
Foreign currency-denominated debt
Net investment hedges (3)	(18)		4		(14)		Other, net	61		—		—		—
Interest rate derivative contracts
Cash flow hedges					—		Interest expense	135		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Six Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges	$	259	$	(58)	$	200	Cost of products sold	$	1,966	$	(71)	$	16	$	(55)
Net investment hedges (2)	49		2		50		Interest expense	343		(5)		1		(4)
Foreign currency-denominated debt
Net investment hedges (3)	86		(19)		66		Other, net	46		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest expense	343		15		(3)		11

(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 period, 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 June 30, 2023, pre-tax net gains or losses for our derivative instruments designated, or previously designated, as cash flow and net investment hedges under FASB ASC Topic 815 that may be reclassified from AOCI to earnings within the next twelve months are presented below:

(in millions)	FASB ASC Topic 815 Designation	Location on Unaudited Consolidated Statements of Operations	Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings
Designated Hedging Instrument
Forward currency contracts	Cash flow hedge	Cost of products sold	$	209
Forward currency contracts	Net investment hedge	Interest expense	9
Interest rate derivative contracts	Cash flow hedge	Interest expense	(2)

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Net gains and losses on currency hedge contracts not designated as hedging instruments offset by net gains and losses from currency transaction exposures are presented below:

	Location on Unaudited Consolidated Statements of Operations	Three Months Ended June 30,				Six Months Ended June 30,
(in millions)		2023		2022		2023		2022
Net gain (loss) on currency hedge contracts	Other, net	$	11	$	(34)	$	2	$	(63)
Net gain (loss) on currency transaction exposures	Other, net	(20)		35		(26)		56
Net currency exchange gain (loss)		$	(9)	$	1	$	(24)	$	(7)

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)		June 30, 2023		December 31, 2022
Derivative and Nonderivative Assets:
Designated Hedging Instruments
Forward currency contracts	Other current assets	$	188	$	196
Forward currency contracts	Other long-term assets	155		149
		342		345
Non-Designated Hedging Instruments
Forward currency contracts	Other current assets	46		36
Total Derivative and Nonderivative Assets		$	388	$	381
Derivative and Nonderivative Liabilities:
Designated Hedging Instruments
Forward currency contracts	Other current liabilities	$	1	$	—
Forward currency contracts	Other long-term liabilities	2		1
Foreign currency-denominated debt(2)	Long-term debt	971		952
		974		953
Non-Designated Hedging Instruments
Forward currency contracts	Other current liabilities	48		52
Total Derivative and Nonderivative Liabilities		$	1,021	$	1,005

(1)    We classify derivative and nonderivative assets and liabilities as current when the settlement date of the contract is one year or less.

(2)    Foreign currency-denominated debt is the €900 million debt principal 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.

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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
	June 30, 2023								December 31, 2022
(in millions)	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Assets
Money market funds and time deposits	$	17	$	—	$	—	$	17	$	673	$	—	$	—	$	673
Publicly-held equity securities	29		—		—		29		2		—		—		2
Hedging instruments	—		388		—		388		—		381		—		381
Licensing arrangements	—		—		102		102		—		—		127		127
	$	46	$	388	$	102	$	535	$	674	$	381	$	127	$	1,182
Liabilities
Hedging instruments	$	—	$	1,021	$	—	$	1,021	$	—	$	1,005	$	—	$	1,005
Contingent consideration liability	—		—		107		107		—		—		149		149
Licensing arrangements	—		—		115		115		—		—		159		159
	$	—	$	1,021	$	222	$	1,244	$	—	$	1,005	$	308	$	1,313

Our investments in money market funds and time deposits are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices. These investments are classified as Cash and cash equivalents within our accompanying unaudited consolidated balance sheets, in accordance with GAAP and our accounting policies. In addition to $17 million invested in money market funds and time deposits as of June 30, 2023 and $673 million as of December 31, 2022, we held $409 million in interest-bearing and non-interest-bearing bank accounts as of June 30, 2023 and $256 million as of December 31, 2022.

Our recurring fair value measurements using Level 3 inputs include those related to our contingent consideration liability. Refer to Note B – Acquisitions, Divestitures 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 in our accompanying 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 in our accompanying unaudited consolidated balance sheets as of June 30, 2023 include the following significant unobservable inputs:

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Licensing Arrangements	Fair Value as of June 30, 2023	Valuation Technique	Unobservable Input	Range				Weighted Average (1)
Financial Asset	$102 million	Discounted Cash Flow	Discount Rate	15%				15%
			Projected Year of Payment	2023		-	2025	2024
Financial Liability	$115 million	Discounted Cash Flow	Discount Rate	12	%	-	15%	13%
			Projected Year of Payment	2023		-	2026	2024

(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, 2022	$	127
Proceeds from royalty rights	(31)
Fair value adjustment (expense) benefit	6
Balance as of June 30, 2023	$	102

Changes in the fair value of our licensing arrangements' financial liability were as follows:

(in millions)
Balance as of December 31, 2022	$	159
Payments for royalty rights	(50)
Fair value adjustment expense (benefit)	6
Balance as of June 30, 2023	$	115

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, Divestitures 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 was $8.441 billion as of June 30, 2023 and $8.203 billion as of December 31, 2022. We determined fair value by using quoted market prices for our publicly registered senior notes, classified as Level 1 within the fair value hierarchy, and face value for commercial paper, term loans and credit facility borrowings outstanding. Refer to Note E – Contractual Obligations and Commitments for a discussion of our debt obligations.

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NOTE E – CONTRACTUAL OBLIGATIONS AND COMMITMENTS

Borrowings and Credit Arrangements

We had total debt outstanding of $9.053 billion as of June 30, 2023 and $8.935 billion as of December 31, 2022, with current obligations of $559 million as of June 30, 2023 and $20 million as of December 31, 2022. The debt maturity schedule for our long-term debt obligations is presented below:

(in millions, except interest rates)	Issuance Date	Maturity Date	As of				Coupon Rate(1)
			June 30, 2023		December 31, 2022
March 2024 Senior Notes	February 2019	March 2024	—		504		3.450%
March 2025 Senior Notes(3)	March 2022	March 2025	1,087		1,067		0.750%
June 2025 Senior Notes	May 2020	June 2025	500		500		1.900%
March 2026 Senior Notes	February 2019	March 2026	255		255		3.750%
December 2027 Senior Notes(3)	November 2019	December 2027	978		960		0.625%
March 2028 Senior Notes(3)	March 2022	March 2028	815		800		1.375%
March 2028 Senior Notes	February 2018	March 2028	344		344		4.000%
March 2029 Senior Notes	February 2019	March 2029	272		272		4.000%
June 2030 Senior Notes	May 2020	June 2030	1,200		1,200		2.650%
March 2031 Senior Notes(3)	March 2022	March 2031	815		800		1.625%
March 2034 Senior Notes(3)	March 2022	March 2034	543		534		1.875%
November 2035 Senior Notes(2)	November 2005	November 2035	350		350		6.500%
March 2039 Senior Notes	February 2019	March 2039	450		450		4.550%
January 2040 Senior Notes	December 2009	January 2040	300		300		7.375%
March 2049 Senior Notes	February 2019	March 2049	650		650		4.700%
Unamortized Debt Issuance Discount and Deferred Financing Costs		2023 - 2049	(70)		(76)
Finance Lease Obligation		Various	5		5
Long-term debt			$	8,494	$	8,915

Note: The table above does not include unamortized amounts related to interest rate contracts designated as cash flow hedges.

(1)    Coupon rates are semi-annual, except for the euro-denominated senior 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 if the lowest credit ratings assigned to these senior notes is either A- or A3 or higher. Effective May 2023, the interest rate payable decreased by 0.25 percent and began accruing at a rate of 6.50 percent following recent upgrades to our credit ratings.

(3)    These notes are euro-denominated and presented in U.S. dollars based on the exchange rate in effect as of June 30, 2023 and December 31, 2022, respectively.

Revolving Credit Facility

On May 10, 2021, we entered into our $2.750 billion revolving credit facility (2021 Revolving Credit Facility) with a global syndicate of commercial banks scheduled to mature on May 10, 2026, with one-year extension options, subject to certain conditions. On March 1, 2023, we entered into an amendment of the 2021 Revolving Credit Facility credit agreement, which provided for an extension of the scheduled maturity date to May 10, 2027 and replaced the London Interbank Offered Rate (LIBOR) with the Secured Overnight Financing Rate (SOFR) as the Eurocurrency Rate for Dollars, including applicable credit spread adjustments and relevant SOFR benchmark provisions, among other things described under Financial Covenant below. This facility provides backing for our commercial paper program, and outstanding commercial paper directly reduces borrowing capacity under the 2021 Revolving Credit Facility. There were no amounts outstanding under the 2021 Revolving Credit Facility as of June 30, 2023 or December 31, 2022.

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Financial Covenant

As of June 30, 2023, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility, as amended.

	Covenant Requirement	Actual
	as of June 30, 2023	as of June 30, 2023
Maximum permitted leverage ratio(1)	3.75 times	2.48 times

(1)Ratio of total debt to consolidated EBITDA, as defined by the credit agreements, 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 through the remaining term. The agreement provides for higher leverage ratios, at our election, for the period following a qualified acquisition for which consideration exceeds $1.000 billion. In the event of such an acquisition, for the four succeeding quarters immediately following, including the quarter in which the acquisition occurs, the maximum permitted leverage ratio is 4.75 times. The maximum permitted ratio steps down for the fifth, sixth and seventh succeeding quarters to 4.50 times, 4.25 times and 4.00 times, respectively. Thereafter, a maximum leverage ratio of 3.75 times is required through the remaining term of the 2021 Revolving Credit Facility. We have not elected to increase the maximum permitted leverage ratio for any qualified acquisitions due to our funding of these acquisitions using cash on hand or commercial paper.

The financial covenant requirement, as amended on March 1, 2023, provides for an exclusion from the calculation of consolidated EBITDA, as defined by the credit agreement, through maturity, of certain charges and expenses. The credit agreement amendment reset the starting date for purposes of calculating such permitted exclusions in each case from March 31, 2021 to December 31, 2022. Permitted exclusions include any non-cash charges and up to $500 million in restructuring charges and restructuring-related expenses associated with our current or future restructuring plans. As of June 30, 2023, we had $416 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, for a total of $1.443 billion. As of June 30, 2023, we had $1.413 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.

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Commercial Paper

Our commercial paper program is backed by the 2021 Revolving Credit Facility. We had $41 million of commercial paper outstanding as of June 30, 2023 and none as of December 31, 2022.

	As of
(in millions, except maturity and yield)	June 30, 2023			December 31, 2022
Commercial paper outstanding (at par)	$	41		$	—
Maximum borrowing capacity	2,750			2,750
Borrowing capacity available	2,709			2,750
Weighted average maturity	5 days			0 days
Weighted average yield	5.30		%	—		%

Senior Notes

We had senior notes outstanding of $9.063 billion as of June 30, 2023 and $8.986 billion as of December 31, 2022. Our senior notes were issued in public offerings, are redeemable prior to maturity and are not subject to sinking fund requirements. Our senior notes are unsecured, unsubordinated obligations and rank on parity with each other. These notes are effectively junior to liabilities of our subsidiaries (refer to Other Arrangements below).

In March 2022, American Medical Systems Europe B.V. (AMS Europe), an indirect, wholly owned subsidiary of Boston Scientific, completed a registered public offering (the Offering) of €3.000 billion in aggregate principal amount of euro-dominated senior notes comprised of €1.000 billion of 0.750% Senior Notes due 2025, €750 million of 1.375% Senior Notes due 2028, €750 million of 1.625% Senior Notes due 2031 and €500 million of 1.875% Senior Notes due 2034 (collectively, the Eurobonds). Boston Scientific has fully and unconditionally guaranteed all of AMS Europe's obligations under the Eurobonds, and no other subsidiary of Boston Scientific will guarantee these obligations. AMS Europe is a “finance subsidiary” as defined in Rule 13-01(a)(4)(vi) of Regulation S-X. The financial condition, results of operations and cash flows of AMS Europe are consolidated in the financial statements of Boston Scientific. The Offering resulted in cash proceeds of $3.270 billion, net of investor discounts and issuance costs.

We used the net proceeds from the Offering to fund the tender offer and early redemption of combined aggregate principal amount of $3.275 billion of certain of our outstanding senior notes, as well as to pay accrued interest, tender premiums, fees and expenses. We recorded associated debt extinguishment charges of $194 million during the first quarter of 2022 presented in Interest expense within our accompanying unaudited consolidated statements of operations.

Other Arrangements

We have accounts receivable factoring programs in certain European countries and with commercial banks in China and Japan which include promissory notes discounting programs. We account for our factoring programs as sales under FASB ASC Topic 860, 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 Arrangements	As of June 30, 2023				As of December 31, 2022
	Amount De-recognized		Weighted Average Interest Rate		Amount De-recognized		Weighted Average Interest Rate
Euro denominated	$	217	5.4	%	$	161	2.4	%
Yen denominated	179		0.7	%	194		0.6	%
Renminbi denominated	17		2.9	%	13		3.1	%

Other Contractual Obligations and Commitments

We had outstanding letters of credit of $148 million as of June 30, 2023 and $135 million as of December 31, 2022, which consisted primarily of bank guarantees and collateral for workers' compensation insurance arrangements. As of June 30, 2023

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and December 31, 2022 we had not recognized a related liability for any outstanding letters of credit within our accompanying unaudited consolidated balance sheets.

We have a supplier financing program offered primarily in the U.S. where our suppliers can 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 $124 million as of June 30, 2023 and $129 million as of December 31, 2022.

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.

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)	June 30, 2023		December 31, 2022
Trade accounts receivable	$	2,261	$	2,079
Allowance for credit losses	(127)		(109)
	$	2,134	$	1,970

The following is a roll forward of our Allowance for credit losses:

	Three Months Ended June 30,				Six Months Ended June 30,
(in millions)	2023		2022		2023		2022
Beginning balance	$	118	$	113	$	109	$	108
Credit loss expense	19		9		35		20
Write-offs	(10)		(5)		(16)		(11)
Ending balance	$	127	$	117	$	127	$	117

In accordance with FASB ASC Topic 326, Financial Instruments - Credit Losses (FASB ASC Topic 326), we record credit loss reserves to Allowance for credit losses when we establish Trade accounts receivable if credit losses are expected over the asset's contractual life. We base our estimates of credit loss reserves on historical experience and adjust, as necessary, to reflect current conditions using reasonable and supportable forecasts not already reflected in the historical loss information. We utilize an accounts receivable aging approach, applying country or region-specific factors, to determine the reserve to record at accounts receivable commencement for certain customers. In performing the assessment of outstanding accounts receivable, regardless of country or region, we may consider significant factors relevant to collectability, including those specific to a customer such as bankruptcy, lengthy average payment cycles and type of account.

We closely monitor outstanding receivables for potential collection risks, including those that may arise from economic and geopolitical conditions. Our sales to government-owned or supported customers, particularly in southern Europe, are subject to an increased number of days outstanding prior to payment relative to other entities, and, in southern Europe, relative to those in other countries. In addition, we have seen an increase in the volume of our U.S. business conducted in ambulatory surgery centers and office-based laboratories. Many of these customers are smaller than those we have historically done business with and may have more limited liquidity. We have adjusted our estimates of credit loss reserves for these customers, regions and conditions based on collection trends.

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Inventories

	As of
(in millions)	June 30, 2023		December 31, 2022
Finished goods	$	1,372	$	1,171
Work-in-process	175		147
Raw materials	703		548
	$	2,250	$	1,867

Other current assets

	As of
(in millions)	June 30, 2023		December 31, 2022
Restricted cash and restricted cash equivalents	$	135	$	149
Derivative assets	234		232
Licensing arrangements	53		60
Other	353		290
	$	773	$	731

Property, plant and equipment, net

	As of
(in millions)	June 30, 2023		December 31, 2022
Land	$	141	$	137
Buildings and improvements	1,790		1,695
Equipment, furniture and fixtures	3,427		3,297
Capital in progress	604		598
	5,962		5,728
Less: accumulated depreciation	3,428		3,282
	$	2,534	$	2,446

Depreciation expense was $88 million for the second quarter of 2023, $80 million for the second quarter of 2022, $170 million for the first six months of 2023 and $156 million for the first six months of 2022.

Other long-term assets

	As of
(in millions)	June 30, 2023		December 31, 2022
Restricted cash equivalents	$	60	$	48
Operating lease right-of-use assets	445		386
Derivative assets	156		149
Investments	422		407
Licensing arrangements	49		67
Indemnification asset	168		172
Other	295		271
	$	1,595	$	1,500

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Accrued expenses

	As of
(in millions)	June 30, 2023		December 31, 2022
Legal reserves	$	209	$	231
Payroll and related liabilities	843		830
Rebates	363		352
Contingent consideration	97		74
Other	653		674
	$	2,164	$	2,160

Other current liabilities

	As of
(in millions)	June 30, 2023		December 31, 2022
Deferred revenue	$	242	$	220
Licensing arrangements	55		79
Taxes payable	400		232
Other	242		230
	$	940	$	761

Other long-term liabilities

	As of
(in millions)	June 30, 2023		December 31, 2022
Accrued income taxes	$	489	$	597
Legal reserves	210		212
Contingent consideration	10		75
Licensing arrangements	60		80
Operating lease liabilities	401		347
Deferred revenue	295		289
Other	460		434
	$	1,926	$	2,035

NOTE G – INCOME TAXES

Our effective tax rate from continuing operations is presented below:

	Three Months Ended June 30,				Six Months Ended June 30,
	2023		2022		2023		2022
Effective tax rate from continuing operations	36.6	%	24.7	%	32.9	%	26.1	%

The changes in our reported tax rates for the second quarter and first six months of 2023, compared to the same periods in 2022, relate primarily to the impact of certain receipts and charges that are taxed at different rates than our effective tax rate. These include acquisition-related charges, debt extinguishment charges, as well as certain discrete tax items primarily related to unrecognized tax benefits and provision-to-return adjustments recorded in the second quarter of 2023.

As of June 30, 2023, we had $471 million of gross unrecognized tax benefits, of which a net $406 million, if recognized, would affect our effective tax rate. As of December 31, 2022, we had $492 million of gross unrecognized tax benefits, of which a net

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$410 million, if recognized, would affect our effective tax rate. The change in our gross unrecognized tax benefit is primarily related to remeasurement of historic positions after tax law changes and audit activities.

It is reasonably possible that within the next 12 months, we will resolve multiple issues with foreign, federal and state taxing authorities, resulting in a reduction in our balance of unrecognized tax benefits of up to $61 million.

NOTE H – COMMITMENTS AND CONTINGENCIES

The medical device market in which we participate is largely technology driven. As a result, intellectual property rights, particularly patents and trade secrets, play a significant role in product development and differentiation. Over the years, there has been litigation initiated against us by others, including our competitors, claiming that our current or former product offerings infringe patents owned or licensed by them. Intellectual property litigation is inherently complex and unpredictable. In addition, competing parties frequently file multiple suits to leverage patent portfolios across product lines, technologies and geographies and to balance risk and exposure between the parties. In some cases, several competitors are parties in the same proceeding, or in a series of related proceedings, or litigate multiple features of a single class of devices. These dynamics frequently drive settlement not only for individual cases, but also for a series of pending and potentially related and unrelated cases. Although monetary and injunctive relief is typically sought, remedies and restitution are generally not determined until the conclusion of the trial court proceedings and can be modified on appeal. Accordingly, the outcomes of individual cases are difficult to time, predict or quantify and are often dependent upon the outcomes of other cases in other geographies.

During recent years, we successfully negotiated closure of several long-standing legal matters and have received favorable rulings in several other matters; however, there continues to be outstanding litigation. Adverse outcomes in one or more of these matters could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity.

In addition, product liability, securities and commercial claims have been asserted against us and similar claims may be asserted against us in the future related to events not known to management at the present time. We maintain an insurance policy providing limited coverage against securities claims and we are substantially self-insured with respect to product liability claims and fully self-insured with respect to intellectual property infringement claims. The absence of significant third-party insurance coverage increases our potential exposure to unanticipated claims or adverse decisions. Product liability claims, securities and commercial litigation and other legal proceedings in the future, regardless of their outcome, could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity.

In addition, like other companies in the medical device industry, we are subject to extensive regulation by national, state and local government agencies in the U.S. and other countries in which we operate. From time to time we are the subject of qui tam actions and governmental investigations often involving regulatory, marketing and other business practices. These qui tam actions and governmental investigations could result in the commencement of civil and criminal proceedings, substantial fines, penalties and administrative remedies and have a material adverse effect on our financial position, results of operations and/or liquidity. For additional information, refer to Note I – Commitments and Contingencies to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K.

In accordance with FASB ASC Topic 450, Contingencies, we accrue anticipated costs of settlement, damages, losses for product liability claims and, under certain conditions, costs of defense, based on historical experience or to the extent specific losses are probable and estimable. Otherwise, we expense these costs as incurred. If the estimate of a probable loss is a range and no amount within the range is more likely, we accrue the minimum amount of the range. We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related net charges (credits) within our accompanying unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses within our accompanying unaudited consolidated statements of operations.

Our accrual for legal matters that are probable and estimable was $419 million as of June 30, 2023 and $443 million as of December 31, 2022 and includes certain estimated costs of settlement, damages and defense primarily related to product liability cases or claims related to our transvaginal surgical mesh products. A portion of this accrual is already funded through our qualified settlement fund, which is included in restricted cash and restricted cash equivalents in Other current assets of $135 million as of June 30, 2023 and $149 million as of December 31, 2022. Refer to Note F – Supplemental Balance Sheet Information for additional information. We did not record litigation-related net charges during the second quarter or first six months of 2023, and recorded $42 million during the second quarter and first six months of 2022.

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We continue to assess certain litigation and claims to determine the amounts, if any, that management believes will be paid as a result of such claims and litigation and, therefore, additional losses may be accrued and paid in the future, which could materially adversely impact our operating results, cash flows and/or our ability to comply with our financial covenant.

In management's opinion, we are not currently involved in any legal proceedings other than those disclosed in our most recent Annual Report on Form 10-K and those specifically identified below, which, individually or in the aggregate, could have a material adverse effect on our financial condition, operations and/or cash flows. Unless included in our legal accrual or otherwise indicated below, a range of loss associated with any individual material legal proceeding cannot be reasonably estimated.

Patent Litigation

On October 28, 2015, the Company filed suit against Cook Group Limited and Cook Medical LLC (collectively, Cook) in the United States District Court for the District of Delaware (1:15-cv-00980) alleging infringement of certain Company patents regarding Cook’s Instinct™ Endoscopic Hemoclip. The Company seeks lost profits, a reasonable royalty and a permanent injunction. The case was transferred to the District Court for the Southern District of Indiana. Cook filed Inter Partes Review (IPR) requests with the U.S. Patent and Trademark Office (USPTO) against four then-asserted patents, which resulted in the court staying the case until 2020. All IPRs concluded and confirmed the validity of certain claims of each challenged patent. In February 2023, the District Court issued summary judgment rulings dismissing certain claims and defenses. Trial on the remaining two asserted patents took place in May and June 2023 and the jury found that the Company’s patents are both valid and infringed and awarded the Company $158 million as lost profits. On July 26, 2023, the parties notified the District Court that they had reached a settlement in principle to resolve all claims and end the related suit.

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 us in Delaware. In January 2023, a jury trial was held on the issue of whether the one UT patent still asserted in the case was valid and whether it was infringed by the Company. On January 31, 2023, a jury concluded that UT’s patent was valid and willfully infringed by the Company, and awarded UT $42 million in damages. Following the trial, UT has filed a motion seeking prejudgment interest and enhanced damages. The Company has filed a motion seeking judgment as a matter of law in its favor or alternatively a new trial.

Product Liability Litigation

Multiple product liability cases or claims related to transvaginal surgical mesh products designed to treat stress urinary incontinence and pelvic organ prolapse have been asserted against us, predominantly in the United States, Canada, the United Kingdom, Scotland, Ireland, and Australia. Plaintiffs generally seek monetary damages based on allegations of personal injury associated with the use of our transvaginal surgical mesh products, including design and manufacturing claims, failure to warn, breach of warranty, fraud, violations of state consumer protection laws and loss of consortium claims. We have entered into individual and master settlement agreements in principle or are in the final stages of entering agreements with certain plaintiffs' counsel, to resolve the majority of these cases and claims. All settlement agreements were entered into solely by way of compromise and without any admission or concession by us of any liability or wrongdoing. In addition, in April 2021 the Company's Board of Directors received a shareholder demand under section 220 of the Delaware General Corporation Law, for inspection of books and records related to mesh settlements. The Company has notified our insurer and retained counsel to respond to the demand.

We have established a product liability accrual for remaining claims asserted against us associated with our transvaginal surgical mesh products and the costs of defense thereof. We continue to engage in discussions with plaintiffs’ counsel regarding potential resolution of pending cases and claims. We continue to vigorously contest these cases and claims. 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.

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Governmental Investigations and Qui Tam Matters

On December 1, 2015, the Brazilian governmental entity known as CADE (the Administrative Council of Economic Defense), served a search warrant on the offices of our Brazilian subsidiary, as well as on the Brazilian offices of several other major medical device makers who do business in Brazil, in furtherance of an investigation into alleged anti-competitive activity with respect to certain tender offers for government contracts. On June 20, 2017, CADE, through the publication of a “technical note,” announced that it was launching a formal administrative proceeding against Boston Scientific’s Brazilian subsidiary, Boston Scientific do Brasil Ltda. (BSB), as well as against the Brazilian operations of Medtronic, Biotronik and St. Jude Medical, two Brazilian associations, ABIMED and AMBIMO and 29 individuals for alleged anti-competitive behavior. Under applicable guidance, BSB could be fined a percentage of BSB’s 2016 gross revenues. In August 2021, the investigating commissioner issued a preliminary recommendation of liability against all of the involved companies, and also recommended that CADE impose fines and penalties. However, on October 25, 2021, the CADE Attorney General's office recommended dismissal of the charges and allegations against BSB and the individual BSB employees who were still individual defendants. Subsequently, on March 30, 2022, the Federal Prosecutor’s office issued a non-binding recommendation that is contrary to the Attorney General’s recommendation. The full Commission is considering both of these recommendations but has not yet issued its decision. We continue to deny the allegations, intend to defend ourselves vigorously and will appeal any decision of liability by the full Commission to the Brazilian courts. During such an appeal, the decision would have no force and effect, and the Court would consider the case without being bound by CADE’s decision.

In March 2022, the Company received a whistleblower letter alleging Foreign Corrupt Practices Act violations in Vietnam. The Company has received related subpoenas for documents from the Office of the U.S. Attorney for the District of Massachusetts and the Securities and Exchange Commission. The Company is cooperating with government agencies while investigating these allegations.

On April 5, 2023, the Company received a subpoena from the U.S. Department of Justice (DOJ) that seeks documents and information relating to its ambulatory electrocardiography monitoring (AECG) business. The Company is cooperating with the DOJ in responding to this subpoena.

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 Mariano Errichiello 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. The Company intends to vigorously defend itself against the surviving allegations. On December 15, 2020, the Securities and Exchange Commission’s Boston Regional Office (Boston SEC) notified the Company that it was conducting an investigation related to the Company’s decision to retire the LOTUS System and issued a voluntary request for documents and information related to that decision. On February 10, 2021, the Boston SEC issued a second voluntary request for additional documents and information. The Company cooperated fully with the requests, and on January 3, 2022, the SEC informed us that it was concluding its investigation and that it did not intend to recommend an enforcement action. On February 8, 2021, the Company received a letter from The Vladimir Gusinsky Revocable Trust, a shareholder, demanding that the Company’s Board of Directors conduct an investigation into actions by the Company’s directors and executive officers regarding statements made about the effectiveness and commercial viability of the LOTUS System. The Trust subsequently agreed to stay its demand, pending the outcome of any dispositive motion against the Amended Complaint in the class action complaint described above. The Company received letters on behalf of the Union Excavators Local 731 Pension Fund, Diane Nachbaur, and Frank Tripson, three stockholders of the Company, on July 26, 2021, July 29, 2021, and February 13, 2023, respectively, each demanding access to certain books and records of the Company, pursuant to Section 220 of the Delaware General Corporation Law, regarding the business, operations, effectiveness and commercial viability of the LOTUS system, and related items. On April 7, 2023, Diane Nachbaur filed a shareholder derivative complaint in the United States District Court for the District of Massachusetts against the Company, Michael F. Mahoney, Nelda J. Connors, Charles J. Dockendorff, Yoshiaki Fujimori, Donna A. James, Edward J. Ludwig, David Roux, John E. Sununu, Ellen M. Zane, Joseph M. Fitzgerald, Daniel J. Brennan, Shawn McCarthy, Ian Meredith, Kevin Ballinger, and Susan Vissers Lisa. On May 8, 2023, the Court stayed the case until the conclusion of the consolidated class action case.

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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.

During the second quarter of 2023, the Audit Committee of our Board of Directors, pursuant to authority delegated to such committee by our Board of Directors, declared, and we paid, a final cash dividend of $1.375 per MCPS share to holders of our MCPS as of May 15, 2023, representing a dividend period from March 2023 through May 2023.

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.

NOTE J – WEIGHTED AVERAGE SHARES OUTSTANDING

	Three Months Ended June 30,		Six Months Ended June 30,
(in millions)	2023	2022	2023	2022
Weighted average shares outstanding — basic	1,446.2	1,429.7	1,441.0	1,428.8
Net effect of common stock equivalents	10.1	8.1	10.1	9.3
Weighted average shares outstanding - diluted	1,456.2	1,437.8	1,451.1	1,438.1

The following securities were excluded from the calculation of diluted weighted average shares outstanding because their effect in the periods presented below would have been anti-dilutive:

	Three Months Ended June 30,		Six Months Ended June 30,
(in millions)	2023	2022	2023	2022
Stock options outstanding(1)	—	7	0	6
MCPS(2)	16	24	20	24

(1)    Represents stock options outstanding pursuant to our employee stock-based compensation plans with exercise prices that were greater than the average fair market value of our common stock for the related periods.

(2)    Represents common stock issuable upon the conversion of MCPS. Refer to Note I – Stockholders' Equity for additional information.

We base Net income (loss) per common share - diluted upon the weighted-average number of common shares and common stock equivalents outstanding during each year. Potential common stock equivalents are determined using the treasury stock method. We exclude stock options, stock awards and, prior to the Mandatory Conversion Date, our MCPS, from the calculation if the effect would be anti-dilutive. The dilutive effect of MCPS is calculated using the if-converted method. The if-converted method assumes that these securities were converted to shares of common stock at the beginning of the reporting period to the extent that the effect is dilutive.

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For the first six months of 2023 and 2022, 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 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 25 million shares of our common stock in the second quarter of 2023, approximately 29 million shares in the first six months of 2023, less than one million shares in the second quarter of 2022, and approximately four million shares in the first six months of 2022. Shares were issued following the automatic conversion of the MCPS, the exercise of stock options, vesting of restricted stock units or purchases under our employee stock purchase plan. We did not repurchase any shares of our common stock in the first six months of 2023 or 2022. 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 June 30, 2023, we had the full amount remaining available under the authorization.

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.

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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 June 30,				Six Months Ended June 30,
Net Sales	2023		2022		2023		2022
MedSurg	$	1,331	$	1,217	$	2,582	$	2,322
Cardiovascular	2,179		1,926		4,228		3,695
Total net sales of reportable segments	3,509		3,143		6,810		6,016
Impact of foreign currency fluctuations	91		101		179		254
	$	3,599	$	3,244	$	6,988	$	6,270

Income (loss) before income taxes
MedSurg	$	448	$	359	$	847	$	689
Cardiovascular	566		454		1,106		843
Total operating income of reportable segments	1,013		812		1,954		1,531
Unallocated amounts:
Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments	(49)		6		(124)		68
Goodwill and 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	(241)		(192)		(351)		(308)
Amortization expense	(210)		(204)		(412)		(402)
Operating income (loss)	514		423		1,066		889
Other expense, net	(88)		(78)		(195)		(388)
Income (loss) before income taxes	$	426	$	345	$	870	$	501

	Three Months Ended June 30,				Six Months Ended June 30,
Operating income margin of reportable segments	2023		2022		2023		2022
MedSurg	33.6	%	29.5	%	32.8	%	29.7	%
Cardiovascular	26.0	%	23.6	%	26.2	%	22.8	%

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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 component and geographic region (in millions). We allocate revenue from contracts with customers to geographic regions based on the location where the sale originated.

	Three Months Ended June 30,
	2023						2022
Businesses	U.S.		Int'l		Total		U.S.		Int'l		Total
Endoscopy	$	384	$	246	$	631	$	338	$	221	$	560
Urology	340		146		485		320		130		450
Neuromodulation	183		61		244		186		53		239
MedSurg	907		453		1,360		844		404		1,248
Interventional Cardiology Therapies	189		440		629		192		382		574
Watchman	286		30		317		225		25		250
Cardiac Rhythm Management	356		209		566		342		199		541
Electrophysiology	85		108		193		73		79		152
Cardiology	917		787		1,704		832		685		1,517
Peripheral Interventions	285		250		535		257		221		478
Cardiovascular	1,202		1,037		2,239		1,089		906		1,996
Total Net Sales	$	2,110	$	1,490	$	3,599	$	1,933	$	1,311	$	3,244

	Six Months Ended June 30,
	2023						2022
Businesses	U.S.		Int'l		Total		U.S.		Int'l		Total
Endoscopy	$	735	$	472	$	1,207	$	650	$	441	$	1,091
Urology	666		289		954		606		257		863
Neuromodulation	356		123		478		346		101		448
MedSurg	1,757		883		2,640		1,602		799		2,402
Interventional Cardiology Therapies	372		848		1,220		378		740		1,118
Watchman	552		55		607		428		48		476
Cardiac Rhythm Management	702		412		1,114		667		394		1,061
Electrophysiology	170		199		370		123		147		270
Cardiology	1,796		1,514		3,310		1,596		1,329		2,925
Peripheral Interventions	560		478		1,039		513		430		944
Cardiovascular	2,356		1,993		4,349		2,109		1,760		3,868
Total Net Sales	$	4,113	$	2,876	$	6,988	$	3,711	$	2,559	$	6,270

Refer to Note K- Segment Reporting for information on our reportable segments.

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	Three Months Ended June 30,				Six Months Ended June 30,
Geographic Regions	2023		2022		2023		2022
U.S.	$	2,110	$	1,933	$	4,113	$	3,711
Europe, Middle East and Africa	723		660		1,435		1,284
Asia-Pacific	626		530		1,174		1,047
Latin America and Canada	140		120		267		228
Total Net Sales	$	3,599	$	3,244	$	6,988	$	6,270
Emerging Markets(1)	$	592	$	498	$	1,121	$	938

(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. We have revised prior year amounts to conform to the current year's presentation.

Deferred Revenue

Contract liabilities are classified within Other current liabilities and Other long-term liabilities within our accompanying unaudited consolidated balance sheets. Our deferred revenue balance was $537 million as of June 30, 2023 and $509 million as of December 31, 2022. Our contractual 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 contractual 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 $35 million in the second quarter that was included in the above contract liability balance as of December 31, 2022. We have elected not to disclose the transaction price allocated to unsatisfied performance obligations when the original expected contract duration is one year or less. In addition, we have not identified material unfulfilled performance obligations for which revenue is not currently deferred.

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.

NOTE M – CHANGES IN OTHER COMPREHENSIVE INCOME

The following tables provide the reclassifications out of Other comprehensive income (loss), net of tax:

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of March 31, 2023	$	(43)	$	225	$	(4)	$	178
Other comprehensive income (loss) before reclassifications	17		58		—		74
(Income) loss amounts reclassified from accumulated other comprehensive income	(2)		(42)		(0)		(44)
Total other comprehensive income (loss)	15		15		(0)		30
Balance as of June 30, 2023	$	(28)	$	241	$	(4)	$	208

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(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of March 31, 2022	$	29	$	229	$	(36)	$	222
Other comprehensive income (loss) before reclassifications	79		165		—		245
(Income) loss amounts reclassified from accumulated other comprehensive income	(2)		(31)		0		(34)
Total other comprehensive income (loss)	77		134		—		211
Balance as of June 30, 2022	$	106	$	363	$	(36)	$	433

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of December 31, 2022	$	(1)	$	269	$	1	$	269
Other comprehensive income (loss) before reclassifications	(24)		67		(5)		39
(Income) loss amounts reclassified from accumulated other comprehensive income	(4)		(95)		(1)		(100)
Total other comprehensive income (loss)	(28)		(28)		(5)		(61)
Balance as of June 30, 2023	$	(28)	$	241	$	(4)	$	208

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of December 31, 2021	$	93	$	206	$	(36)	$	263
Other comprehensive income (loss) before reclassifications	17		200		0		217
(Income) loss amounts reclassified from accumulated other comprehensive income	(4)		(43)		0		(47)
Total other comprehensive income (loss)	13		157		—		170
Balance as of June 30, 2022	$	106	$	363	$	(36)	$	433

Refer to Note D – Hedging Activities and Fair Value Measurements for further detail on our net investment hedges recorded in Foreign currency translation adjustments and our cash flow hedges recorded in Net change in derivative financial instruments.

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 six months of 2023, we implemented the following standards on a prospective basis, none of which had a material impact on our financial position or results of operations.

ASC Update No. 2022-01

ASC Update No. 2022-01, Derivatives and Hedging (Topic 815): Fair Value Hedging - Portfolio Layer Method. Update No. 2022-01 expands the current single-layer method to allow multiple hedged layers of a single closed portfolio under the method, among other updates to these methods.

ASC Update No. 2022-02

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ASC Update No. 2022-02, Financial Instruments- Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures makes amendments related to troubled debt restructurings for entities that have adopted Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, as well as amendments related to vintage disclosures for entities with investments in financing receivables that have adopted Update No. 2016-13.

ASC Update No. 2022-04

ASC Update No. 2022-04, Liabilities— Supplier Finance Programs (Subtopic 405-50) enhances the transparency of supplier finance programs by requiring that a buyer in a supplier finance program disclose sufficient qualitative and quantitative information about the program to allow a user of financial statements to understand the program's nature, activity during the period, changes from period to period, and potential magnitude.

Standards to be Implemented

In June 2022, the FASB issued ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions. Update No. 2022-03 clarifies the guidance in Topic 820 related to measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale of an equity security, as well as introduces new disclosure requirements for these types of equity securities. Update No. 2022-03 is effective for fiscal years beginning after December 15, 2023, including interim periods within those fiscal years. We do not expect the adoption to have a material impact on our financial position or results of operations.

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.

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ITEM 2.MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

Introduction

Boston Scientific Corporation is a global developer, manufacturer and marketer of medical devices that are used in a broad range of interventional medical specialties. Our mission is to transform lives through innovative medical solutions that improve the health of patients around the world. As a medical technology leader for more than 40 years, we have advanced the practice of less-invasive medicine by helping physicians and other medical professionals diagnose and treat a wide range of diseases and medical conditions and improve patients’ quality of life by providing alternatives to surgery and other medical procedures that are typically traumatic to the body. We advance science for life by providing a broad range of high performance solutions to address unmet patient needs and reduce the cost of healthcare. When used in this report, the terms "we," "us," "our" and "the Company" mean Boston Scientific Corporation and its divisions and subsidiaries.

Financial Summary

Three Months Ended June 30, 2023

Our net sales for the second quarter of 2023 were $3.599 billion, compared to $3.244 billion for the second quarter of 2022. This increase of $355 million, or 11.0 percent, included operational1 net sales growth of 12.0 percent and the negative impact of 100 basis points from foreign currency fluctuations. Operational net sales growth included organic2 net sales growth of 11.6 percent and the positive impact of 30 basis points from our acquisition of Apollo Endosurgery, Inc. (Apollo) during the second quarter of 2023, for which there is less than a full period of comparable sales. The increase in our net sales was primarily driven by the diversity of our product portfolio and strong execution, coupled with growth in the underlying markets in which we compete. Refer to Quarterly Results and Business Overview for a discussion of our net sales by global business.

Our reported net income attributable to Boston Scientific common stockholders for the second quarter of 2023 was $261 million, or $0.18 per diluted share. Our reported results for the second quarter of 2023 included certain charges and/or credits totaling $516 million (after-tax), or $0.35 per diluted share. Excluding these items, adjusted net income available to Boston Scientific common stockholders3 was $777 million, or $0.53 per diluted share.

Our reported net income available to common stockholders for the second quarter of 2022 was $246 million, or $0.17 per diluted share. Our reported results for the second quarter of 2022 included certain charges and/or credits totaling $389 million (after-tax), or $0.27 per diluted share. Excluding these items, adjusted net income available to common stockholders3 was $635 million, or $0.44 per diluted share.

1Operational net sales growth excludes the impact of foreign currency fluctuations.

2Organic net sales growth excludes the impact of foreign currency fluctuations and net sales attributable to acquisitions and divestitures for which there are less than a full period of comparable net sales.

3Adjusted measures, including operational and organic net sales growth, exclude certain items required by generally accepted accounting principles in the United States (GAAP), are not prepared in accordance with GAAP and should not be considered in isolation from, or as a replacement for, the most directly comparable GAAP measure. Refer to Additional Information for a discussion of management’s use of these non-GAAP financial measures.

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The following is a reconciliation of our results of operations prepared in accordance with GAAP to those adjusted results considered by management. Refer to Quarterly Results and Business Overview and Additional Information for a discussion of these reconciling items:

	Three Months Ended June 30, 2023
(in millions, except per share data)	Income (Loss) Before Income Taxes		Income Tax Expense (Benefit)		Net Income (Loss)		Preferred Stock Dividends		Net Income (Loss) Attributable to Boston Scientific Common Stockholders		Impact per Share(4)
Reported	$	426	$	156	$	270	$	(9)	$	261	$	0.18
Non-GAAP adjustments:
Amortization expense	210		28		182		—		182		0.12
Goodwill and other intangible asset impairment charges	57		3		54		—		54		0.04
Acquisition/divestiture-related net charges (credits)	118		(57)		175		—		175		0.12
Restructuring and restructuring-related net charges (credits)	42		7		35		—		35		0.02
Investment portfolio net losses (gains)	(2)		(6)		5		—		5		0.00
European Union (EU) Medical device regulation (MDR) implementation costs	20		3		17		—		17		0.01
Deferred tax expenses (benefits)	—		(47)		47		—		47		0.03
Discrete tax items	—		(1)		1		—		1		0.00
Adjusted	$	871	$	86	$	786	$	(9)	$	777	$	0.53

	Three Months Ended June 30, 2022
(in millions, except per share data)	Income (Loss) Before Income Taxes		Income Tax Expense (Benefit)		Net Income (Loss)		Preferred Stock Dividends		Net Income (Loss) Attributable to Boston Scientific Common Stockholders		Impact per Share(4)
Reported	$	345	$	85	$	260	$	(14)	$	246	$	0.17
Non-GAAP adjustments:
Amortization expense	204		29		175		—		175		0.12
Goodwill and other intangible asset impairment charges	7		—		7		—		7		0.00
Acquisition/divestiture-related net charges (credits)	91		(5)		95		—		95		0.07
Restructuring and restructuring-related net charges (credits)	35		5		30		—		30		0.02
Litigation-related net charges (credits)	42		10		33		—		33		0.02
Investment portfolio net losses (gains)	4		2		2		—		2		0.00
European Union (EU) Medical device regulation (MDR) implementation costs	17		2		14		—		14		0.01
Debt extinguishment charges	0		0		0		—		0		0.00
Deferred tax expenses (benefits)	—		(34)		34		—		34		0.02
Discrete tax items	—		1		(1)		—		(1)		(0.00)
Adjusted	$	744	$	95	$	649	$	(14)	$	635	$	0.44

(4) For the second quarter of 2023 and 2022, the effect of assuming the conversion of Mandatory Convertible Preferred Stock (MCPS) into shares of common stock was anti-dilutive, and therefore excluded from the calculation of earnings per share (EPS). Accordingly, GAAP Net income and Adjusted net income were reduced by cumulative Preferred stock dividends, as presented in our unaudited consolidated statements of operations, for purposes of calculating GAAP Net income attributable to Boston Scientific common stockholders. On June 1, 2023, all outstanding shares of MCPS automatically converted into shares of common stock.

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Six Months Ended June 30, 2023

Our net sales for the first six months of 2023 were $6.988 billion, compared to $6.270 billion for the first six months of 2022. This increase of $718 million, or 11.5 percent, included operational1 net sales growth of 13.4 percent and the negative impact of 190 basis points from foreign currency fluctuations. Operational net sales growth included organic2 net sales growth of 12.8 percent and the positive impact of 60 basis points from our acquisition of Apollo during the first six months of 2023 and Baylis Medical Company Inc. (Baylis Medical) in the first six months of 2022, for which there is less than a full period of comparable sales. The increase in our net sales was primarily driven by the diversity of our product portfolio and strong execution, coupled with growth in the underlying markets in which we compete, as well as our recent acquisitions. Refer to Quarterly Results and Business Overview for a discussion of our net sales by global business.

Our reported net income attributable to Boston Scientific common stockholders for the first six months of 2023 was $561 million, or $0.39 per diluted share. Our reported results for the first six months of 2023 included certain charges and/or credits totaling $889 million (after-tax), or $0.61 per diluted share. Excluding these items, adjusted net income available to common stockholders3 for the first six months of 2023 was $1.449 billion, or $1.00 per diluted share.

Our reported net income available to common stockholders for the first six months of 2022 was $342 million, or $0.24 per diluted share. Our reported results for the first six months of 2022 included certain charges and/or credits totaling $854 million (after-tax), or $0.59 per diluted share. Excluding these items, adjusted net income available to common stockholders3 for the first six months of 2022 was $1.197 billion, or $0.83 per diluted share.

1Operational net sales growth excludes the impact of foreign currency fluctuations.

2Organic net sales growth excludes the impact of foreign currency fluctuations and net sales attributable to acquisitions and divestitures for which there are less than a full period of comparable net sales.

3Adjusted measures, including operational and organic net sales growth, exclude certain items required by generally accepted accounting principles in the United States (GAAP), are not prepared in accordance with GAAP and should not be considered in isolation from, or as a replacement for, the most directly comparable GAAP measure. Refer to Additional Information for a discussion of management’s use of these non-GAAP financial measures.

39

The following is a reconciliation of our results of operations prepared in accordance with GAAP to those adjusted results considered by management. Refer to Quarterly Results and Business Overview and Additional Information for a discussion of these reconciling items:

	Six Months Ended June 30, 2023
(in millions, except per share data)	Income (Loss) Before Income Taxes		Income Tax Expense (Benefit)		Net Income (Loss)		Preferred Stock Dividends		Net Income (Loss) Attributable to Boston Scientific Common Stockholders		Impact per Share(5)
Reported	$	870	$	287	$	584	$	(23)	$	561	$	0.39
Non-GAAP adjustments:
Amortization expense	412		56		357		—		357		0.25
Goodwill and other intangible asset impairment charges	57		3		54		—		54		0.04
Acquisition/divestiture-related net charges (credits)	178		(64)		242		—		242		0.17
Restructuring and restructuring-related net charges (credits)	86		14		71		—		71		0.05
Investment portfolio net losses (gains)	19		(2)		20		—		20		0.01
European Union (EU) Medical device regulation (MDR) implementation costs	36		5		31		—		31		0.02
Deferred tax expenses (benefits)	—		(88)		88		—		88		0.06
Discrete tax items	—		(26)		26		—		26		0.02
Adjusted	$	1,659	$	186	$	1,472	$	(23)	$	1,449	$	1.00

	Six Months Ended June 30, 2022
(in millions, except per share data)	Income (Loss) Before Income Taxes		Income Tax Expense (Benefit)		Net Income (Loss)		Preferred Stock Dividends		Net Income (Loss) Available to Common Stockholders		Impact per Share(5)
Reported	$	501	$	131	$	370	$	(28)	$	342	$	0.24
Non-GAAP adjustments:
Amortization expense	402		56		345		—		345		0.24
Goodwill and other intangible asset impairment charges	7		—		7		—		7		0.00
Acquisition/divestiture-related net charges (credits)	163		(5)		167		—		167		0.12
Restructuring and restructuring-related net charges (credits)	64		9		55		—		55		0.04
Litigation-related net charges (credits)	42		10		33		—		33		0.02
Investment portfolio net losses (gains)	11		4		7		—		7		0.00
European Union (EU) Medical device regulation (MDR) implementation costs	33		5		28		—		28		0.02
Debt extinguishment charges	194		45		149		—		149		0.10
Deferred tax expenses (benefits)	—		(63)		63		—		63		0.04
Discrete tax items	—		0		(0)		—		(0)		(0.00)
Adjusted	$	1,416	$	191	$	1,224	$	(28)	$	1,197	$	0.83

(5) For the first six months of 2023 and 2022, the effect of assuming the conversion of MCPS into shares of common stock was anti-dilutive, and therefore excluded from the calculation of EPS. Accordingly, GAAP Net income and Adjusted net income were reduced by cumulative Preferred stock dividends, as presented in our unaudited consolidated statements of operations, for purposes of calculating GAAP Net income attributable to Boston Scientific common stockholders. On June 1, 2023, all outstanding shares of MCPS automatically converted into shares of common stock.

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Quarterly Results and Business Overview

The following section describes our net sales and results of operations by reportable segment and business unit. For additional information on our businesses and product offerings, refer to Item 1. Business of our most recent Annual Report on Form 10-K.

	Three Months Ended June 30,
(in millions)	2023		2022		Increase/(Decrease)
Endoscopy	$	631	$	560	12.7%
Urology	485		450		7.8%
Neuromodulation	244		239		2.5%
MedSurg	1,360		1,248		9.0%
Cardiology	1,704		1,517		12.3%
Peripheral Interventions	535		478		11.9%
Cardiovascular	2,239		1,996		12.2%
Net Sales	$	3,599	$	3,244	11.0%
	Six Months Ended June 30,
(in millions)	2023		2022		Increase/(Decrease)
Endoscopy	$	1,207	$	1,091	10.7%
Urology	954		863		10.5%
Neuromodulation	478		448		6.9%
MedSurg	2,640		2,402		9.9%
Cardiology	3,310		2,925		13.2%
Peripheral Interventions	1,039		944		10.0%
Cardiovascular	4,349		3,868		12.4%
Net Sales	$	6,988	$	6,270	11.5%

MedSurg

Endoscopy

Our Endoscopy business develops and manufactures devices to diagnose and treat a broad range of gastrointestinal (GI) and pulmonary conditions with innovative, less-invasive technologies. Net sales of Endoscopy products of $631 million for the second quarter and $1.207 billion for the first six months of 2023 represented 18 percent and 17 percent of our consolidated net sales, respectively. Endoscopy net sales increased $71 million, or 12.7 percent, during the second quarter and $117 million, or 10.7 percent, during the first six months of 2023, compared to the prior year periods. During the second quarter of 2023, this increase included operational net sales growth of 13.6 percent and a negative impact of 80 basis points from foreign currency fluctuations, compared to the prior year period. During the first six months of 2023, this increase included operational net sales growth of 12.6 percent and a negative impact of 180 basis points from foreign currency fluctuations, compared to the prior year period.

Operational net sales growth included organic net sales growth of 11.6 percent during the second quarter and first six months of 2023, and the positive impact of 190 and 100 basis points, respectively, from our acquisition of Apollo in the second quarter of 2023. Organic net sales growth was primarily driven by our biliary franchise led by our AXIOS™ Stent and Delivery System, and our hemostasis, single use imaging and metal stents franchises.

41

Urology

Our Urology business develops and manufactures devices to treat various urological and pelvic conditions for both male and female anatomies. Net sales of Urology products of $485 million for the second quarter and $954 million for the first six months of 2023 represented 13 percent and 14 percent of our consolidated net sales, respectively. Urology net sales increased $35 million, or 7.8 percent, during the second quarter and $91 million, or 10.5 percent, during the first six months of 2023, compared to the prior year periods. During the second quarter of 2023, this increase included operational net sales growth of 8.4 percent and a negative impact of 60 basis points from foreign currency fluctuations, compared to the prior year period. During the first six months of 2023, this increase included operational net sales growth of 11.8 percent and a negative impact of 130 basis points from foreign currency fluctuations, compared to the prior year period. This growth was driven by our stone management franchise led by our LithoVue™ Single-Use Digital Flexible Ureteroscope System, our prostate health franchise led by our Rezum™ Water Vapor Therapy System and our prosthetic urology franchise.

Neuromodulation

Our Neuromodulation business develops and manufactures devices to treat various neurological movement disorders and manage chronic pain. Net sales of Neuromodulation products of $244 million for the second quarter and $478 million for the first six months of 2023 represented 7 percent of our consolidated net sales in both periods. Neuromodulation net sales increased $6 million, or 2.5 percent during the second quarter and $31 million, or 6.9 percent during the first six months of 2023, compared to the prior year periods. During the second quarter of 2023, operational net sales growth of 2.8 percent was offset by a negative impact of 30 basis points from foreign currency fluctuations, compared to the prior year period. During the first six months of 2023, operational net sales growth of 7.9 percent was offset by a negative impact of 100 basis points from foreign currency fluctuations, compared to the prior year period. Operational net sales growth during the second quarter of 2023 was primarily driven by growth within our deep brain stimulation franchise while operational net sales growth during the first six months of 2023 was driven by improved procedural volume growth within our spinal cord stimulation (SCS) franchise led by our WaveWriter Alpha™ SCS System, as well as growth within our deep brain stimulation franchise.

Cardiovascular

Cardiology

Our Cardiology business develops and manufactures devices and medical technologies for diagnosing and treating a variety of diseases and abnormalities of the heart. Net sales of Cardiology products of $1.704 billion for the second quarter and $3.310 billion for the first six months of 2023 and represented 47 percent of our consolidated net sales in both periods. Cardiology net sales increased $187 million, or 12.3 percent, during the second quarter and $386 million, or 13.2 percent during the first six months of 2023, compared to the prior year periods. During the second quarter of 2023, this increase included operational net sales growth of 13.4 percent and a negative impact of 110 basis points from foreign currency fluctuations, compared to the prior year period. During the first six months of 2023, this increase included operational net sales growth of 15.3 percent and a negative impact of 210 basis points from foreign currency fluctuations, compared to the prior year period. Operational net sales growth for the first six months of 2023 included organic net sales growth of 14.4 percent and the positive impact of 90 basis points from our acquisition of Baylis Medical in the first quarter of 2022.

Organic net sales growth was primarily driven by strong demand and continued market expansion of Left Atrial Appendage Closure (LAAC) procedures with our WATCHMAN FLX™ LAAC Device, as well as growth of our percutaneous coronary intervention guidance and access solutions franchises and our Farapulse™ Ablation System.

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Peripheral Interventions

Our Peripheral Interventions business develops and manufactures products to diagnose and treat peripheral arterial and venous diseases, as well as products to diagnose, treat and ease various forms of cancer. Net sales of Peripheral Interventions products of $535 million for the second quarter and $1.039 billion for the first six months of 2023 represented 15 percent of our consolidated net sales in both periods. Peripheral Interventions net sales increased $57 million, or 11.9 percent, during the second quarter and $95 million, or 10.0 percent, during the first six months of 2023, compared to the prior year periods. During the second quarter of 2023, this increase included operational net sales growth of 13.5 percent and a negative impact of 160 basis points from foreign currency fluctuations, compared to the prior year period. During the first six months of 2023, this increase included operational net sales growth of 12.5 percent and a negative impact of 250 basis points from foreign currency fluctuations, compared to the prior year period. This growth was primarily driven by our interventional oncology franchise led by our Therasphere™ Y-90 Radioactive Glass Microspheres and our EMBOLD™ Fibered Coil, as well as our Ranger™ Drug-Coated Balloon and Eluvia™ Drug-Eluting Stent System. In the first quarter of 2023, we acquired a majority stake investment in Acotec and have elected to consolidate their results of operations on a one quarter lag. Additionally, during the second quarter of 2023, we began our limited market release for Obsidio™ Conformable Embolic, the only conformable gel embolic material indicated for the peripheral vasculature.

Emerging Markets

As part of our strategic imperative to drive global expansion, we are seeking to grow net sales and market share by expanding our global presence, including in Emerging Markets. Periodically, we assess our list of Emerging Markets countries, and effective January 1, 2023, modified our list to include all countries except the United States, Western and Central Europe, Japan, Australia, New Zealand and Canada. We have revised prior year amounts to conform to the current year's presentation.

Our Emerging Markets net sales represented 16 percent of our consolidated net sales during the second quarter and first six months of 2023, and 15 percent during the second quarter and first six months of 2022. During the second quarter of 2023, our Emerging Markets net sales grew 19 percent on a reported basis, which included operational net sales growth of 24 percent and a negative impact of 540 basis points from foreign currency fluctuations, compared to the prior year period. During the first six months of 2023, our Emerging Markets net sales grew 19 percent on a reported basis, which included operational net sales growth of 25 percent and a negative impact of 570 basis points from foreign currency fluctuations, compared to the prior year period. Operational growth in both periods was driven primarily by growth in China, fueled by the breadth of our portfolio.

Economic Trends

Our business has been impacted by global supply chain disruptions. In particular, we have experienced, and may continue to experience, increases in cost and limited availability of raw materials, components, and other inputs necessary to manufacture and distribute our products due to constraints and inflation within the global supply chain, as well as increases in wage costs and the cost and time to distribute our products. Uncertainty around inflationary pressures, rising interest rates, monetary policy and changes in tax laws could potentially cause new, or exacerbate existing, economic challenges that we may face, including the impact of foreign currency fluctuations on our results of operations. These conditions could worsen, or others could arise, if the U.S. and global economies were to enter recessionary periods, triggered or exacerbated by monetary policy designed to curb inflation. Existing and future potential geopolitical dynamics, including matters related to the Russia/Ukraine war, as well as the tension between China/Taiwan, may create economic, supply chain, energy, and other challenges, which impact, and may in the future negatively impact our business. In particular, international conflicts may result in sanctions, tariffs, and other measures that restrict international trade and negatively affect our business operations and results.

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Gross Profit

Our Gross profit was $2.542 billion for the second quarter of 2023, $2.233 billion for the second quarter of 2022, $4.891 billion for the first six months of 2023 and $4.304 billion for the first six months of 2022. As a percentage of net sales, our Gross profit increased to 70.6 percent during the second quarter of 2023, compared to 68.8 percent in the second quarter of 2022 and increased to 70.0 percent during the first six months of 2023, compared to 68.6 percent during the first six months of 2022. The following is a reconciliation of our gross profit margin and a description of the drivers of the changes from period to period:

	Percentage of Net Sales
	Three Months	Six Months
Gross profit margin - period ended June 30, 2022	68.8%	68.6%
Sales pricing, volume and mix	2.3	1.6
Manufacturing and supply costs	2.3	1.9
Net impact of foreign currency fluctuations	(2.0)	(1.6)
All other, including other period expenses	(0.8)	(0.6)
Gross profit margin - period ended June 30, 2023	70.6%	70.0%

The increase in our gross profit margin in the second quarter and first six months of 2023 resulted primarily from favorable sales mix and increased sales of higher margin products, as well as improvements in manufacturing and supply costs. While global supply chain challenges persist, we experienced improvement in the first half of 2023 as recovery continues. These impacts were partially offset by the unfavorable impact of foreign currency and period expenses. We continue to expect our gross profit margin for the first half of 2023 to be higher than the second half primarily due to timing of foreign currency movements in the prior year period.

Operating Expenses

The following table provides a summary of certain of our operating expenses:

	Three Months Ended June 30,								Six Months Ended June 30,
	2023				2022				2023				2022
(in millions)	$		% of Net Sales		$		% of Net Sales		$		% of Net Sales		$		% of Net Sales
Selling, general and administrative expenses	$	1,354	37.6	%	$	1,165	35.9	%	$	2,570	36.8	%	$	2,225	35.5	%
Research and development expenses	359		10.0	%	335		10.3	%	695		10.0	%	654		10.4	%

Selling, general and administrative expenses (SG&A Expenses)

During the second quarter of 2023, SG&A expenses increased $189 million, or 16 percent, compared to the prior year period and were 170 basis points higher as a percentage of net sales. During the first six months of 2023, SG&A expenses increased $345 million, or 15 percent, compared to the prior year period and were 130 basis points higher as a percentage of net sales. The increase in SG&A expenses for both periods was primarily due to higher selling costs driven by higher global net sales and in 2023, was also due to comparatively higher acquisition-related expenses.

Research and development expenses (R&D Expenses)

We remain committed to advancing medical technologies and investing in meaningful R&D projects across our businesses. During the second quarter of 2023, R&D expenses increased $24 million, or 7 percent, compared to the prior year period and were 30 basis points lower as a percentage of net sales. During the first six months of 2023, R&D expenses increased $42 million, or 6 percent, compared to the prior year period, and were 50 basis points lower as a percentage of net sales. R&D expenses increased in both periods as a result of investments across our businesses in order to maintain a pipeline of new products that we believe will contribute to profitable sales growth.

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Other Operating Expenses

The following provides a summary of certain of our other operating expenses, which are excluded by management for purposes of evaluating operating performance; refer to Additional Information for a further description.

Amortization Expense

During the second quarter of 2023, Amortization expense increased $6 million, or 3 percent, compared to the prior year period. In the first six months of 2023, Amortization expense increased $11 million, or 3 percent, compared to the first six months of 2022. The increase in Amortization expense during both periods was driven by the addition of amortizable intangible assets associated with our recent acquisitions.

Intangible Asset Impairment Charges

We recorded Intangible asset impairment charges of $57 million in the second quarter and first six months of 2023, and $7 million in the second quarter and first six months of 2022. The impairment charges recorded in 2023 were primarily associated with the cancellation of an in-process research and development (IPR&D) program due to the incremental time and cost to complete the program and bring the technology to market. Refer to Note C – Goodwill and Other Intangible Assets to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q and Critical Accounting Policies and Estimates contained in Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations of our most recent Annual Report on Form 10-K for additional details and a discussion of key assumptions used in our goodwill and intangible asset impairment testing and future events that could have a negative impact on the recoverability of our goodwill and intangible assets.

Contingent Consideration Net Expense (Benefit)

To recognize changes in the fair value of our contingent consideration liability, we recorded net charges of $19 million in the second quarter of 2023, $36 million in the second quarter of 2022, $31 million in the first six months of 2023 and $48 million in the first six months of 2022. The net charges recorded in the first six months of 2023 and 2022 related to an increase in expected payments for achievement of commercialization-based milestones and revenue-based payments as a result of over-performance. In addition, we made payments of $73 million and $314 million associated with prior acquisitions during the first six months of 2023 and 2022, following the achievement of revenue and/or regulatory milestones. Refer to Note B – Acquisitions, Divestitures and Strategic Investments to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q for additional details related to our contingent consideration arrangements.

Restructuring Charges (Credits)

On February 22, 2023, our Board of Directors approved, and we committed to, a new global restructuring program (the 2023 Restructuring Plan). The 2023 Restructuring Plan is intended to meet evolving global market demands and conditions by ensuring that we are structured and resourced to support our strategic imperatives and deliver sustainable value. For more information, refer to 2023 Restructuring Plan contained in Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations of our most recent Annual Report on Form 10-K.

Pursuant to this program, we recorded restructuring charges in accordance with FASB ASC Topic 420, Exit or Disposal Cost Obligations of $16 million and $36 million in the second quarter and first six months of 2023. In addition, we recorded restructuring-related charges of $26 million and $50 million in the second quarter and first six months of 2023 primarily within Cost of products sold and SG&A Expenses. During the second quarter and first six months of 2022, we recorded restructuring charges of $11 million and $14 million, respectively, and restructuring-related charges of $24 million and $49 million, respectively, all associated with our 2019 Restructuring Plan, which was substantially completed as of December 31, 2022.

Litigation-related net charges (credits)

We did not record any litigation-related net charges during the second quarter and first six months of 2023. We recorded litigation-related net charges of $42 million during the second quarter and first six months of 2022, primarily related to ongoing litigation associated with our transvaginal surgical mesh products. We increased the accrual associated with this matter to account for changes in our estimates regarding settlement and litigation activity. 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

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charges (credits) within our accompanying unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within SG&A expenses.

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 the financial covenant required by our credit arrangements. Refer to Note H – Commitments and Contingencies to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q for discussion of our material legal proceedings.

Interest Expense

The following table provides a summary of our Interest expense and average borrowing rate:

	Three Months Ended June 30,						Six Months Ended June 30,
	2023			2022			2023			2022
Interest expense (in millions)	$	(70)		$	(64)		$	(135)		$	(343)
Average borrowing rate	2.9		%	2.7		%	2.8		%	7.2		%

Interest expense and our average borrowing rate increased during the second quarter of 2023 compared to the prior year period, primarily due to the increase in commercial paper usage following our acquisitions as well as rising global interest rates. Interest expense and our average borrowing rate decreased during the first six months of 2023 compared to the prior year period, primarily due to $194 million of charges associated with the early extinguishment of $3.275 billion of certain of our senior notes, including payment of tender premiums and the acceleration of unamortized debt issuance costs, as well as the issuance of euro-denominated bonds, which carry lower interest rates, during the first quarter of 2022. For the first six months of 2022, the weighted average borrowing rates associated with our outstanding senior notes were 3.3 percent. Refer to Liquidity and Capital Resources and Note E – Contractual Obligations and Commitments to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q for information regarding our debt obligations.

Tax Rate

Our effective tax rate from continuing operations is presented below:

	Three Months Ended June 30,				Six Months Ended June 30,
	2023		2022		2023		2022
Effective tax rate from continuing operations	36.6	%	24.7	%	32.9	%	26.1	%

The changes in our reported tax rates for the second quarter and first six months of 2023, compared to the same periods in 2022, relate primarily to the impact of certain receipts and charges that are taxed at different rates than our effective tax rate. These include acquisition-related charges, debt extinguishment charges, as well as certain discrete tax items primarily related to unrecognized tax benefits and provision-to-return adjustments recorded in the second quarter of 2023.

On August 16, 2022, the Inflation Reduction Act of 2022 (Inflation Reduction Act) was enacted into law by the U.S. government and includes a new corporate alternative minimum tax (CAMT) of 15 percent on the adjusted financial statement income (AFSI) of corporations with average AFSI exceeding $1.000 billion over a three-year period. Additionally, the Inflation Reduction Act includes a 1 percent excise tax on the fair market value of net corporate stock repurchases. It is possible that in certain circumstances CAMT could result in an additional tax liability in a particular year due to temporary differences between book and taxable income. Based on our evaluation, we currently do not anticipate the Inflation Reduction Act will have a material impact on our financial position, results of operations, or cash flows.

Critical Accounting Policies and Estimates

Our financial results are affected by the selection and application of accounting policies and methods. During the second quarter and first six months of 2023, there were no material changes to the application of critical accounting policies previously disclosed in our most recent Annual Report on Form 10-K.

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Liquidity and Capital Resources

Based on our current business plan, we believe our existing balance of Cash and cash equivalents, future cash generated from operations, access to capital markets and existing credit facilities will be sufficient to fund our operations, invest in our infrastructure, pay our legal-related liabilities, pay taxes due, service and repay our existing debt and fund possible acquisitions for the next 12 months and for the foreseeable future.

As of June 30, 2023, we had $426 million of unrestricted Cash and cash equivalents on hand, including approximately $140 million held by Acotec, a less than wholly owned entity of which we acquired a majority stake investment during the first quarter of 2023. The balance is comprised of $17 million invested in money market funds and time deposits and $409 million in interest bearing and non-interest-bearing bank accounts. We invest excess cash on hand in short-term financial instruments that earn at market interest rates while mitigating principal risk through instrument and counterparty diversification, as well as what we believe to be prudent instrument selection. We limit our direct exposure to securities in any one industry or issuer.

In 2021, we entered into our $2.750 billion revolving credit facility (2021 Revolving Credit Facility) with a global syndicate of commercial banks scheduled to mature on May 10, 2026, with one-year extension options, subject to certain conditions. On March 1, 2023, we entered into an amendment of the 2021 Revolving Credit Facility credit agreement, which provided for an extension of the scheduled maturity date to May 10, 2027 and replaced the London Interbank Offered Rate (LIBOR) with the Secured Overnight Financing Rate (SOFR) as the Eurocurrency Rate for Dollars, including applicable credit spread adjustments and relevant SOFR benchmark provisions, as well as modification to the calculation of consolidated EBITDA, described under Financial Covenant below. This facility provides backing for our commercial paper program, and outstanding commercial paper directly reduces borrowing capacity under the 2021 Revolving Credit Facility. As of June 30, 2023, we had $41 million commercial paper debt outstanding, resulting in an additional $2.709 billion of available liquidity under the 2021 Revolving Credit Facility.

For additional details related to our debt obligations, including our financial covenant requirement, refer to Note E – Contractual Obligations and Commitments to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q.

The following provides a summary and description of our net cash inflows (outflows):

	Six Months Ended June 30,
(in millions)	2023		2022
Cash provided by (used for) operating activities	$	848	$	249
Cash provided by (used for) investing activities	(1,324)		(1,603)
Cash provided by (used for) financing activities	(26)		(350)

Operating Activities

During the first six months of 2023, cash provided by (used for) operating activities increased $599 million as compared to the prior year period primarily due to comparatively higher net sales and operating income as well as lower tax-related and litigation-related payments and changes in operating assets and liabilities.

Investing Activities

During the first six months of 2023, cash provided by (used for) investing activities included cash payments of $1.018 billion, net of cash acquired, for the acquisition of Apollo and a majority stake investment in Acotec, as well as purchases of property, plant and equipment and internal use software of $254 million. During the first six months of 2022, cash used for investing activities included a net cash payment of $1.471 billion for the acquisition of Baylis Medical. For more information, refer to Note B – Acquisitions, Divestitures and Strategic Investments to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q. In addition, we made purchases of property, plant and equipment and internal use software of $226 million during the first six months of 2022.

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Financing Activities

Cash provided by (used for) financing activities in the first six months of 2023 included proceeds from issuances of common stock pursuant to employee stock compensation and purchase plans of $90 million, cash used to net share settle employee equity awards of $52 million and payments of contingent consideration previously established in purchase accounting of $39 million. In the first six months of 2022, we completed a public offering (the Offering) of €3.000 billion in aggregate principal amount of euro-dominated senior notes. The Offering resulted in cash proceeds of $3.270 billion, net of investor discounts and issuance costs. We used the net proceeds from the Offering to fund the tender offer and early redemption of combined aggregate principal amount of $3.275 billion of certain of our outstanding senior notes, as well as to pay accrued interest, tender premiums, fees and expenses. Additionally, cash provided by (used for) financing activities in the first six months of 2022 included payments of contingent consideration previously established in purchase accounting of $283 million, payments on short-term borrowings of $250 million and an increase (decrease) in commercial paper of $154 million. For more information, refer to Note E – Contractual Obligations and Commitments to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q.

Financial Covenant

As of June 30, 2023, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility, as amended, as described below.

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 through the remaining term. The agreement provides for higher leverage ratios, at our election, for the period following a qualified acquisition for which consideration exceeds $1.000 billion. In the event of such an acquisition, for the four succeeding quarters immediately following, including the quarter in which the acquisition occurs, the maximum permitted leverage ratio is 4.75 times. The maximum permitted ratio steps down for the fifth, sixth and seventh succeeding quarters to 4.50 times, 4.25 times and 4.00 times, respectively. Thereafter, a maximum leverage ratio of 3.75 times is required through the remaining term of the 2021 Revolving Credit Facility. We have not elected to increase the maximum permitted leverage ratio for any qualified acquisitions due to the funding of these acquisitions using cash on hand or commercial paper. We believe that we have the ability to comply with the financial covenant for the next 12 months.

The financial covenant requirement, as amended on March 1, 2023, provides for an exclusion from the calculation of consolidated EBITDA, as defined by the credit agreement, through maturity, of certain charges and expenses. The credit agreement amendment reset the starting date for purposes of calculating such permitted exclusions in each case from March 31, 2021 to December 31, 2022. Permitted exclusions include any non-cash charges and up to $500 million in restructuring charges and restructuring-related expenses associated with our current or future restructuring plans. As of June 30, 2023, we had $416 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 for a total of $1.443 billion. As of June 30, 2023, we had $1.413 billion of the litigation exclusion remaining.

Contractual Obligations and Commitments

Certain of our acquisitions involve the payment of contingent consideration. Refer to Note B – Acquisitions, Divestitures and Strategic Investments to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q for further details regarding the estimated potential amount of future contingent consideration we could be required to pay associated with our acquisitions. There have been no other material changes to our contractual obligations and commitments as of June 30, 2023.

Equity

On June 1, 2023, all outstanding shares of MCPS automatically converted into shares of common stock. No action by the holders of the MCPS was required in connection with the mandatory conversion. The conversion rate for each share of MCPS was 2.3834 shares of common stock. 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.

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During the second quarter of 2023, the Audit Committee of our Board of Directors, pursuant to authority delegated to such committee by our Board of Directors, declared, and we paid, a final cash dividend of $1.375 per MCPS share to holders of our MCPS as of May 15, 2023, representing a dividend period from March 2023 through May 2023. Following the mandatory conversion of the MCPS, there were no outstanding shares of MCPS, resulting in the retirement of the annualized approximately $55 million cash dividend payment on the MCPS.

We received $90 million during the first six months of 2023 and $58 million during the first six months of 2022 in proceeds from stock issuances related to our stock option and employee stock purchase plans. Proceeds from the exercise of employee stock options and employee stock purchases vary from period to period based upon, among other factors, fluctuations in the trading price of our common stock and in the exercise and stock purchase patterns of our employees.

We did not repurchase any shares of our common stock during the first six months of 2023 or 2022. On December 14, 2020, our Board of Directors approved a new stock repurchase program authorizing the repurchase of up to $1.000 billion of our common stock. As of June 30, 2023, we had the full amount remaining available under the authorization.

Legal Matters

For a discussion of our material legal proceedings refer to Note H – Commitments and Contingencies to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q and Note I – Commitments and Contingencies to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K.

Recent Accounting Pronouncements

Information regarding new accounting pronouncements implemented since December 31, 2022, and relevant accounting pronouncements to be implemented in the future are included in Note N – New Accounting Pronouncements to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q.

Additional Information

Corporate Responsibility

Our sustainable environmental, social and governance (ESG) practices underpin all aspects of our global business. Our approach is aligned with the United Nations Sustainable Development Goals and our material topics and practices are informed by a broad range of internal and external stakeholders – locally, nationally and globally. Our employees around the world work with suppliers and other organizations that share our commitment to these practices that help address issues related to health inequity, economic disparity, climate change and environmental protection. Our global ESG vision and strategy is led by our ESG Executive Steering Committee and our vice president of ESG, who provides regular updates to the Board of Directors. Our ESG team works closely with subject matter experts and key advisors from across the business to implement our ESG practices and determine how we measure and share progress. These efforts are supported by our cross-functional teams, our Environmental Health and Safety teams and policies, our Global Council for Inclusion, as well as our local, regional and national employee and community engagement programs. In addition, since 2021, our annual bonus plan has included performance measured against certain ESG goals. For additional information on our sustainability efforts, as well as our Diversity, Equity and Inclusion initiatives, refer to our most recent Annual Report on Form 10-K. For additional information on our annual bonus plan, refer to our Proxy Statement for the 2023 Annual Meeting of Shareholders.

Cybersecurity

We have established controls and procedures to escalate enterprise level issues, including cybersecurity matters, to the appropriate management levels within our organization and our Board of Directors, or members or committees thereof, as appropriate. Under our framework, cybersecurity issues are analyzed by subject matter experts and a crisis committee for potential financial, operational, and reputational risks, based on, among other factors, the nature of the matter and breadth of impact. Matters determined to present potential material impacts to the Company’s financial results, operations, and/or reputation are immediately reported by management to the Board of Directors, or individual members or committees thereof, as appropriate, in accordance with our escalation framework. In addition, we have established procedures to ensure that management responsible for overseeing the effectiveness of disclosure controls is informed in a timely manner of known cybersecurity risks and incidents that may materially impact our operations and that timely public disclosure is made or updated, as appropriate. 

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International conflicts, including, but not limited to the Russia/Ukraine war and tension between China/Taiwan, have heightened cybersecurity risks on a global basis. While there is significant uncertainty around implications of cybersecurity attacks resulting from the conflict, we have taken steps to better understand our readiness, including the resilience of our critical business functions, with the goal of reducing the impact if such an event were to occur.

Stock Trading Policy

Our directors and executive officers are subject to our Stock Trading Policy, which is designed to facilitate compliance with insider trading laws and governs transactions in our common stock and related derivative securities. Our policy designates certain regular periods, dictated by release of financial results, in which trading is restricted for individuals in information-sensitive positions, including directors and executive officers. In addition, additional periods of trading restriction may be imposed as determined by the President and Chief Executive Officer, General Counsel, or Chief Financial Officer in light of material pending developments. Further, during permitted windows, certain individuals in information-sensitive positions are required to seek pre-clearance for trades from the General Counsel, who assesses whether there are any important pending developments which need to be made public before the individual may participate in the market.

Periodically, certain of our executive officers adopt written stock trading plans in accordance with Rule 10b5-1 under the Exchange Act and our own Stock Trading Policy. A Rule 10b5-1 Trading Plan is a written document that pre-establishes the amount, prices and dates (or formulas for determining the amounts, prices and dates) of future purchases or sales of our stock, including shares issued upon exercise of stock options or vesting of deferred stock units. These plans are entered into at a time when the person is not in possession of material non-public information about the Company. In addition to the plans described in Part II, Item 5 of this Quarterly Report on Form 10-Q, we disclose details regarding individual Rule 10b5-1 Trading Plans on the Investor Relations section of our website.

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Use of Non-GAAP Financial Measures

To supplement our unaudited consolidated financial statements presented on a GAAP basis, we disclose certain non-GAAP financial measures, including adjusted net income (loss), adjusted net income (loss) attributable to Boston Scientific common stockholders and adjusted net income (loss) per share (EPS) that exclude certain charges (credits); operational net sales, which exclude the impact of foreign currency fluctuations; and organic net sales, which exclude the impact of foreign currency fluctuations as well as the impact of acquisitions and divestitures with less than a full period of comparable net sales. These non-GAAP financial measures are not in accordance with generally accepted accounting principles in the United States and should not be considered in isolation from or as a replacement for the most directly comparable GAAP financial measures. Further, other companies may calculate these non-GAAP financial measures differently than we do, which may limit the usefulness of those measures for comparative purposes.

To calculate adjusted net income (loss), adjusted net income (loss) attributable to Boston Scientific common stockholders and adjusted net income (loss) per share we exclude certain charges (credits) from GAAP net income and GAAP net income attributable to Boston Scientific common stockholders, which include amortization expense, goodwill and intangible asset impairment charges, acquisition/divestiture-related net charges (credits), investment portfolio gains and losses, restructuring and restructuring-related net charges (credits), certain litigation-related net charges (credits), EU MDR implementation costs, debt extinguishment charges, deferred tax expenses (benefits) and discrete tax items. Amounts are presented after-tax using our effective tax rate, unless the amount is a significant unusual or infrequently occurring item in accordance with Financial Accounting Standards Board Accounting Standards Codification Topic 740-270-30, “General Methodology and Use of Estimated Annual Effective Tax Rate.” Please refer to Part II, Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations in our most recent Annual Report filed on Form 10-K filed with the Securities and Exchange Commission for an explanation of each of these adjustments and the reasons for excluding each item.

The GAAP financial measures most directly comparable to adjusted net income (loss), adjusted net income (loss) attributable to Boston Scientific common stockholders and adjusted net income (loss) per share are GAAP net income (loss), GAAP net income (loss) attributable to Boston Scientific common stockholders and GAAP net income (loss) per common share – diluted, respectively.

To calculate operational net sales growth rates, which exclude the impact of foreign currency fluctuations, we convert actual net sales from local currency to U.S. dollars using constant foreign currency exchange rates in the current and prior periods. To calculate organic net sales growth rates, we also remove the impact of acquisitions and divestitures with less than a full period of comparable net sales. The GAAP financial measure most directly comparable to operational net sales and organic net sales is net sales on a GAAP basis.

Reconciliations of each of these non-GAAP financial measures to the corresponding GAAP financial measure are included in the relevant sections of this Quarterly Report.

Management uses these supplemental non-GAAP financial measures to evaluate performance period over period, to analyze the underlying trends in our business, to assess our performance relative to our competitors and to establish operational goals and forecasts that are used in allocating resources. In addition, management uses these non-GAAP financial measures to further its understanding of the performance of our operating segments. The adjustments excluded from our non-GAAP financial measures are consistent with those excluded from our operating segments’ measures of net sales and profit or loss. These adjustments are excluded from the segment measures reported to our chief operating decision maker that are used to make operating decisions and assess performance.

We believe that presenting adjusted net income (loss), adjusted net income (loss) attributable to Boston Scientific common stockholders, adjusted net income (loss) per share, operational net sales and organic net sales growth rates, in addition to the corresponding GAAP financial measures, provides investors greater transparency to the information used by management for its operational decision-making and allows investors to see our results “through the eyes” of management. We further believe that providing this information assists our investors in understanding our operating performance and the methodology used by management to evaluate and measure such performance.

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Safe Harbor for Forward-Looking Statements

Certain statements that we may make from time to time, including statements contained in this Quarterly Report on Form 10-Q and information incorporated by reference herein, constitute “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking statements may be identified by words like “anticipate,” “expect,” “project,” “believe,” “plan,” “estimate,” “intend,” “aim,” "goal," "target," "continue," "hope," "may" and similar words. These forward-looking statements are based on our beliefs, assumptions and estimates using information available to us at the time and are not intended to be guarantees of future events or performance. If our underlying assumptions turn out to be incorrect, or if certain risks or uncertainties materialize, actual results could vary materially from the expectations and projections expressed or implied by our forward-looking statements.

The forward-looking statements in this Quarterly Report on Form 10-Q are based on certain risks and uncertainties, including the risk factors described in Part I, Item 1A. Risk Factors in our most recent Annual Report on Form 10-K and the specific risk factors discussed herein and in connection with forward-looking statements throughout this Quarterly Report on Form 10-Q, which could cause actual results to vary materially from the expectations and projections expressed or implied by our forward-looking statements. These risks and uncertainties, in some cases, have affected and in the future could affect our ability to implement our business strategy and may cause actual results to differ materially from those contemplated by the statements expressed in this Quarterly Report on Form 10-Q. As a result, readers are cautioned not to place undue reliance on any of our forward-looking statements. Risks and uncertainties that may cause such differences include, among other things: the impact of foreign currency fluctuations, future U.S. and global economic, political, competitive, reimbursement and regulatory conditions; manufacturing, distribution and supply chain disruptions and cost increases; disruptions caused by cybersecurity events; the impact of the COVID-19 pandemic on our operations and financial results; disruptions caused by extreme weather or other climate change-related events; labor shortages and increases in labor costs; new product introductions and the market acceptance of those products; markets for our products; expected pricing environment; expected procedural volumes; the closing and integration of acquisitions; clinical trial results; demographic trends; intellectual property rights; litigation; financial market conditions; the execution and effect of our restructuring program; the execution and effect of our business strategy, including our cost-savings and growth initiatives; our ability to achieve environmental, social and governance goals and commitments; and future business decisions made by us and our competitors. New risks and uncertainties may arise from time to time and are difficult to predict, including those that have emerged or may increase in significance or likelihood as a result of the COVID-19 pandemic. All of these factors are difficult or impossible to predict accurately and many of them are beyond our control. For a further list and description of these and other important risks and uncertainties that may affect our future operations, refer to Part I, Item 1A. Risk Factors in our most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission, which we may update in Part II, Item 1A. Risk Factors in subsequent Quarterly Reports on Form 10-Q that we will file hereafter. We disclaim any intention or obligation to publicly update or revise any forward-looking statement to reflect any change in our expectations or in events, conditions, or circumstances on which those expectations may be based, or that may affect the likelihood that actual results will differ from those contained in the forward-looking statements. This cautionary statement is applicable to all forward-looking statements contained in this Quarterly Report.

The following are some of the important risk factors that could cause our actual results to differ materially from our expectations in any forward-looking statements. For further discussion of these and other risk factors, refer to Part I, Item 1A. Risk Factors in our most recent Annual Report on Form 10-K.

Our Businesses

•Labor shortages and the impact of inflation on the cost of raw materials and direct labor,

•Risks associated with challenging or uncertain domestic and international economic conditions, including those related to rising interest rates, inflation, supply chain disruptions and constraints, adverse developments and volatility in the banking industry, currency devaluations or economies entering into periods of recession,

•The impact of the COVID-19 pandemic and economic conditions created in part by the pandemic on worldwide economies, financial markets, manufacturing and distribution systems, including disruption in the manufacture or supply of certain components, materials or products, and business operations,

•The impact of natural disasters, climate change, additional future public health crises and other catastrophic events on our ability to manufacture, distribute and sell our products,

•The impact of competitive offerings, value-based procurement practices, government-imposed payback provisions and changes in reimbursement practices and policies on average selling prices for our products,

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•The ongoing impact on our business of physician alignment to hospitals, governmental investigations and audits of hospitals and other market and economic conditions on the overall number of procedures performed,

•The performance of, and physician and patient confidence in, our products and technologies or those of our competitors,

•The impact and outcome of ongoing and future clinical trials and market studies undertaken by us, our competitors or other third parties or perceived product performance of our or our competitors' products,

•Variations in clinical results, reliability or product performance of our and our competitors' products,

•Our ability to acquire or develop, launch and supply new or next-generation products and technologies worldwide and in line with our commercialization strategies in a timely and successful manner and with respect to our recent acquisitions,

•The effect of consolidation and competition in the markets in which we do business or plan to do business,

•Our ability to achieve our projected level or mix of product sales, as some of our products are more profitable than others,

•Our ability to attract and retain talent, including key personnel associated with recent acquisitions, and to maintain our robust corporate culture,

•The impact of enhanced requirements to obtain and maintain regulatory approval in the U.S. and around the world, including EU MDR and the associated timing and cost of product approval,

•The impact of increased pressure on the availability and rate of third-party reimbursement for our products and procedures in the U.S. and around the world, including with respect to the timing and costs of creating and expanding markets for new products and technologies,

•The issuance of new or revised accounting standards by the Financial Accounting Standards Board or the Securities and Exchange Commission, and

•The impact of potential goodwill and intangible asset impairment charges on our results of operations.

Regulatory Compliance, Litigation and Data Protection

•The impact of healthcare policy changes and legislative or regulatory efforts in the U.S., the EU and around the world to modify product approval or reimbursement processes, including a trend toward demonstrating clinical outcomes, comparative effectiveness and cost efficiency, as well as the impact of other healthcare reform legislation,

•Risks associated with our regulatory compliance and quality systems and activities in the U.S., the EU and around the world, including meeting regulatory standards applicable to manufacturing and quality processes,

•The effect of global legal, regulatory or market responses to climate change, including increased compliance burdens and costs to meet regulatory obligations,

•Our ability to minimize or avoid future field actions or FDA warning letters relating to our products and processes and the ongoing inherent risk of potential physician advisories related to our or our competitors' products,

•The impact of increased scrutiny of and heightened global regulatory enforcement facing the medical device industry arising from political and regulatory changes, economic pressures or otherwise, including under U.S. Anti-Kickback Statute, U.S. False Claims Act and similar laws in other jurisdictions, U.S. Foreign Corrupt Practices Act (FCPA) and similar laws in other jurisdictions, and U.S. and foreign export control, trade embargo and customs laws,

•Costs and risks associated with current and future asserted litigation,

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•The effect of our litigation and risk management practices, including self-insurance and compliance activities on our loss contingencies, legal provisions and cash flows,

•The impact of, diversion of management attention as a result of, and costs to cooperate with, litigate and/or resolve governmental investigations and our class action, product liability, contract and other legal proceedings,

•The possibility of failure to protect our intellectual property rights and the outcome of patent litigation,

•Our ability to operate properly our information systems that support our business operations and protect our data integrity and products from a cyber-attack or other breach that has a material adverse effect on our business, reputation or results of operations, including increased risks as an indirect result of the ongoing Russia/ Ukraine war, and

•The potential impact to internal control over financial reporting relating to potential restrictions to access to consigned inventory at customer locations for our inventory count procedures.

Innovation and Certain Growth Initiatives

•The timing, size and nature of our strategic growth initiatives and market opportunities, including with respect to our internal research and development platforms and externally available research and development platforms and technologies and the ultimate cost and success of those initiatives and opportunities,

•Our ability to complete planned clinical trials successfully, obtain regulatory approvals and launch new and next generation products in a timely manner consistent with cost estimates, including the successful completion of projects from in-process research and development,

•Our ability to identify and prioritize our internal research and development project portfolio and our external investment portfolio on profitable net sales growth opportunities as well as to maintain the estimated timing and costs of such projects and expected revenue levels for the resulting products and technologies,

•Our ability to develop, manufacture and market new products and technologies successfully and in a timely manner and the ability of our competitors and other third parties to develop products or technologies that render our products or technologies noncompetitive or obsolete,

•Our ability to execute appropriate decisions to discontinue, write-down or reduce the funding of any of our research and development projects, including projects from in-process research and development from our acquisitions, in our growth adjacencies or otherwise,

•Our dependence on acquisitions, alliances or investments to introduce new products or technologies and to enter new or adjacent growth markets and our ability to fund them or to fund contingent payments with respect to those acquisitions, alliances and investments, and

•The potential failure to complete, successfully integrate and/or realize the expected benefits, including cost synergies, from the strategic acquisitions, alliances and investments we have consummated or may consummate in the future.

International Markets

•Our dependency on international net sales to achieve growth, and our ability to maintain or expand our worldwide market positions in the various markets in which we compete or seek to compete, including through investments in Emerging Markets such as Brazil, India and China,

•The timing and collectability of customer payments, as well as our ability to continue factoring customer receivables where we have factoring arrangements, or to enter new factoring arrangements with favorable terms,

•The impact on pricing due to national and regional tenders, including value-based procurement practices and government-imposed payback provisions,

•Geopolitical and economic conditions, including civil unrest, terrorist activity, governmental changes, restrictions on the ability to transfer capital across borders, tariffs and other protectionist measures,

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•The impact of the Russia/Ukraine war and tension between China/Taiwan, and related, downstream effects thereof, including the impact of sanctions on U.S. manufacturers doing business in these regions,

•Protection of our intellectual property,

•Our ability to comply with established and developing U.S. and foreign legal and regulatory requirements, including FCPA, EU MDR and similar laws in other jurisdictions,

•Our ability to comply with U.S. and foreign export control, trade embargo and customs laws,

•The impact of significant developments or uncertainties stemming from changes in the U.S. government following congressional elections, including changes in U.S. trade policies, tariffs and the reaction of other countries thereto, particularly China, and

•The potential effect of foreign currency fluctuations and interest rate fluctuations on our net sales, operating expenses and resulting profit margins.

Liquidity

•Our ability to generate sufficient cash flow to fund operations, capital expenditures, global expansion initiatives, any litigation settlements and judgments, share repurchases and strategic investments and acquisitions as well as maintaining our investment grade ratings and managing our debt levels and financial covenant compliance,

•Our ability to access the public and private capital markets when desired and to issue debt or equity securities on terms reasonably acceptable to us,

•The unfavorable resolution of open tax matters, exposure to additional tax liabilities and the impact of changes in U.S. and international tax laws,

•The unfavorable resolution of open litigation matters, exposure to additional loss contingencies and legal provisions,

•The impact of examinations and assessments by domestic and international taxing authorities on our tax provisions, financial condition or results of operations,

•The possibility of counterparty default on our derivative financial instruments, and

•Our ability to collect outstanding and future receivables and/or sell receivables under our factoring programs.

Cost Reduction and Optimization Initiatives

•Risks associated with changes made or expected to be made to our organizational and operational structure, pursuant to our restructuring plans as well as any further restructuring or optimization plans we may undertake in the future and our ability to recognize benefits and cost reductions from such programs, and

•Business disruption and employee distraction as we execute our global compliance program, restructuring and optimization plans and divestitures of assets or businesses and implement our other strategic and cost reduction initiatives.

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ITEM 3.QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

We develop, manufacture and sell medical devices globally and our earnings and cash flows are exposed to market risk from changes in currency exchange rates and interest rates. We address these risks through a risk management program that includes the use of derivative financial instruments. We operate the program pursuant to documented corporate risk management policies. We do not enter derivative transactions for speculative purposes. Gains and losses on derivative financial instruments substantially offset losses and gains on underlying hedged exposures. Furthermore, we manage our exposure to counterparty risk on derivative instruments by entering into contracts with a diversified group of major financial institutions and by actively monitoring outstanding positions.

Our currency risk consists primarily of foreign currency denominated firm commitments, forecasted foreign currency denominated intercompany and third-party transactions and net investments in certain subsidiaries. We use both nonderivative (primarily European manufacturing operations) and derivative instruments to manage our earnings and cash flow exposure to changes in currency exchange rates. We had currency derivative instruments outstanding in the contract amount of $6.363 billion as of June 30, 2023 and $7.324 billion as of December 31, 2022. A ten percent appreciation in the U.S. dollar’s value relative to the hedged currencies would increase the derivative instruments’ fair value by $263 million as of June 30, 2023 as compared to $208 million as of December 31, 2022. A ten percent depreciation in the U.S. dollar’s value relative to the hedged currencies would decrease the derivative instruments’ fair value by $322 million as of June 30, 2023 as compared to $254 million as of December 31, 2022. Any increase or decrease in the fair value of our currency exchange rate sensitive derivative instruments would be substantially offset by a corresponding decrease or increase in the fair value of the hedged underlying asset, liability or forecasted transaction, resulting in minimal impacts on our unaudited consolidated statements of operations.

Our interest rate risk relates primarily to U.S. dollar borrowings partially offset by U.S. dollar cash investments. We have historically used interest rate derivative instruments to manage our earnings and cash flow exposure to changes in interest rates. We had no interest rate derivative instruments outstanding as of June 30, 2023 and December 31, 2022. As of June 30, 2023, $9.063 billion in aggregate principal amount of our outstanding debt obligations was at fixed interest rates, representing approximately 100 percent of our total debt, on an amortized cost basis. As of June 30, 2023, our outstanding debt obligations at fixed interest rates were comprised of senior notes.

Refer to Note D – Hedging Activities and Fair Value Measurements to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q for further information regarding our derivative financial instruments.

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ITEM 4.CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and Procedures

Our management, with the participation of our Chief Executive Officer (CEO) and our Chief Financial Officer (CFO), evaluated the effectiveness of our disclosure controls and procedures as of June 30, 2023 pursuant to Rule 13a-15(b) of the Securities Exchange Act of 1934, as amended (the Exchange Act). Disclosure controls and procedures are designed to ensure that material information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the Securities and Exchange Commission’s rules and forms and that such material information is accumulated and communicated to our management, including our CEO and CFO, as appropriate, to allow timely decisions regarding required disclosure. Based on their evaluation, our CEO and CFO concluded that, as of June 30, 2023, our disclosure controls and procedures were effective.

Changes in Internal Control Over Financial Reporting

During 2022, we began a multi-year implementation of a new global enterprise resource planning (ERP) system, which will replace our existing system. The implementation is expected to occur in phases over the next several years. The portion of the transition to the new ERP system which we have completed to date resulted in changes in our internal control over financial reporting during the first six months of 2023. As future phases are implemented, we expect the changes to have a material impact on our internal controls over financial reporting and we will evaluate whether these process changes necessitate further changes in the design of and testing for effectiveness of internal controls over financial reporting.

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PART II

OTHER INFORMATION

ITEM 1. LEGAL PROCEEDINGS

Refer to Note H – Commitments and Contingencies to our unaudited consolidated financial statements contained in Item 1 of Part I of this Quarterly Report on Form 10-Q, which is incorporated herein by reference.

ITEM 1A. RISK FACTORS

In addition to other information contained elsewhere in this report, you should carefully consider the factors discussed in Part I, Item 1A. Risk Factors in our most recent Annual Report filed on Form 10-K, which could materially affect our business, financial condition or future results.

ITEM 5. OTHER INFORMATION

(a)

On August 1, 2023, we filed a Certificate of Elimination with respect to our 5.50% Mandatory Convertible Preferred Stock, Series A (MCPS), which upon filing with the Secretary of State of the State of Delaware, eliminated from the Third Restated Certificate of Incorporation of the Company, as amended, all references and matters set forth in the Certificate of Designations with respect to the MCPS as filed with the Secretary of State of the State of Delaware on May 26, 2020.

Following the mandatory conversion of the outstanding shares of the MCPS on June 1, 2023, there were no outstanding shares of MCPS. The foregoing summary of the Certificate of Elimination relating to the MCPS does not purport to be complete and is subject to, and qualified in its entirety by reference to, the Certificate of Elimination, a copy of which is attached as Exhibit 3.1 to this Quarterly Report on Form 10-Q and is incorporated herein by reference.

(c)

On April 6, 2023, Jeffrey B. Mirviss, our Senior Vice President and President, Peripheral Interventions, terminated a trading plan that was originally entered into on February 23, 2023 and intended to satisfy the affirmative defense conditions of the prior version of Rule 10b5-1(c). The plan covered the sale of up to 76,992 shares of our common stock, including up to 27,208 shares to be acquired upon vesting of performance share units and restricted share units and 30,172 shares to be acquired upon exercise of stock options, between March 27, 2023 and February 23, 2024. Transactions under the plan were based upon pre-established dates and stock price thresholds.

On May 19, 2023, Charles Dockendorff, an independent member of our Board of Directors, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Dockendorff’s plan covers the sale of 21,025 shares of our common stock between August 18, 2023 and May 31, 2024. Transactions under the plan are based upon pre-established dates and stock price thresholds.

On May 25, 2023, Jeffrey B. Mirviss, our Senior Vice President and President, Peripheral Interventions, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Mirviss’ plan covers the sale of up 105,490 shares of our common stock, including up to 56,690 shares to be acquired upon determination and/or vesting of performance share units and restricted share units and 30,172 shares to be acquired upon exercise of stock options, between August 24, 2023 and March 29, 2024. Transactions under the plan are based upon pre-established dates and stock price thresholds.

On May 26, 2023, Vance R. Brown, our Senior Vice President, General Counsel and Corporate Secretary, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Brown’s plan covers the sale of 15,750 shares of our common stock between August 25, 2023 and December 29, 2023. Transactions under the plan are based upon pre-established dates and stock price thresholds.

ITEM 6. EXHIBITS (* documents filed or furnished with this report; # compensatory plans or arrangements)

3.1* Certificate of Elimination relating to the 5.50% Mandatory Convertible Preferred Stock, Series A.

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22	Subsidiary Issuer of Guaranteed Securities (incorporated herein by reference to Exhibit 22 to the Company’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2023, filed on May 4, 2023, File No. 1-11083).
31.1*	Certification of the Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
31.2*	Certification of the Chief Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
32.1*	Certification of the Chief Executive Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
32.2*	Certification of the Chief Financial Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
101.SCH*	Inline XBRL Taxonomy Extension Schema Document.
101.CAL*	Inline XBRL Taxonomy Extension Calculation Linkbase Document.
101.DEF*	Inline XBRL Taxonomy Extension Definition Linkbase Document.
101.LAB*	Inline XBRL Taxonomy Extension Label Linkbase Document.
101.PRE*	Inline XBRL Taxonomy Extension Presentation Linkbase Document.
104	Cover Page Interactive Data File (embedded within the Inline XBRL document and contained in Exhibit 101).

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SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized on August 3, 2023.

BOSTON SCIENTIFIC CORPORATION
By:	/s/ Daniel J. Brennan
	Name:	Daniel J. Brennan
	Title:	Executive Vice President and Chief Financial Officer

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EX-3.1

Exhibit 3.1

CERTIFICATE OF ELIMINATION

OF

5.50% MANDATORY CONVERTIBLE PREFERRED STOCK, SERIES A

OF

BOSTON SCIENTIFIC CORPORATION

Boston Scientific Corporation, a Delaware corporation (the “Corporation”), hereby certifies that, pursuant to the provisions of Sections 103, 141 and 151 of the General Corporation Law of the State of Delaware:

1.On May 19, 2020, the board of directors of the Corporation (the “Board of Directors”), pursuant to authority conferred upon the Board of Directors by the Third Restated Certificate of Incorporation of the Corporation (as such may be amended, modified or restated from time to time, the “Third Restated Certificate of Incorporation”), delegated to its Pricing Committee (the “Pricing Committee”), the power to create, designate, authorize and provide for the issuance of shares of a new series of the Corporation’s undesignated preferred stock, to be designated the “5.50% Mandatory Convertible Preferred Stock, Series A,” and to establish the number of shares to be included in such series, and to fix the powers, designations, preferences, rights and qualifications, limitations or restrictions and other terms thereof, to be set forth in this Certificate of Designations (the “Certificate of Designations”); on May 21, 2020, the Pricing Committee, by resolution duly adopted, authorized the issuance of a series of 10,062,500 shares of preferred stock designated the “5.50% Mandatory Convertible Preferred Stock, Series A,” and established the powers, designations, preferences, rights and qualifications, limitations or restrictions and other terms thereof; and on May 26, 2020, the Corporation filed the Certificate of Designations with respect to such 5.50% Mandatory Convertible Preferred Stock, Series A, with the Secretary of State of the State of Delaware.

2.No shares of said 5.50% Mandatory Convertible Preferred Stock, Series A, are outstanding and no shares thereof will be issued subject to the Certificate of Designations.

3.On July 24, the Board adopted the following resolutions, which resolutions are now, and at all times since their date of adoption have been, in full force and effect:

WHEREAS, by resolutions of the board of directors of the Corporation (the “Board of Directors”) and a duly established Pricing Committee of the Board of Directors, and by a Certificate of Designations (the “Certificate of Designations”) filed with the Secretary of State of the State of Delaware on May 26, 2020, the Corporation authorized the issuance of a series of 10,062,500 shares of 5.50% Mandatory Convertible Preferred Stock, Series A, par value $0.01 per share (the “Mandatory Convertible Preferred Stock”), and established the powers, designations, preferences, rights and qualifications, limitations, restrictions and other terms thereof;

WHEREAS, 10,062,500 shares of such Mandatory Convertible Preferred Stock were issued by the Corporation on May 27, 2020, and all such shares have been reacquired by the Corporation pursuant to the conversion thereof (the “Conversion”) into shares of Common Stock, par value $0.01 per share, of the Corporation (the “Common Stock”); and

WHEREAS, the Board of Directors (i) deems it desirable that, pursuant to Section 151(g) of the General Corporation Law of the State of Delaware, a certificate of elimination of the Mandatory Convertible Preferred Stock (the “Certificate of Elimination”) be executed and filed with the Secretary of State of the State of Delaware and that all 10,062,500 shares of Mandatory Convertible Preferred Stock heretofore designated resume the status of authorized and unissued shares of preferred stock, par value $0.01 per share, of the Corporation and (ii) has determined it is desirable that all matters set forth in the Certificate of Designations with respect to the Mandatory Convertible Preferred Stock be eliminated from the Third Restated Certificate of Incorporation of the Corporation (as such may be amended, modified or restated from time to time, the “Third Restated Certificate of Incorporation”).

NOW, THEREFORE, it is hereby:

RESOLVED: that, pursuant to the Conversion, no shares of Mandatory Convertible Preferred Stock are outstanding and no shares of Mandatory Convertible Preferred Stock will be issued subject to the Certificate of Designations;

FURTHER RESOLVED: that, pursuant to the Conversion, when the Certificate of Elimination becomes effective, all references and matters set forth in the Certificate of Designations with respect to the Mandatory Convertible Preferred Stock be eliminated from the Third Restated Certificate of Incorporation and the shares of the Mandatory Convertible Preferred Stock shall resume the status of authorized and unissued shares of preferred stock, par value $0.01 per share, of the Corporation, without designation as to series;

FURTHER RESOLVED: that, pursuant to the authorization granted, any of the Corporation’s Chief Executive Officer, Chief Financial Officer, any Executive Vice President, the Treasurer, the General Counsel, the Vice President and Chief Corporate Counsel, and the Senior Vice President, New Business Development, of the Corporation (each, an “Appropriate Officer” and collectively, the “Appropriate Officers”) shall prepare, execute and file on behalf of the Corporation the Certificate of Elimination with the Secretary of State of the State of Delaware setting forth a copy of these resolutions whereupon all references and matters set forth in the Certificate of Designations with respect to the Mandatory Convertible Preferred Stock shall be eliminated from the Third Restated Certificate of Incorporation;

4.That, in accordance with the provisions of Section 151(g) of the General Corporation Law of the State of Delaware, upon the filing of this Certificate of Elimination, all references and matters set forth in the Certificate of Designations with respect to the 5.50% Mandatory Convertible Preferred Stock, Series A, shall be, and hereby are, eliminated from the Third Restated Certificate of Incorporation, and all shares of the Mandatory Convertible Preferred Stock shall resume the status of authorized and unissued shares of preferred stock, par value $0.01 per share, of the Corporation, without designation as to series.

IN WITNESS WHEREOF, the Corporation has caused this Certificate of Elimination to be duly executed this 31st day of July, 2023.

BOSTON SCIENTIFIC CORPORATION

By: /s/ Robert J. Castagna            

Name: Robert J. Castagna

Title: Vice President and Treasurer

[Signature Page to Certificate of Elimination of Mandatory Convertible Preferred Stock]

EX-31.1

EXHIBIT 31.1

CERTIFICATIONS

I, Michael F. Mahoney, certify that:

1	I have reviewed this Quarterly Report on Form 10-Q of Boston Scientific Corporation;
2	Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3	Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4	The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
	a)	Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
	b)	Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
	c)	Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
	d)	Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and
5	The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):
	a)	All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and
	b)	Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date:	August 3, 2023	/s/ Michael F. Mahoney
		Michael F. Mahoney
		Chief Executive Officer

EX-31.2

EXHIBIT 31.2

CERTIFICATIONS

I, Daniel J. Brennan, certify that:

1	I have reviewed this Quarterly Report on Form 10-Q of Boston Scientific Corporation;
2	Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3	Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4	The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
	a)	Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
	b)	Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
	c)	Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
	d)	Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and
5	The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):
	a)	All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and
	b)	Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date:	August 3, 2023	/s/ Daniel J. Brennan
		Daniel J. Brennan
		Executive Vice President and Chief Financial Officer

EX-32.1

EXHIBIT 32.1

CERTIFICATION OF CHIEF EXECUTIVE OFFICER PURSUANT TO 18 U.S.C.

SECTION 1350 AS ADOPTED PURSUANT TO SECTION 906 OF THE

SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report on Form 10-Q of Boston Scientific Corporation (the “Company”) for the period ended June 30, 2023 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), the undersigned Chief Executive Officer of the Company hereby certifies, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that based on his knowledge:

(1)	the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
(2)	the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of Boston Scientific Corporation.

This certification shall not be deemed "filed" for any purpose, nor shall it be deemed to be incorporated by reference into any filing under the Securities Act of 1933 or the Securities Exchange Act of 1934 regardless of any general incorporation language in such filing.

By:	/s/ Michael F. Mahoney
	Michael F. Mahoney
	Chief Executive Officer
	August 3, 2023

EX-32.2

EXHIBIT 32.2

CERTIFICATION OF CHIEF FINANCIAL OFFICER PURSUANT TO 18 U.S.C.

SECTION 1350 AS ADOPTED PURSUANT TO SECTION 906 OF THE

SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report on Form 10-Q of Boston Scientific Corporation (the “Company”) for the period ended June 30, 2023 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), the undersigned Chief Financial Officer of the Company hereby certifies, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that based on his knowledge:

(1)	the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
(2)	the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of Boston Scientific Corporation.

This certification shall not be deemed "filed" for any purpose, nor shall it be deemed to be incorporated by reference into any filing under the Securities Act of 1933 or the Securities Exchange Act of 1934 regardless of any general incorporation language in such filing.

By:	/s/ Daniel J. Brennan
	Daniel J. Brennan
	Executive Vice President and Chief Financial Officer
	August 3, 2023

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Cover Document - $ / shares	6 Months Ended
	Jun. 30, 2023	Jul. 31, 2023
Entity Information [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2023
Document Transition Report	false
Entity File Number	1-11083
Entity Registrant Name	BOSTON SCIENTIFIC CORPORATION
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-2695240
Entity Address, Address Line One	300 Boston Scientific Way
Entity Address, City or Town	Marlborough
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01752-1234
City Area Code	508
Local Phone Number	683-4000
Entity 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		1,464,223,263
Entity Central Index Key	0000885725
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Amendment Flag	false
Common Stock [Member]
Entity Information [Line Items]
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	BSX
Security Exchange Name	NYSE
Senior Note due 2027 [Member]
Entity Information [Line Items]
Title of 12(b) Security	0.625% Senior Notes due 2027
Trading Symbol	BSX27
Security Exchange Name	NYSE

XML

Consolidated Statements of Operations (Unaudited) - USD ($) shares in Millions, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Net sales	$ 3,599	$ 3,244	$ 6,988	$ 6,270
Cost of products sold	1,058	1,011	2,098	1,966
Gross profit	2,542	2,233	4,891	4,304
Operating expenses:
Selling, general and administrative expenses	1,354	1,165	2,570	2,225
Research and development expenses	359	335	695	654
Royalty expense	12	11	23	23
Amortization expense	210	204	412	402
Intangible asset impairment charges	57	7	57	7
Contingent consideration net expense (benefit)	19	36	31	48
Restructuring net charges (credits)	16	11	36	14
Litigation-related net charges (credits)	0	42	0	42
Operating expenses	2,028	1,810	3,825	3,415
Operating income (loss)	514	423	1,066	889
Other income (expense):
Interest expense	(70)	(64)	(135)	(343)
Other, net	(18)	(14)	(61)	(46)
Income (loss) before income taxes	426	345	870	501
Income tax expense (benefit)	156	85	287	131
Net income (loss)	270	260	584	370
Preferred stock dividends	(9)	(14)	(23)	(28)
Net income (loss) attributable to noncontrolling interests	0	0	0	0
Net income (loss) attributable to Boston Scientific common stockholders	$ 261	$ 246	$ 561	$ 342
Net income (loss) per common share — basic	$ 0.18	$ 0.17	$ 0.39	$ 0.24
Net income (loss) per common share — diluted	$ 0.18	$ 0.17	$ 0.39	$ 0.24
Weighted-average shares outstanding
Basic	1,446.2	1,429.7	1,441.0	1,428.8
Diluted	1,456.2	1,437.8	1,451.1	1,438.1

XML

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Net income (loss)	$ 270	$ 260	$ 584	$ 370
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustment	15	77	(28)	13
Net change in derivative financial instruments	15	134	(28)	157
Net change in defined benefit pensions and other items	0	0	(5)	0
Other comprehensive income (loss)	30	211	(61)	170
Comprehensive income (loss)	300	471	523	540
Other Comprehensive Income (Loss), before Tax, Portion Attributable to Noncontrolling Interest	0	0	0	0
Comprehensive Income (Loss), Net of Tax, Attributable to Parent	$ 300	$ 471	$ 523	$ 540

XML

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 426	$ 928
Trade accounts receivable, net	2,134	1,970
Inventories	2,250	1,867
Prepaid income taxes	303	264
Other current assets	773	731
Total current assets	5,886	5,760
Property, plant and equipment, net	2,534	2,446
Goodwill	13,659	12,920
Other intangible assets, net	6,063	5,902
Deferred tax assets	3,865	3,942
Other long-term assets	1,595	1,500
TOTAL ASSETS	33,601	32,469
Current liabilities:
Current debt obligations	559	20
Accounts payable	899	862
Accrued expenses	2,164	2,160
Other current liabilities	940	761
Total current liabilities	4,562	3,803
Long-term debt	8,494	8,915
Deferred income taxes	135	144
Other long-term liabilities	1,926	2,035
Commitments and contingencies
Preferred Stock, Par or Stated Value Per Share	$ 0.01	$ 0.01
Stockholders’ equity
Preferred stock, $0.01 par value - authorized 50,000,000 shares - 0 shares issued as of June 30, 2023 and 10,062,500 shares as of December 31, 2022	$ 0	$ 0
Common stock, $0.01 par value - authorized 2,000,000,000 shares - issued 1,725,956,141 shares as of June 30, 2023 and 1,696,633,993 shares as of December 31, 2022	17	17
Treasury stock, at cost - 263,289,848 shares as of June 30, 2023 and December 31, 2022	(2,251)	(2,251)
Additional paid-in capital	20,441	20,289
Accumulated deficit	(189)	(750)
Accumulated other comprehensive income (loss), net of tax	208	269
Total stockholders’ equity	18,226	17,573
Noncontrolling interests	259	0
Total equity	18,485	17,573
TOTAL LIABILITIES AND EQUITY	$ 33,601	$ 32,469

XML

Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2023	Dec. 31, 2022
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	10,062,500
Common Stock, Par or Stated Value Per Share	$ 0.01	$ 0.01
Common Stock, Shares Authorized	2,000,000,000	2,000,000,000
Common Stock, Shares, Issued	1,725,956,141	1,696,633,993
Treasury Stock, Common, Shares	263,289,848	263,289,848

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Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Millions	Total	Preferred Stock	Common Stock [Member]	Treasury Stock, Common	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Noncontrolling Interest
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common Stock, Shares, Issued	1,688,810,052
Shares, Issued at Dec. 31, 2021		10,062,500
Total stockholders' equity at Dec. 31, 2021		$ 0	$ 17	$ (2,251)	$ 19,986	$ (1,392)	$ 263	$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation (Shares)			4,382,733
Stock issuance (Par value)			$ 0
Treasury Stock, Value, Acquired, Cost Method				0
Stock-based compensation					117
Net income (loss)	$ 370					370
Dividends, Preferred Stock, Cash						(28)
Conversion of Stock, Shares Converted		0	0
Net income (loss) attributable to noncontrolling interests	0							0
Total other comprehensive income (loss)	170						170	0
Noncontrolling Interest, Period Increase (Decrease)								0
Ending Balance (Shares Issued) at Jun. 30, 2022		10,062,500
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest at Jun. 30, 2022	$ 17,251	$ 0	$ 17	(2,251)	20,103	(1,050)	433	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common Stock, Shares, Issued	1,692,828,987
Shares, Issued at Mar. 31, 2022		10,062,500
Total stockholders' equity at Mar. 31, 2022		$ 0	$ 17	(2,251)	20,043	(1,296)	222	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation (Shares)			363,798
Stock issuance (Par value)			$ 0
Treasury Stock, Value, Acquired, Cost Method				0
Stock-based compensation					60
Net income (loss)	$ 260					260
Dividends, Preferred Stock, Cash						(14)
Conversion of Stock, Shares Converted		0	0
Net income (loss) attributable to noncontrolling interests	0							0
Total other comprehensive income (loss)	211						211	0
Noncontrolling Interest, Period Increase (Decrease)								0
Ending Balance (Shares Issued) at Jun. 30, 2022		10,062,500
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest at Jun. 30, 2022	$ 17,251	$ 0	$ 17	(2,251)	20,103	(1,050)	433	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common Stock, Shares, Issued	1,693,192,785
Total stockholders’ equity	$ 17,251
Common Stock, Shares, Issued	1,696,633,993
Total stockholders’ equity	$ 17,573
Shares, Issued at Dec. 31, 2022		10,062,500
Total stockholders' equity at Dec. 31, 2022	17,573	$ 0	$ 17	(2,251)	20,289	(750)	269	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation (Shares)			5,339,246
Stock issuance (Par value)			$ 0
Treasury Stock, Value, Acquired, Cost Method				0
Stock-based compensation					153
Net income (loss)	584					584
Dividends, Preferred Stock, Cash						(23)
Conversion of Stock, Shares Converted		(10,062,500)	23,982,902
Net income (loss) attributable to noncontrolling interests	0							0
Total other comprehensive income (loss)	(61)						(61)	0
Noncontrolling Interest, Period Increase (Decrease)								259
Ending Balance (Shares Issued) at Jun. 30, 2023		0
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest at Jun. 30, 2023	$ 18,485	$ 0	$ 17	(2,251)	20,441	(189)	208	259
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common Stock, Shares, Issued	1,700,828,873
Shares, Issued at Mar. 31, 2023		10,062,500
Total stockholders' equity at Mar. 31, 2023		$ 0	$ 17	(2,251)	20,356	(450)	178	259
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation (Shares)			1,144,366
Stock issuance (Par value)			$ 0
Treasury Stock, Value, Acquired, Cost Method				0
Stock-based compensation					85
Net income (loss)	$ 270					270
Dividends, Preferred Stock, Cash						(9)
Conversion of Stock, Shares Converted		(10,062,500)	23,982,902
Net income (loss) attributable to noncontrolling interests	0							0
Total other comprehensive income (loss)	30						30	0
Noncontrolling Interest, Period Increase (Decrease)								0
Ending Balance (Shares Issued) at Jun. 30, 2023		0
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest at Jun. 30, 2023	$ 18,485	$ 0	$ 17	$ (2,251)	$ 20,441	$ (189)	$ 208	$ 259
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common Stock, Shares, Issued	1,725,956,141
Total stockholders’ equity	$ 18,226

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Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash provided by (used for) operating activities
Net income (loss)	$ 584	$ 370
Depreciation and amortization	583	558
Deferred and prepaid income taxes	(45)	(93)
Stock-based compensation expense	115	107
Goodwill and other intangible asset impairment charges	57	7
Net loss (gain) on investments and notes receivable	35	36
Contingent consideration net expense (benefit)	31	48
Inventory step-up amortization	3	25
Gain (Loss) on Extinguishment of Debt	0	194
Other, net	23	31
Trade accounts receivable	(161)	(162)
Inventories	(399)	(180)
Other assets	(55)	(244)
Accounts payable, accrued expenses and other liabilities	78	(449)
Cash provided by (used for) operating activities	848	249
Investing activities:
Purchases of property, plant and equipment and internal use software	(254)	(226)
Proceeds from sale of property, plant and equipment	3	9
Payments for acquisitions of businesses, net of cash acquired	(1,018)	(1,471)
Proceeds from royalty rights	16	36
Payments for (Proceeds from) Hedge, Investing Activities	2	56
Proceeds from (payments for) investments and acquisitions of certain technologies	(73)	(10)
Cash provided by (used for) investing activities	(1,324)	(1,603)
Financing activities:
Payment of contingent consideration previously established in purchase accounting	(39)	(283)
Payments for royalty rights	(34)	(39)
Payments on short-term borrowings	0	(250)
Net increase (decrease) in commercial paper	37	154
Payments on long-term borrowings and debt extinguishment costs	0	(3,184)
Proceeds from long-term borrowings, net of debt issuance costs	0	3,270
Cash dividends paid on preferred stock	(28)	(28)
Cash used to net share settle employee equity awards	(52)	(47)
Proceeds from issuances of common stock pursuant to employee stock compensation and purchase plans	90	58
Cash provided by (used for) financing activities	(26)	(350)
Effect of foreign exchange rates on cash	(3)	(6)
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted cash equivalents	(506)	(1,710)
Cash, cash equivalents, restricted cash and restricted cash equivalents at beginning of period	1,126	2,168
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period	$ 620	$ 458

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Consolidated Statements of Cash Flows (Supplemental Disclosure) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022	Dec. 31, 2021
Supplemental Information
Stock-based compensation expense	$ 115	$ 107
Non-cash impact of transferred royalty rights	(16)	(36)
Cash and cash equivalents	426	276	$ 928
Restricted cash and restricted cash equivalents included in Other current assets	135	132	149
Restricted cash equivalents included in Other long-term assets	60	50	48
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	$ 620	$ 458	$ 1,126	$ 2,168

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Basis of Presentation

6 Months Ended

Jun. 30, 2023

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 six months ended June 30, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. 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.

Subsequent Events

We evaluate events occurring after the date of our accompanying unaudited consolidated balance sheet for potential recognition or disclosure in our financial statements. Those items requiring recognition in the financial statements have been recorded and disclosed accordingly.

Those items requiring disclosure (non-recognized subsequent events) in the financial statements have been disclosed accordingly. Refer to Note H – Commitments and Contingencies for further details.

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Acquisitions, Divestitures and Strategic Investments

6 Months Ended

Jun. 30, 2023

Business Combinations [Abstract]

ACQUISITIONS AND STRATEGIC INVESTMENTS

NOTE B – ACQUISITIONS, DIVESTITURES 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 June 15, 2022, we announced our entry into a definitive agreement with Synergy Innovation Co, Ltd, to purchase its majority stake in M.I. Tech Co., Ltd., (M.I. Tech), a publicly traded Korean manufacturer and distributor of medical devices for endoscopic and urological procedures. The agreement required global regulatory approvals that we were not able to obtain in some countries. As a result, the original agreement was terminated, and on June 15, 2023, we purchased a 9.9 percent minority stake in M.I. Tech.

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, a publicly traded Chinese manufacturer of drug-coated balloons used in the treatment of vascular and other diseases. 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 Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 805, Business Combinations (FASB ASC Topic 805). The preliminary purchase prices were comprised of the amounts presented below:

(in millions)	Acotec(1)		Apollo
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) Represents majority stake investment in Acotec

We recorded the assets acquired, liabilities assumed and specific to Acotec, the noncontrolling interest, at their respective fair values as of the closing of the transaction. The preliminary purchase price allocations were comprised of the following components and the final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with FASB ASC Topic 805:

(in millions)	Acotec		Apollo
Goodwill	$	340	$	374
Amortizable intangible assets	334		248
Other assets acquired	93		50
Liabilities assumed	(48)		(26)
Net deferred tax liabilities	(79)		(9)
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 within 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	11	14%
Customer relationships	15		11	14%
Other intangible assets	11		13	14%
	$	334
Apollo:
Amortizable intangible assets:
Technology-related	$	222	11	12%
Customer relationships	26		11	12%
	$	248

2022 Acquisition

On February 14, 2022, we completed our acquisition of Baylis Medical Company Inc. (Baylis Medical), a privately-held company which developed the radiofrequency (RF) NRG™ and VersaCross™ Transseptal Platforms as well as a family of guidewires, sheaths and dilators used to support left heart access, which expanded our electrophysiology and structural heart product portfolios. The transaction consisted of an upfront cash payment of $1.463 billion, net of cash acquired, subject to closing adjustments. We are integrating the Baylis Medical business into our Cardiology division.

Purchase Price Allocation

We accounted for the acquisition of Baylis Medical as a business combination in accordance with FASB ASC Topic 805. The final purchase price was comprised of the amount presented below:

(in millions)
Payment for acquisition, net of cash acquired	$	1,463
	$	1,463

We recorded the assets acquired and liabilities assumed at their respective fair values as of the acquisition date. The final purchase price allocation was comprised of the following components:

(in millions)
Goodwill	$	988
Amortizable intangible assets	657
Other assets acquired	112
Liabilities assumed	(287)
Net deferred tax liabilities	(7)
	$	1,463

Goodwill was primarily established due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies, and was deductible for tax purposes.

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

	Amount Assigned (in millions)		Weighted Average Amortization Period (in years)	Risk-Adjusted Discount Rates used in Purchase Price Allocation
Amortizable intangible assets:
Technology-related	$	622	11	11%
Other intangible assets	36		11	11%
	$	657

Contingent Consideration

None of our acquisitions that closed during 2023 or 2022 contained contingent consideration arrangements. Changes in the fair value of our contingent consideration liability during the first six months of 2023 associated with prior period acquisitions were as follows:

(in millions)
Balance as of December 31, 2022	$	149
Contingent consideration net expense (benefit)	31
Contingent consideration payments	(73)
Balance as of June 30, 2023	$	107

The payments made during the first six months of 2023 primarily related to our 2021 acquisition of Farapulse, Inc. As of June 30, 2023, the maximum amount of future contingent consideration (undiscounted) that we could be required to pay associated with our completed acquisitions was approximately $364 million. Refer to Note B – Acquisitions and Strategic Investments to our audited financial statements contained in Item 8. Financial Statements and Supplementary Data of our most recent Annual Report on Form 10-K for additional information.

The recurring Level 3 fair value measurements of our contingent consideration liability that we expect to be required to settle include the following significant unobservable inputs:

Contingent Consideration Liability	Fair Value as of June 30, 2023	Valuation Technique	Unobservable Input	Range			Weighted Average(1)
R&D, Regulatory and Commercialization-based Milestones	$13 million	Discounted Cash Flow	Discount Rate	1%	-	2%	1%
			Probability of Payment	10%	-	25%	22%
			Projected Year of Payment	2023	-	2025	2024
Revenue-based Payments	$94 million	Discounted Cash Flow	Discount Rate	6%	-	14%	6%
			Probability of Payment	100%			100%
			Projected Year of Payment	2023	-	2024	2023

(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 research and development (R&D), regulatory and commercialization-based milestones and revenue-based payments 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 June 30, 2023.

Strategic Investments

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

	As of
(in millions)	June 30, 2023		December 31, 2022
Equity method investments	$	206	$	188
Measurement alternative investments(1, 2)	215		219
	$	422	$	407

(1)    Measurement alternative investments are privately-held equity securities without readily determinable fair values that are measured at cost less impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer, recognized in Other, net within our accompanying 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 June 30, 2023, the cost of our aggregated equity method investments exceeded our share of the underlying equity in net assets by $230 million, which represents amortizable intangible assets, in-process research and development (IPR&D), goodwill and deferred tax liabilities.

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Goodwill and Other Intangible Assets

6 Months Ended

Jun. 30, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

GOODWILL AND OTHER INTANGIBLE ASSETS

NOTE C – GOODWILL AND OTHER INTANGIBLE ASSETS

The gross carrying amount of goodwill and other intangible assets and the related accumulated amortization for intangible assets subject to amortization and accumulated goodwill impairment charges are as follows:

	As of June 30, 2023				As of December 31, 2022
(in millions)	Gross Carrying Amount		Accumulated Amortization/ Write-offs		Gross Carrying Amount		Accumulated Amortization/ Write-offs
Technology-related	$	12,932	$	(7,737)	$	12,397	$	(7,378)
Patents	478		(385)		486		(394)
Other intangible assets	2,050		(1,448)		1,960		(1,400)
Amortizable intangible assets	$	15,459	$	(9,571)	$	14,843	$	(9,173)
Goodwill	$	23,559	$	(9,900)	$	22,820	$	(9,900)
IPR&D	$	54			$	112
Technology-related	120				120
Indefinite-lived intangible assets	$	174			$	232

The increase in our balance of goodwill and amortizable intangible assets is related primarily to our majority stake investment in Acotec completed in the first quarter of 2023 and our acquisition of Apollo completed in the second quarter of 2023.

The following represents a roll-forward of our goodwill balance by global reportable segment:

(in millions)	MedSurg		Cardiovascular		Total
As of December 31, 2022	$	4,237	$	8,684	$	12,920
Goodwill acquired	374		340		714
Impact of foreign currency fluctuations and purchase price adjustments	(3)		28		25
As of June 30, 2023	$	4,607	$	9,052	$	13,659

Goodwill and Intangible Asset Impairments

We did not record any goodwill impairment charges in the first six months of 2023 or 2022. 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, 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 2023, we performed our annual goodwill impairment test utilizing both the qualitative and quantitative approach described in FASB ASC Topic 350, Intangibles - Goodwill and Other (FASB ASC Topic 350). The qualitative approach was used for testing reporting units where fair value has historically exceeded carrying value by greater than 100 percent, and all other reporting units were tested using the quantitative approach. 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 unit tested using the quantitative approach, we determined that the fair value of the reporting unit exceeded the carrying value and concluded that goodwill was not impaired or at risk of impairment.

We recorded Intangible asset impairment charges of $57 million in the second quarter and first six months of 2023 and $7 million in the second quarter and first six months of 2022. 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. 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.

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.

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Hedging Activities and Fair Value Measurements

6 Months Ended

Jun. 30, 2023

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 actively monitoring counterparty credit ratings. 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

Our risk from changes in currency exchange rates consists primarily of monetary assets and liabilities, forecasted intercompany and third-party transactions, and net investments in certain subsidiaries. We manage currency exchange rate risk at a consolidated level to reduce the cost of hedging by taking advantage of offsetting transactions. We employ derivative and nonderivative instruments, primarily forward currency contracts, to reduce the risk to our earnings and cash flows associated with changes in currency exchange rates.

The success of our currency risk management program depends, in part, on forecast transactions denominated primarily in euro, British pound sterling, Swiss franc, Japanese yen, Chinese renminbi and Australian dollar. We may experience unanticipated currency exchange gains or losses to the extent the actual activity is different than forecast. In addition, changes in currency exchange rates related to any unhedged transactions may impact our earnings and cash flows.

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 in 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 in our consolidated statements of cash flows.

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 June 30, 2023 and December 31, 2022, we designated as a net investment hedge our €900 million in aggregate principal amount of 0.625% euro-denominated 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 Foreign currency translation adjustment (CTA) component of Other comprehensive income (loss), net of tax. We reclassify these gains and losses to current period earnings within Other, net in 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

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.

We had no interest rate derivative instruments designated as cash flow hedges outstanding as of June 30, 2023 or December 31, 2022. In the event that we designate outstanding interest rate derivative instruments as cash flow hedges, we record the changes in the fair value of the derivatives within OCI until the underlying hedged transaction occurs.

The following table presents the contractual amounts of our hedging instruments outstanding:

(in millions)	FASB ASC Topic 815 Designation	As of
		June 30, 2023		December 31, 2022
Forward currency contracts	Cash flow hedge	$	2,454	$	2,725
Forward currency contracts	Net investment hedge	333		365
Foreign currency-denominated debt(1)	Net investment hedge	997		997
Forward currency contracts	Non-designated	3,575		4,235
Total Notional Outstanding		$	7,360	$	8,321

(1)    Foreign currency-denominated debt is the €900 million debt principal associated with our 2027 Notes designated as a net investment hedge.

As of June 30, 2023, the remaining time to maturity 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 three years. The euro-denominated debt principal designated as a net investment hedge has a contractual maturity of December 1, 2027.

The following presents the effect of our derivative and nonderivative instruments designated as cash flow and net investment hedges under FASB ASC Topic 815 in our accompanying unaudited consolidated statements of operations. Refer to Note M – Changes in Other Comprehensive Income for the total amounts relating to derivative and nonderivative instruments presented within our accompanying unaudited consolidated statements of comprehensive income (loss).

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Three Months Ended June 30, 2023
Forward currency contracts
Cash flow hedges	$	74	$	(17)	$	58	Cost of products sold	$	1,058	$	(55)	$	12	$	(43)
Net investment hedges(2)	22		(5)		17		Interest expense	70		(2)		1		(2)
Foreign currency-denominated debt
Net investment hedges(3)	1		—		1		Other, net	18		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest expense	70		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Three Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges	$	213	$	(48)	$	165	Cost of products sold	$	1,011	$	(41)	$	9	$	(32)
Net investment hedges(2)	34		5		39		Interest expense	64		(3)		1		(2)
Foreign currency-denominated debt
Net investment hedges(3)	62		(14)		48		Other, net	14		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest Expense	64		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Six Months Ended June 30, 2023
Forward currency contracts
Cash flow hedges	$	87	$	(20)	$	67	Cost of products sold	$	2,098	$	(125)	$	28	$	(97)
Net investment hedges (2)	28		(6)		22		Interest expense	135		(5)		1		(4)
Foreign currency-denominated debt
Net investment hedges (3)	(18)		4		(14)		Other, net	61		—		—		—
Interest rate derivative contracts
Cash flow hedges					—		Interest expense	135		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Six Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges	$	259	$	(58)	$	200	Cost of products sold	$	1,966	$	(71)	$	16	$	(55)
Net investment hedges (2)	49		2		50		Interest expense	343		(5)		1		(4)
Foreign currency-denominated debt
Net investment hedges (3)	86		(19)		66		Other, net	46		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest expense	343		15		(3)		11

(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 period, 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 June 30, 2023, pre-tax net gains or losses for our derivative instruments designated, or previously designated, as cash flow and net investment hedges under FASB ASC Topic 815 that may be reclassified from AOCI to earnings within the next twelve months are presented below:

(in millions)	FASB ASC Topic 815 Designation	Location on Unaudited Consolidated Statements of Operations	Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings
Designated Hedging Instrument
Forward currency contracts	Cash flow hedge	Cost of products sold	$	209
Forward currency contracts	Net investment hedge	Interest expense	9
Interest rate derivative contracts	Cash flow hedge	Interest expense	(2)

Net gains and losses on currency hedge contracts not designated as hedging instruments offset by net gains and losses from currency transaction exposures are presented below:

	Location on Unaudited Consolidated Statements of Operations	Three Months Ended June 30,				Six Months Ended June 30,
(in millions)		2023		2022		2023		2022
Net gain (loss) on currency hedge contracts	Other, net	$	11	$	(34)	$	2	$	(63)
Net gain (loss) on currency transaction exposures	Other, net	(20)		35		(26)		56
Net currency exchange gain (loss)		$	(9)	$	1	$	(24)	$	(7)

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)		June 30, 2023		December 31, 2022
Derivative and Nonderivative Assets:
Designated Hedging Instruments
Forward currency contracts	Other current assets	$	188	$	196
Forward currency contracts	Other long-term assets	155		149
		342		345
Non-Designated Hedging Instruments
Forward currency contracts	Other current assets	46		36
Total Derivative and Nonderivative Assets		$	388	$	381
Derivative and Nonderivative Liabilities:
Designated Hedging Instruments
Forward currency contracts	Other current liabilities	$	1	$	—
Forward currency contracts	Other long-term liabilities	2		1
Foreign currency-denominated debt(2)	Long-term debt	971		952
		974		953
Non-Designated Hedging Instruments
Forward currency contracts	Other current liabilities	48		52
Total Derivative and Nonderivative Liabilities		$	1,021	$	1,005

(1)    We classify derivative and nonderivative assets and liabilities as current when the settlement date of the contract is one year or less.

(2)    Foreign currency-denominated debt is the €900 million debt principal 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
	June 30, 2023								December 31, 2022
(in millions)	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Assets
Money market funds and time deposits	$	17	$	—	$	—	$	17	$	673	$	—	$	—	$	673
Publicly-held equity securities	29		—		—		29		2		—		—		2
Hedging instruments	—		388		—		388		—		381		—		381
Licensing arrangements	—		—		102		102		—		—		127		127
	$	46	$	388	$	102	$	535	$	674	$	381	$	127	$	1,182
Liabilities
Hedging instruments	$	—	$	1,021	$	—	$	1,021	$	—	$	1,005	$	—	$	1,005
Contingent consideration liability	—		—		107		107		—		—		149		149
Licensing arrangements	—		—		115		115		—		—		159		159
	$	—	$	1,021	$	222	$	1,244	$	—	$	1,005	$	308	$	1,313

Our investments in money market funds and time deposits are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices. These investments are classified as Cash and cash equivalents within our accompanying unaudited consolidated balance sheets, in accordance with GAAP and our accounting policies. In addition to $17 million invested in money market funds and time deposits as of June 30, 2023 and $673 million as of December 31, 2022, we held $409 million in interest-bearing and non-interest-bearing bank accounts as of June 30, 2023 and $256 million as of December 31, 2022.

Our recurring fair value measurements using Level 3 inputs include those related to our contingent consideration liability. Refer to Note B – Acquisitions, Divestitures 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 in our accompanying 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 in our accompanying unaudited consolidated balance sheets as of June 30, 2023 include the following significant unobservable inputs:

Licensing Arrangements	Fair Value as of June 30, 2023	Valuation Technique	Unobservable Input	Range				Weighted Average (1)
Financial Asset	$102 million	Discounted Cash Flow	Discount Rate	15%				15%
			Projected Year of Payment	2023		-	2025	2024
Financial Liability	$115 million	Discounted Cash Flow	Discount Rate	12	%	-	15%	13%
			Projected Year of Payment	2023		-	2026	2024

(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, 2022	$	127
Proceeds from royalty rights	(31)
Fair value adjustment (expense) benefit	6
Balance as of June 30, 2023	$	102

Changes in the fair value of our licensing arrangements' financial liability were as follows:

(in millions)
Balance as of December 31, 2022	$	159
Payments for royalty rights	(50)
Fair value adjustment expense (benefit)	6
Balance as of June 30, 2023	$	115

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, Divestitures 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 was $8.441 billion as of June 30, 2023 and $8.203 billion as of December 31, 2022. We determined fair value by using quoted market prices for our publicly registered senior notes, classified as Level 1 within the fair value hierarchy, and face value for commercial paper, term loans and credit facility borrowings outstanding. Refer to Note E – Contractual Obligations and Commitments for a discussion of our debt obligations.

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Contractual Obligations and Commitments

6 Months Ended

Jun. 30, 2023

Debt Disclosure [Abstract]

CONTRACTUAL OBLIGATIONS AND COMMITMENTS

NOTE E – CONTRACTUAL OBLIGATIONS AND COMMITMENTS

Borrowings and Credit Arrangements

We had total debt outstanding of $9.053 billion as of June 30, 2023 and $8.935 billion as of December 31, 2022, with current obligations of $559 million as of June 30, 2023 and $20 million as of December 31, 2022. The debt maturity schedule for our long-term debt obligations is presented below:

(in millions, except interest rates)	Issuance Date	Maturity Date	As of				Coupon Rate(1)
			June 30, 2023		December 31, 2022
March 2024 Senior Notes	February 2019	March 2024	—		504		3.450%
March 2025 Senior Notes(3)	March 2022	March 2025	1,087		1,067		0.750%
June 2025 Senior Notes	May 2020	June 2025	500		500		1.900%
March 2026 Senior Notes	February 2019	March 2026	255		255		3.750%
December 2027 Senior Notes(3)	November 2019	December 2027	978		960		0.625%
March 2028 Senior Notes(3)	March 2022	March 2028	815		800		1.375%
March 2028 Senior Notes	February 2018	March 2028	344		344		4.000%
March 2029 Senior Notes	February 2019	March 2029	272		272		4.000%
June 2030 Senior Notes	May 2020	June 2030	1,200		1,200		2.650%
March 2031 Senior Notes(3)	March 2022	March 2031	815		800		1.625%
March 2034 Senior Notes(3)	March 2022	March 2034	543		534		1.875%
November 2035 Senior Notes(2)	November 2005	November 2035	350		350		6.500%
March 2039 Senior Notes	February 2019	March 2039	450		450		4.550%
January 2040 Senior Notes	December 2009	January 2040	300		300		7.375%
March 2049 Senior Notes	February 2019	March 2049	650		650		4.700%
Unamortized Debt Issuance Discount and Deferred Financing Costs		2023 - 2049	(70)		(76)
Finance Lease Obligation		Various	5		5
Long-term debt			$	8,494	$	8,915

Note: The table above does not include unamortized amounts related to interest rate contracts designated as cash flow hedges.

(1)    Coupon rates are semi-annual, except for the euro-denominated senior 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 if the lowest credit ratings assigned to these senior notes is either A- or A3 or higher. Effective May 2023, the interest rate payable decreased by 0.25 percent and began accruing at a rate of 6.50 percent following recent upgrades to our credit ratings.

(3)    These notes are euro-denominated and presented in U.S. dollars based on the exchange rate in effect as of June 30, 2023 and December 31, 2022, respectively.

Revolving Credit Facility

On May 10, 2021, we entered into our $2.750 billion revolving credit facility (2021 Revolving Credit Facility) with a global syndicate of commercial banks scheduled to mature on May 10, 2026, with one-year extension options, subject to certain conditions. On March 1, 2023, we entered into an amendment of the 2021 Revolving Credit Facility credit agreement, which provided for an extension of the scheduled maturity date to May 10, 2027 and replaced the London Interbank Offered Rate (LIBOR) with the Secured Overnight Financing Rate (SOFR) as the Eurocurrency Rate for Dollars, including applicable credit spread adjustments and relevant SOFR benchmark provisions, among other things described under Financial Covenant below. This facility provides backing for our commercial paper program, and outstanding commercial paper directly reduces borrowing capacity under the 2021 Revolving Credit Facility. There were no amounts outstanding under the 2021 Revolving Credit Facility as of June 30, 2023 or December 31, 2022.

Financial Covenant

As of June 30, 2023, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility, as amended.

	Covenant Requirement	Actual
	as of June 30, 2023	as of June 30, 2023
Maximum permitted leverage ratio(1)	3.75 times	2.48 times

(1)Ratio of total debt to consolidated EBITDA, as defined by the credit agreements, 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 through the remaining term. The agreement provides for higher leverage ratios, at our election, for the period following a qualified acquisition for which consideration exceeds $1.000 billion. In the event of such an acquisition, for the four succeeding quarters immediately following, including the quarter in which the acquisition occurs, the maximum permitted leverage ratio is 4.75 times. The maximum permitted ratio steps down for the fifth, sixth and seventh succeeding quarters to 4.50 times, 4.25 times and 4.00 times, respectively. Thereafter, a maximum leverage ratio of 3.75 times is required through the remaining term of the 2021 Revolving Credit Facility. We have not elected to increase the maximum permitted leverage ratio for any qualified acquisitions due to our funding of these acquisitions using cash on hand or commercial paper.

The financial covenant requirement, as amended on March 1, 2023, provides for an exclusion from the calculation of consolidated EBITDA, as defined by the credit agreement, through maturity, of certain charges and expenses. The credit agreement amendment reset the starting date for purposes of calculating such permitted exclusions in each case from March 31, 2021 to December 31, 2022. Permitted exclusions include any non-cash charges and up to $500 million in restructuring charges and restructuring-related expenses associated with our current or future restructuring plans. As of June 30, 2023, we had $416 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, for a total of $1.443 billion. As of June 30, 2023, we had $1.413 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 had $41 million of commercial paper outstanding as of June 30, 2023 and none as of December 31, 2022.

	As of
(in millions, except maturity and yield)	June 30, 2023			December 31, 2022
Commercial paper outstanding (at par)	$	41		$	—
Maximum borrowing capacity	2,750			2,750
Borrowing capacity available	2,709			2,750
Weighted average maturity	5 days			0 days
Weighted average yield	5.30		%	—		%

Senior Notes

We had senior notes outstanding of $9.063 billion as of June 30, 2023 and $8.986 billion as of December 31, 2022. Our senior notes were issued in public offerings, are redeemable prior to maturity and are not subject to sinking fund requirements. Our senior notes are unsecured, unsubordinated obligations and rank on parity with each other. These notes are effectively junior to liabilities of our subsidiaries (refer to Other Arrangements below).

In March 2022, American Medical Systems Europe B.V. (AMS Europe), an indirect, wholly owned subsidiary of Boston Scientific, completed a registered public offering (the Offering) of €3.000 billion in aggregate principal amount of euro-dominated senior notes comprised of €1.000 billion of 0.750% Senior Notes due 2025, €750 million of 1.375% Senior Notes due 2028, €750 million of 1.625% Senior Notes due 2031 and €500 million of 1.875% Senior Notes due 2034 (collectively, the Eurobonds). Boston Scientific has fully and unconditionally guaranteed all of AMS Europe's obligations under the Eurobonds, and no other subsidiary of Boston Scientific will guarantee these obligations. AMS Europe is a “finance subsidiary” as defined in Rule 13-01(a)(4)(vi) of Regulation S-X. The financial condition, results of operations and cash flows of AMS Europe are consolidated in the financial statements of Boston Scientific. The Offering resulted in cash proceeds of $3.270 billion, net of investor discounts and issuance costs.

We used the net proceeds from the Offering to fund the tender offer and early redemption of combined aggregate principal amount of $3.275 billion of certain of our outstanding senior notes, as well as to pay accrued interest, tender premiums, fees and expenses. We recorded associated debt extinguishment charges of $194 million during the first quarter of 2022 presented in Interest expense within our accompanying unaudited consolidated statements of operations.

Other Arrangements

We have accounts receivable factoring programs in certain European countries and with commercial banks in China and Japan which include promissory notes discounting programs. We account for our factoring programs as sales under FASB ASC Topic 860, 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 Arrangements	As of June 30, 2023				As of December 31, 2022
	Amount De-recognized		Weighted Average Interest Rate		Amount De-recognized		Weighted Average Interest Rate
Euro denominated	$	217	5.4	%	$	161	2.4	%
Yen denominated	179		0.7	%	194		0.6	%
Renminbi denominated	17		2.9	%	13		3.1	%

Other Contractual Obligations and Commitments

We had outstanding letters of credit of $148 million as of June 30, 2023 and $135 million as of December 31, 2022, which consisted primarily of bank guarantees and collateral for workers' compensation insurance arrangements. As of June 30, 2023

and December 31, 2022 we had not recognized a related liability for any outstanding letters of credit within our accompanying unaudited consolidated balance sheets.

We have a supplier financing program offered primarily in the U.S. where our suppliers can 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 $124 million as of June 30, 2023 and $129 million as of December 31, 2022.

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.

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Supplemental Balance Sheet Information

6 Months Ended

Jun. 30, 2023

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)	June 30, 2023		December 31, 2022
Trade accounts receivable	$	2,261	$	2,079
Allowance for credit losses	(127)		(109)
	$	2,134	$	1,970

The following is a roll forward of our Allowance for credit losses:

	Three Months Ended June 30,				Six Months Ended June 30,
(in millions)	2023		2022		2023		2022
Beginning balance	$	118	$	113	$	109	$	108
Credit loss expense	19		9		35		20
Write-offs	(10)		(5)		(16)		(11)
Ending balance	$	127	$	117	$	127	$	117

In accordance with FASB ASC Topic 326, Financial Instruments - Credit Losses (FASB ASC Topic 326), we record credit loss reserves to Allowance for credit losses when we establish Trade accounts receivable if credit losses are expected over the asset's contractual life. We base our estimates of credit loss reserves on historical experience and adjust, as necessary, to reflect current conditions using reasonable and supportable forecasts not already reflected in the historical loss information. We utilize an accounts receivable aging approach, applying country or region-specific factors, to determine the reserve to record at accounts receivable commencement for certain customers. In performing the assessment of outstanding accounts receivable, regardless of country or region, we may consider significant factors relevant to collectability, including those specific to a customer such as bankruptcy, lengthy average payment cycles and type of account.

We closely monitor outstanding receivables for potential collection risks, including those that may arise from economic and geopolitical conditions. Our sales to government-owned or supported customers, particularly in southern Europe, are subject to an increased number of days outstanding prior to payment relative to other entities, and, in southern Europe, relative to those in other countries. In addition, we have seen an increase in the volume of our U.S. business conducted in ambulatory surgery centers and office-based laboratories. Many of these customers are smaller than those we have historically done business with and may have more limited liquidity. We have adjusted our estimates of credit loss reserves for these customers, regions and conditions based on collection trends.

Inventories

	As of
(in millions)	June 30, 2023		December 31, 2022
Finished goods	$	1,372	$	1,171
Work-in-process	175		147
Raw materials	703		548
	$	2,250	$	1,867

Other current assets

	As of
(in millions)	June 30, 2023		December 31, 2022
Restricted cash and restricted cash equivalents	$	135	$	149
Derivative assets	234		232
Licensing arrangements	53		60
Other	353		290
	$	773	$	731

Property, plant and equipment, net

	As of
(in millions)	June 30, 2023		December 31, 2022
Land	$	141	$	137
Buildings and improvements	1,790		1,695
Equipment, furniture and fixtures	3,427		3,297
Capital in progress	604		598
	5,962		5,728
Less: accumulated depreciation	3,428		3,282
	$	2,534	$	2,446

Depreciation expense was $88 million for the second quarter of 2023, $80 million for the second quarter of 2022, $170 million for the first six months of 2023 and $156 million for the first six months of 2022.

Other long-term assets

	As of
(in millions)	June 30, 2023		December 31, 2022
Restricted cash equivalents	$	60	$	48
Operating lease right-of-use assets	445		386
Derivative assets	156		149
Investments	422		407
Licensing arrangements	49		67
Indemnification asset	168		172
Other	295		271
	$	1,595	$	1,500

Accrued expenses

	As of
(in millions)	June 30, 2023		December 31, 2022
Legal reserves	$	209	$	231
Payroll and related liabilities	843		830
Rebates	363		352
Contingent consideration	97		74
Other	653		674
	$	2,164	$	2,160

Other current liabilities

	As of
(in millions)	June 30, 2023		December 31, 2022
Deferred revenue	$	242	$	220
Licensing arrangements	55		79
Taxes payable	400		232
Other	242		230
	$	940	$	761

Other long-term liabilities

	As of
(in millions)	June 30, 2023		December 31, 2022
Accrued income taxes	$	489	$	597
Legal reserves	210		212
Contingent consideration	10		75
Licensing arrangements	60		80
Operating lease liabilities	401		347
Deferred revenue	295		289
Other	460		434
	$	1,926	$	2,035

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Income Taxes

6 Months Ended

Jun. 30, 2023

Income Tax Disclosure [Abstract]

INCOME TAXES

NOTE G – INCOME TAXES

Our effective tax rate from continuing operations is presented below:

	Three Months Ended June 30,				Six Months Ended June 30,
	2023		2022		2023		2022
Effective tax rate from continuing operations	36.6	%	24.7	%	32.9	%	26.1	%

The changes in our reported tax rates for the second quarter and first six months of 2023, compared to the same periods in 2022, relate primarily to the impact of certain receipts and charges that are taxed at different rates than our effective tax rate. These include acquisition-related charges, debt extinguishment charges, as well as certain discrete tax items primarily related to unrecognized tax benefits and provision-to-return adjustments recorded in the second quarter of 2023.

As of June 30, 2023, we had $471 million of gross unrecognized tax benefits, of which a net $406 million, if recognized, would affect our effective tax rate. As of December 31, 2022, we had $492 million of gross unrecognized tax benefits, of which a net

$410 million, if recognized, would affect our effective tax rate. The change in our gross unrecognized tax benefit is primarily related to remeasurement of historic positions after tax law changes and audit activities.

It is reasonably possible that within the next 12 months, we will resolve multiple issues with foreign, federal and state taxing authorities, resulting in a reduction in our balance of unrecognized tax benefits of up to $61 million.

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Commitments and Contingencies

6 Months Ended

Jun. 30, 2023

Commitments and Contingencies Disclosure [Abstract]

COMMITMENTS AND CONTINGENCIES

NOTE H – COMMITMENTS AND CONTINGENCIES

The medical device market in which we participate is largely technology driven. As a result, intellectual property rights, particularly patents and trade secrets, play a significant role in product development and differentiation. Over the years, there has been litigation initiated against us by others, including our competitors, claiming that our current or former product offerings infringe patents owned or licensed by them. Intellectual property litigation is inherently complex and unpredictable. In addition, competing parties frequently file multiple suits to leverage patent portfolios across product lines, technologies and geographies and to balance risk and exposure between the parties. In some cases, several competitors are parties in the same proceeding, or in a series of related proceedings, or litigate multiple features of a single class of devices. These dynamics frequently drive settlement not only for individual cases, but also for a series of pending and potentially related and unrelated cases. Although monetary and injunctive relief is typically sought, remedies and restitution are generally not determined until the conclusion of the trial court proceedings and can be modified on appeal. Accordingly, the outcomes of individual cases are difficult to time, predict or quantify and are often dependent upon the outcomes of other cases in other geographies.

During recent years, we successfully negotiated closure of several long-standing legal matters and have received favorable rulings in several other matters; however, there continues to be outstanding litigation. Adverse outcomes in one or more of these matters could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity.

In addition, product liability, securities and commercial claims have been asserted against us and similar claims may be asserted against us in the future related to events not known to management at the present time. We maintain an insurance policy providing limited coverage against securities claims and we are substantially self-insured with respect to product liability claims and fully self-insured with respect to intellectual property infringement claims. The absence of significant third-party insurance coverage increases our potential exposure to unanticipated claims or adverse decisions. Product liability claims, securities and commercial litigation and other legal proceedings in the future, regardless of their outcome, could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity.

In addition, like other companies in the medical device industry, we are subject to extensive regulation by national, state and local government agencies in the U.S. and other countries in which we operate. From time to time we are the subject of qui tam actions and governmental investigations often involving regulatory, marketing and other business practices. These qui tam actions and governmental investigations could result in the commencement of civil and criminal proceedings, substantial fines, penalties and administrative remedies and have a material adverse effect on our financial position, results of operations and/or liquidity. For additional information, refer to Note I – Commitments and Contingencies to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K.

In accordance with FASB ASC Topic 450, Contingencies, we accrue anticipated costs of settlement, damages, losses for product liability claims and, under certain conditions, costs of defense, based on historical experience or to the extent specific losses are probable and estimable. Otherwise, we expense these costs as incurred. If the estimate of a probable loss is a range and no amount within the range is more likely, we accrue the minimum amount of the range. We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related net charges (credits) within our accompanying unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses within our accompanying unaudited consolidated statements of operations.

Our accrual for legal matters that are probable and estimable was $419 million as of June 30, 2023 and $443 million as of December 31, 2022 and includes certain estimated costs of settlement, damages and defense primarily related to product liability cases or claims related to our transvaginal surgical mesh products. A portion of this accrual is already funded through our qualified settlement fund, which is included in restricted cash and restricted cash equivalents in Other current assets of $135 million as of June 30, 2023 and $149 million as of December 31, 2022. Refer to Note F – Supplemental Balance Sheet Information for additional information. We did not record litigation-related net charges during the second quarter or first six months of 2023, and recorded $42 million during the second quarter and first six months of 2022.

We continue to assess certain litigation and claims to determine the amounts, if any, that management believes will be paid as a result of such claims and litigation and, therefore, additional losses may be accrued and paid in the future, which could materially adversely impact our operating results, cash flows and/or our ability to comply with our financial covenant.

In management's opinion, we are not currently involved in any legal proceedings other than those disclosed in our most recent Annual Report on Form 10-K and those specifically identified below, which, individually or in the aggregate, could have a material adverse effect on our financial condition, operations and/or cash flows. Unless included in our legal accrual or otherwise indicated below, a range of loss associated with any individual material legal proceeding cannot be reasonably estimated.

Patent Litigation

On October 28, 2015, the Company filed suit against Cook Group Limited and Cook Medical LLC (collectively, Cook) in the United States District Court for the District of Delaware (1:15-cv-00980) alleging infringement of certain Company patents regarding Cook’s Instinct™ Endoscopic Hemoclip. The Company seeks lost profits, a reasonable royalty and a permanent injunction. The case was transferred to the District Court for the Southern District of Indiana. Cook filed Inter Partes Review (IPR) requests with the U.S. Patent and Trademark Office (USPTO) against four then-asserted patents, which resulted in the court staying the case until 2020. All IPRs concluded and confirmed the validity of certain claims of each challenged patent. In February 2023, the District Court issued summary judgment rulings dismissing certain claims and defenses. Trial on the remaining two asserted patents took place in May and June 2023 and the jury found that the Company’s patents are both valid and infringed and awarded the Company $158 million as lost profits. On July 26, 2023, the parties notified the District Court that they had reached a settlement in principle to resolve all claims and end the related suit.

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 us in Delaware. In January 2023, a jury trial was held on the issue of whether the one UT patent still asserted in the case was valid and whether it was infringed by the Company. On January 31, 2023, a jury concluded that UT’s patent was valid and willfully infringed by the Company, and awarded UT $42 million in damages. Following the trial, UT has filed a motion seeking prejudgment interest and enhanced damages. The Company has filed a motion seeking judgment as a matter of law in its favor or alternatively a new trial.

Product Liability Litigation

Multiple product liability cases or claims related to transvaginal surgical mesh products designed to treat stress urinary incontinence and pelvic organ prolapse have been asserted against us, predominantly in the United States, Canada, the United Kingdom, Scotland, Ireland, and Australia. Plaintiffs generally seek monetary damages based on allegations of personal injury associated with the use of our transvaginal surgical mesh products, including design and manufacturing claims, failure to warn, breach of warranty, fraud, violations of state consumer protection laws and loss of consortium claims. We have entered into individual and master settlement agreements in principle or are in the final stages of entering agreements with certain plaintiffs' counsel, to resolve the majority of these cases and claims. All settlement agreements were entered into solely by way of compromise and without any admission or concession by us of any liability or wrongdoing. In addition, in April 2021 the Company's Board of Directors received a shareholder demand under section 220 of the Delaware General Corporation Law, for inspection of books and records related to mesh settlements. The Company has notified our insurer and retained counsel to respond to the demand.

We have established a product liability accrual for remaining claims asserted against us associated with our transvaginal surgical mesh products and the costs of defense thereof. We continue to engage in discussions with plaintiffs’ counsel regarding potential resolution of pending cases and claims. We continue to vigorously contest these cases and claims. The final resolution of the cases and claims is uncertain and could have a material impact on our results of operations, financial condition and/or liquidity. Trials involving our transvaginal surgical mesh products have resulted in both favorable and unfavorable judgments for us. We do not believe that the judgment in any one trial is representative of potential outcomes of all cases or claims related to our transvaginal surgical mesh products.

Governmental Investigations and Qui Tam Matters

On December 1, 2015, the Brazilian governmental entity known as CADE (the Administrative Council of Economic Defense), served a search warrant on the offices of our Brazilian subsidiary, as well as on the Brazilian offices of several other major medical device makers who do business in Brazil, in furtherance of an investigation into alleged anti-competitive activity with respect to certain tender offers for government contracts. On June 20, 2017, CADE, through the publication of a “technical note,” announced that it was launching a formal administrative proceeding against Boston Scientific’s Brazilian subsidiary, Boston Scientific do Brasil Ltda. (BSB), as well as against the Brazilian operations of Medtronic, Biotronik and St. Jude Medical, two Brazilian associations, ABIMED and AMBIMO and 29 individuals for alleged anti-competitive behavior. Under applicable guidance, BSB could be fined a percentage of BSB’s 2016 gross revenues. In August 2021, the investigating commissioner issued a preliminary recommendation of liability against all of the involved companies, and also recommended that CADE impose fines and penalties. However, on October 25, 2021, the CADE Attorney General's office recommended dismissal of the charges and allegations against BSB and the individual BSB employees who were still individual defendants. Subsequently, on March 30, 2022, the Federal Prosecutor’s office issued a non-binding recommendation that is contrary to the Attorney General’s recommendation. The full Commission is considering both of these recommendations but has not yet issued its decision. We continue to deny the allegations, intend to defend ourselves vigorously and will appeal any decision of liability by the full Commission to the Brazilian courts. During such an appeal, the decision would have no force and effect, and the Court would consider the case without being bound by CADE’s decision.

In March 2022, the Company received a whistleblower letter alleging Foreign Corrupt Practices Act violations in Vietnam. The Company has received related subpoenas for documents from the Office of the U.S. Attorney for the District of Massachusetts and the Securities and Exchange Commission. The Company is cooperating with government agencies while investigating these allegations.

On April 5, 2023, the Company received a subpoena from the U.S. Department of Justice (DOJ) that seeks documents and information relating to its ambulatory electrocardiography monitoring (AECG) business. The Company is cooperating with the DOJ in responding to this subpoena.

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 Mariano Errichiello 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. The Company intends to vigorously defend itself against the surviving allegations. On December 15, 2020, the Securities and Exchange Commission’s Boston Regional Office (Boston SEC) notified the Company that it was conducting an investigation related to the Company’s decision to retire the LOTUS System and issued a voluntary request for documents and information related to that decision. On February 10, 2021, the Boston SEC issued a second voluntary request for additional documents and information. The Company cooperated fully with the requests, and on January 3, 2022, the SEC informed us that it was concluding its investigation and that it did not intend to recommend an enforcement action. On February 8, 2021, the Company received a letter from The Vladimir Gusinsky Revocable Trust, a shareholder, demanding that the Company’s Board of Directors conduct an investigation into actions by the Company’s directors and executive officers regarding statements made about the effectiveness and commercial viability of the LOTUS System. The Trust subsequently agreed to stay its demand, pending the outcome of any dispositive motion against the Amended Complaint in the class action complaint described above. The Company received letters on behalf of the Union Excavators Local 731 Pension Fund, Diane Nachbaur, and Frank Tripson, three stockholders of the Company, on July 26, 2021, July 29, 2021, and February 13, 2023, respectively, each demanding access to certain books and records of the Company, pursuant to Section 220 of the Delaware General Corporation Law, regarding the business, operations, effectiveness and commercial viability of the LOTUS system, and related items. On April 7, 2023, Diane Nachbaur filed a shareholder derivative complaint in the United States District Court for the District of Massachusetts against the Company, Michael F. Mahoney, Nelda J. Connors, Charles J. Dockendorff, Yoshiaki Fujimori, Donna A. James, Edward J. Ludwig, David Roux, John E. Sununu, Ellen M. Zane, Joseph M. Fitzgerald, Daniel J. Brennan, Shawn McCarthy, Ian Meredith, Kevin Ballinger, and Susan Vissers Lisa. On May 8, 2023, the Court stayed the case until the conclusion of the consolidated class action case.

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Stockholders' Equity

6 Months Ended

Jun. 30, 2023

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.

During the second quarter of 2023, the Audit Committee of our Board of Directors, pursuant to authority delegated to such committee by our Board of Directors, declared, and we paid, a final cash dividend of $1.375 per MCPS share to holders of our MCPS as of May 15, 2023, representing a dividend period from March 2023 through May 2023.

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.

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Weighted Average Shares Outstanding

6 Months Ended

Jun. 30, 2023

Earnings Per Share [Abstract]

Weighted Average Number Of Shares Outstanding [Text Block]

NOTE J – WEIGHTED AVERAGE SHARES OUTSTANDING

	Three Months Ended June 30,		Six Months Ended June 30,
(in millions)	2023	2022	2023	2022
Weighted average shares outstanding — basic	1,446.2	1,429.7	1,441.0	1,428.8
Net effect of common stock equivalents	10.1	8.1	10.1	9.3
Weighted average shares outstanding - diluted	1,456.2	1,437.8	1,451.1	1,438.1

The following securities were excluded from the calculation of diluted weighted average shares outstanding because their effect in the periods presented below would have been anti-dilutive:

	Three Months Ended June 30,		Six Months Ended June 30,
(in millions)	2023	2022	2023	2022
Stock options outstanding(1)	—	7	0	6
MCPS(2)	16	24	20	24

(1)    Represents stock options outstanding pursuant to our employee stock-based compensation plans with exercise prices that were greater than the average fair market value of our common stock for the related periods.

(2)    Represents common stock issuable upon the conversion of MCPS. Refer to Note I – Stockholders' Equity for additional information.

We base Net income (loss) per common share - diluted upon the weighted-average number of common shares and common stock equivalents outstanding during each year. Potential common stock equivalents are determined using the treasury stock method. We exclude stock options, stock awards and, prior to the Mandatory Conversion Date, our MCPS, from the calculation if the effect would be anti-dilutive. The dilutive effect of MCPS is calculated using the if-converted method. The if-converted method assumes that these securities were converted to shares of common stock at the beginning of the reporting period to the extent that the effect is dilutive.

For the first six months of 2023 and 2022, 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 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 25 million shares of our common stock in the second quarter of 2023, approximately 29 million shares in the first six months of 2023, less than one million shares in the second quarter of 2022, and approximately four million shares in the first six months of 2022. Shares were issued following the automatic conversion of the MCPS, the exercise of stock options, vesting of restricted stock units or purchases under our employee stock purchase plan. We did not repurchase any shares of our common stock in the first six months of 2023 or 2022. 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 June 30, 2023, we had the full amount remaining available under the authorization.

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Segment Reporting

6 Months Ended

Jun. 30, 2023

Segment Reporting [Abstract]

Segment Reporting Disclosure [Text Block]

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 June 30,				Six Months Ended June 30,
Net Sales	2023		2022		2023		2022
MedSurg	$	1,331	$	1,217	$	2,582	$	2,322
Cardiovascular	2,179		1,926		4,228		3,695
Total net sales of reportable segments	3,509		3,143		6,810		6,016
Impact of foreign currency fluctuations	91		101		179		254
	$	3,599	$	3,244	$	6,988	$	6,270

Income (loss) before income taxes
MedSurg	$	448	$	359	$	847	$	689
Cardiovascular	566		454		1,106		843
Total operating income of reportable segments	1,013		812		1,954		1,531
Unallocated amounts:
Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments	(49)		6		(124)		68
Goodwill and 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	(241)		(192)		(351)		(308)
Amortization expense	(210)		(204)		(412)		(402)
Operating income (loss)	514		423		1,066		889
Other expense, net	(88)		(78)		(195)		(388)
Income (loss) before income taxes	$	426	$	345	$	870	$	501

	Three Months Ended June 30,				Six Months Ended June 30,
Operating income margin of reportable segments	2023		2022		2023		2022
MedSurg	33.6	%	29.5	%	32.8	%	29.7	%
Cardiovascular	26.0	%	23.6	%	26.2	%	22.8	%

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Revenue

6 Months Ended

Jun. 30, 2023

Revenue from Contract with Customer [Abstract]

Revenue from Contract with Customer [Text Block]

NOTE L – REVENUE

We generate revenue primarily from the sale of single-use medical devices and present revenue net of sales taxes within our accompanying unaudited consolidated statements of operations. Our business structure is organized into five operating segments. The following tables disaggregate our revenue from contracts with customers by component and geographic region (in millions). We allocate revenue from contracts with customers to geographic regions based on the location where the sale originated.

	Three Months Ended June 30,
	2023						2022
Businesses	U.S.		Int'l		Total		U.S.		Int'l		Total
Endoscopy	$	384	$	246	$	631	$	338	$	221	$	560
Urology	340		146		485		320		130		450
Neuromodulation	183		61		244		186		53		239
MedSurg	907		453		1,360		844		404		1,248
Interventional Cardiology Therapies	189		440		629		192		382		574
Watchman	286		30		317		225		25		250
Cardiac Rhythm Management	356		209		566		342		199		541
Electrophysiology	85		108		193		73		79		152
Cardiology	917		787		1,704		832		685		1,517
Peripheral Interventions	285		250		535		257		221		478
Cardiovascular	1,202		1,037		2,239		1,089		906		1,996
Total Net Sales	$	2,110	$	1,490	$	3,599	$	1,933	$	1,311	$	3,244

	Six Months Ended June 30,
	2023						2022
Businesses	U.S.		Int'l		Total		U.S.		Int'l		Total
Endoscopy	$	735	$	472	$	1,207	$	650	$	441	$	1,091
Urology	666		289		954		606		257		863
Neuromodulation	356		123		478		346		101		448
MedSurg	1,757		883		2,640		1,602		799		2,402
Interventional Cardiology Therapies	372		848		1,220		378		740		1,118
Watchman	552		55		607		428		48		476
Cardiac Rhythm Management	702		412		1,114		667		394		1,061
Electrophysiology	170		199		370		123		147		270
Cardiology	1,796		1,514		3,310		1,596		1,329		2,925
Peripheral Interventions	560		478		1,039		513		430		944
Cardiovascular	2,356		1,993		4,349		2,109		1,760		3,868
Total Net Sales	$	4,113	$	2,876	$	6,988	$	3,711	$	2,559	$	6,270

Refer to Note K- Segment Reporting for information on our reportable segments.

	Three Months Ended June 30,				Six Months Ended June 30,
Geographic Regions	2023		2022		2023		2022
U.S.	$	2,110	$	1,933	$	4,113	$	3,711
Europe, Middle East and Africa	723		660		1,435		1,284
Asia-Pacific	626		530		1,174		1,047
Latin America and Canada	140		120		267		228
Total Net Sales	$	3,599	$	3,244	$	6,988	$	6,270
Emerging Markets(1)	$	592	$	498	$	1,121	$	938

(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. We have revised prior year amounts to conform to the current year's presentation.

Deferred Revenue

Contract liabilities are classified within Other current liabilities and Other long-term liabilities within our accompanying unaudited consolidated balance sheets. Our deferred revenue balance was $537 million as of June 30, 2023 and $509 million as of December 31, 2022. Our contractual 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 contractual 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 $35 million in the second quarter that was included in the above contract liability balance as of December 31, 2022. We have elected not to disclose the transaction price allocated to unsatisfied performance obligations when the original expected contract duration is one year or less. In addition, we have not identified material unfulfilled performance obligations for which revenue is not currently deferred.

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.

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Changes in Other Comprehensive Income

6 Months Ended

Jun. 30, 2023

Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]

Comprehensive Income (Loss) Note [Text Block]

NOTE M – CHANGES IN OTHER COMPREHENSIVE INCOME

The following tables provide the reclassifications out of Other comprehensive income (loss), net of tax:

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of March 31, 2023	$	(43)	$	225	$	(4)	$	178
Other comprehensive income (loss) before reclassifications	17		58		—		74
(Income) loss amounts reclassified from accumulated other comprehensive income	(2)		(42)		(0)		(44)
Total other comprehensive income (loss)	15		15		(0)		30
Balance as of June 30, 2023	$	(28)	$	241	$	(4)	$	208

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of March 31, 2022	$	29	$	229	$	(36)	$	222
Other comprehensive income (loss) before reclassifications	79		165		—		245
(Income) loss amounts reclassified from accumulated other comprehensive income	(2)		(31)		0		(34)
Total other comprehensive income (loss)	77		134		—		211
Balance as of June 30, 2022	$	106	$	363	$	(36)	$	433

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of December 31, 2022	$	(1)	$	269	$	1	$	269
Other comprehensive income (loss) before reclassifications	(24)		67		(5)		39
(Income) loss amounts reclassified from accumulated other comprehensive income	(4)		(95)		(1)		(100)
Total other comprehensive income (loss)	(28)		(28)		(5)		(61)
Balance as of June 30, 2023	$	(28)	$	241	$	(4)	$	208

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of December 31, 2021	$	93	$	206	$	(36)	$	263
Other comprehensive income (loss) before reclassifications	17		200		0		217
(Income) loss amounts reclassified from accumulated other comprehensive income	(4)		(43)		0		(47)
Total other comprehensive income (loss)	13		157		—		170
Balance as of June 30, 2022	$	106	$	363	$	(36)	$	433

Refer to Note D – Hedging Activities and Fair Value Measurements for further detail on our net investment hedges recorded in Foreign currency translation adjustments and our cash flow hedges recorded in Net change in derivative financial instruments.

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New Accounting Pronouncements

6 Months Ended

Jun. 30, 2023

Accounting Standards Update and Change in Accounting Principle [Abstract]

New Accounting Pronouncements, Policy

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 six months of 2023, we implemented the following standards on a prospective basis, none of which had a material impact on our financial position or results of operations.

ASC Update No. 2022-01

ASC Update No. 2022-01, Derivatives and Hedging (Topic 815): Fair Value Hedging - Portfolio Layer Method. Update No. 2022-01 expands the current single-layer method to allow multiple hedged layers of a single closed portfolio under the method, among other updates to these methods.

ASC Update No. 2022-02

ASC Update No. 2022-02, Financial Instruments- Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures makes amendments related to troubled debt restructurings for entities that have adopted Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, as well as amendments related to vintage disclosures for entities with investments in financing receivables that have adopted Update No. 2016-13.

ASC Update No. 2022-04

ASC Update No. 2022-04, Liabilities— Supplier Finance Programs (Subtopic 405-50) enhances the transparency of supplier finance programs by requiring that a buyer in a supplier finance program disclose sufficient qualitative and quantitative information about the program to allow a user of financial statements to understand the program's nature, activity during the period, changes from period to period, and potential magnitude.

Standards to be Implemented

In June 2022, the FASB issued ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions. Update No. 2022-03 clarifies the guidance in Topic 820 related to measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale of an equity security, as well as introduces new disclosure requirements for these types of equity securities. Update No. 2022-03 is effective for fiscal years beginning after December 15, 2023, including interim periods within those fiscal years. We do not expect the adoption to have a material impact on our financial position or results of operations.

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.

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Insider Trading Arrangements - shares		3 Months Ended	6 Months Ended
	Apr. 06, 2023	Jun. 30, 2023	Jun. 30, 2023
Trading Arrangements, by Individual
Non-Rule 10b5-1 Arrangement Adopted			false
Non-Rule 10b5-1 Arrangement Terminated			false
Jeffrey B. Mirviss [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On April 6, 2023, Jeffrey B. Mirviss, our Senior Vice President and President, Peripheral Interventions, terminated a trading plan that was originally entered into on February 23, 2023 and intended to satisfy the affirmative defense conditions of the prior version of Rule 10b5-1(c). The plan covered the sale of up to 76,992 shares of our common stock, including up to 27,208 shares to be acquired upon vesting of performance share units and restricted share units and 30,172 shares to be acquired upon exercise of stock options, between March 27, 2023 and February 23, 2024. Transactions under the plan were based upon pre-established dates and stock price thresholds.		On May 25, 2023, Jeffrey B. Mirviss, our Senior Vice President and President, Peripheral Interventions, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Mirviss’ plan covers the sale of up 105,490 shares of our common stock, including up to 56,690 shares to be acquired upon determination and/or vesting of performance share units and restricted share units and 30,172 shares to be acquired upon exercise of stock options, between August 24, 2023 and March 29, 2024. Transactions under the plan are based upon pre-established dates and stock price thresholds.
Name	Jeffrey B. Mirviss	Jeffrey B. Mirviss
Title	Senior Vice President and President, Peripheral Interventions	Senior Vice President and President, Peripheral Interventions
Rule 10b5-1 Arrangement Adopted		true
Adoption Date	April 6, 2023	May 25, 2023
Rule 10b5-1 Arrangement Terminated	true
Arrangement Duration	333 days	218 days
Aggregate Available	76,992	105,490	105,490
Charles Dockendorff [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement			On May 19, 2023, Charles Dockendorff, an independent member of our Board of Directors, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Dockendorff’s plan covers the sale of 21,025 shares of our common stock between August 18, 2023 and May 31, 2024. Transactions under the plan are based upon pre-established dates and stock price thresholds.
Name		Charles Dockendorff
Title		independent member of our Board of Directors
Adoption Date		May 19, 2023
Arrangement Duration		287 days
Aggregate Available		21,025	21,025
Vance R. Brown [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement			On May 26, 2023, Vance R. Brown, our Senior Vice President, General Counsel and Corporate Secretary, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). Mr. Brown’s plan covers the sale of 15,750 shares of our common stock between August 25, 2023 and December 29, 2023. Transactions under the plan are based upon pre-established dates and stock price thresholds.
Name		Vance R. Brown
Title		Senior Vice President, General Counsel and Corporate Secretary
Rule 10b5-1 Arrangement Adopted		true
Adoption Date		May 26, 2023
Arrangement Duration		126 days
Aggregate Available		15,750	15,750

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Basis of Presentation Basis of Presentation (Policies)

6 Months Ended

Jun. 30, 2023

Accounting Policies [Abstract]

Subsequent Events, Policy [Policy Text Block]

Subsequent Events

We evaluate events occurring after the date of our accompanying unaudited consolidated balance sheet for potential recognition or disclosure in our financial statements. Those items requiring recognition in the financial statements have been recorded and disclosed accordingly.

Those items requiring disclosure (non-recognized subsequent events) in the financial statements have been disclosed accordingly. Refer to Note H – Commitments and Contingencies for further details.

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Fair Value Measurements Hedging Activities and Fair Value Measurements (Policies)	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurement, Policy [Policy Text Block]	FASB ASC Topic 815 requires all derivative and nonderivative instruments to be recognized at their fair values as either assets or liabilities on the balance sheet. We determine the fair value of our derivative and nonderivative instruments using the framework prescribed by FASB ASC Topic 820, Fair Value Measurements and Disclosures

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Commitments and Contingencies Commitments and Contingencies (Policies)	6 Months Ended
	Jun. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Legal Costs, Policy [Policy Text Block]	In accordance with FASB ASC Topic 450, Contingencies, we accrue anticipated costs of settlement, damages, losses for product liability claims and, under certain conditions, costs of defense, based on historical experience or to the extent specific losses are probable and estimable. Otherwise, we expense these costs as incurred. If the estimate of a probable loss is a range and no amount within the range is more likely, we accrue the minimum amount of the range. We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related net charges (credits) within our accompanying unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses within our accompanying unaudited consolidated statements of operations.

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New Accounting Pronouncements (Policies)	6 Months Ended
	Jun. 30, 2023
Accounting Standards Update and Change in Accounting Principle [Abstract]
ASC Update No. 2022-01, Derivatives and Hedging (Topic 815): FV Hedging -Portfolio Layer Method	ASC Update No. 2022-01, Derivatives and Hedging (Topic 815): Fair Value Hedging - Portfolio Layer Method. Update No. 2022-01 expands the current single-layer method to allow multiple hedged layers of a single closed portfolio under the method, among other updates to these methods.
ASC Update No. 2022-02, Financial Instruments, Credit Losses (Topic 326:Troubled Debt Restructurings and Vintage Disclosures)	ASC Update No. 2022-02, Financial Instruments- Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures makes amendments related to troubled debt restructurings for entities that have adopted Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, as well as amendments related to vintage disclosures for entities with investments in financing receivables that have adopted Update No. 2016-13.
ASC Update No. 2022-04, Liabilities - Supplier Finance Programs (Subtopic 405-50)	ASC Update No. 2022-04, Liabilities— Supplier Finance Programs (Subtopic 405-50) enhances the transparency of supplier finance programs by requiring that a buyer in a supplier finance program disclose sufficient qualitative and quantitative information about the program to allow a user of financial statements to understand the program's nature, activity during the period, changes from period to period, and potential magnitude.
ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions.	In June 2022, the FASB issued ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions. Update No. 2022-03 clarifies the guidance in Topic 820 related to measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale of an equity security, as well as introduces new disclosure requirements for these types of equity securities. Update No. 2022-03 is effective for fiscal years beginning after December 15, 2023, including interim periods within those fiscal years. We do not expect the adoption to have a material impact on our financial position or results of operations.

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Acquisitions, Divestitures and Strategic Investments (Tables)

6 Months Ended

Jun. 30, 2023

Business Acquisition [Line Items]

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]

Changes in the fair value of our contingent consideration liability during the first six months of 2023 associated with prior period acquisitions were as follows:

(in millions)
Balance as of December 31, 2022	$	149
Contingent consideration net expense (benefit)	31
Contingent consideration payments	(73)
Balance as of June 30, 2023	$	107

Fair Value Measurement Inputs and Valuation Techniques [Table Text Block]

The recurring Level 3 fair value measurements of our contingent consideration liability that we expect to be required to settle include the following significant unobservable inputs:

Contingent Consideration Liability	Fair Value as of June 30, 2023	Valuation Technique	Unobservable Input	Range			Weighted Average(1)
R&D, Regulatory and Commercialization-based Milestones	$13 million	Discounted Cash Flow	Discount Rate	1%	-	2%	1%
			Probability of Payment	10%	-	25%	22%
			Projected Year of Payment	2023	-	2025	2024
Revenue-based Payments	$94 million	Discounted Cash Flow	Discount Rate	6%	-	14%	6%
			Probability of Payment	100%			100%
			Projected Year of Payment	2023	-	2024	2023

(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 [Table Text Block]

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

	As of
(in millions)	June 30, 2023		December 31, 2022
Equity method investments	$	206	$	188
Measurement alternative investments(1, 2)	215		219
	$	422	$	407

(1)    Measurement alternative investments are privately-held equity securities without readily determinable fair values that are measured at cost less impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer, recognized in Other, net within our accompanying unaudited consolidated statements of operations.

(2)    Includes publicly-held securities and convertible notes measured at fair value with changes in fair value recognized in Other, net within our accompanying unaudited consolidated statements of operations.

Acotec

Business Acquisition [Line Items]

Schedule of Business Acquisitions, by Acquisition [Table Text Block]

(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) Represents majority stake investment in Acotec

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]

The preliminary purchase price allocations were comprised of the following components and the final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with FASB ASC Topic 805:

(in millions)	Acotec		Apollo
Goodwill	$	340	$	374
Amortizable intangible assets	334		248
Other assets acquired	93		50
Liabilities assumed	(48)		(26)
Net deferred tax liabilities	(79)		(9)
Fair value of noncontrolling interest	(259)		—
	$	381	$	636

Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination [Table Text Block]

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	11	14%
Customer relationships	15		11	14%
Other intangible assets	11		13	14%
	$	334
Apollo:
Amortizable intangible assets:
Technology-related	$	222	11	12%
Customer relationships	26		11	12%
	$	248

Baylis Medical

Business Acquisition [Line Items]

Schedule of Business Acquisitions, by Acquisition [Table Text Block]

(in millions)
Payment for acquisition, net of cash acquired	$	1,463
	$	1,463

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]

The final purchase price allocation was comprised of the following components:

(in millions)
Goodwill	$	988
Amortizable intangible assets	657
Other assets acquired	112
Liabilities assumed	(287)
Net deferred tax liabilities	(7)
	$	1,463

Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination [Table Text Block]

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	$	622	11	11%
Other intangible assets	36		11	11%
	$	657

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Goodwill and Other Intangible Assets Goodwill (Tables)

6 Months Ended

Jun. 30, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Intangible Assets and Goodwill [Table Text Block]

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 June 30, 2023				As of December 31, 2022
(in millions)	Gross Carrying Amount		Accumulated Amortization/ Write-offs		Gross Carrying Amount		Accumulated Amortization/ Write-offs
Technology-related	$	12,932	$	(7,737)	$	12,397	$	(7,378)
Patents	478		(385)		486		(394)
Other intangible assets	2,050		(1,448)		1,960		(1,400)
Amortizable intangible assets	$	15,459	$	(9,571)	$	14,843	$	(9,173)
Goodwill	$	23,559	$	(9,900)	$	22,820	$	(9,900)
IPR&D	$	54			$	112
Technology-related	120				120
Indefinite-lived intangible assets	$	174			$	232

Schedule of Goodwill [Table Text Block]

The following represents a roll-forward of our goodwill balance by global reportable segment:

(in millions)	MedSurg		Cardiovascular		Total
As of December 31, 2022	$	4,237	$	8,684	$	12,920
Goodwill acquired	374		340		714
Impact of foreign currency fluctuations and purchase price adjustments	(3)		28		25
As of June 30, 2023	$	4,607	$	9,052	$	13,659

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Hedging Activities and Fair Value Measurements (Tables)

6 Months Ended

Jun. 30, 2023

Derivative [Line Items]

Schedule of Notional Amounts of Outstanding Derivative Positions [Table Text Block]

The following table presents the contractual amounts of our hedging instruments outstanding:

(in millions)	FASB ASC Topic 815 Designation	As of
		June 30, 2023		December 31, 2022
Forward currency contracts	Cash flow hedge	$	2,454	$	2,725
Forward currency contracts	Net investment hedge	333		365
Foreign currency-denominated debt(1)	Net investment hedge	997		997
Forward currency contracts	Non-designated	3,575		4,235
Total Notional Outstanding		$	7,360	$	8,321

(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) [Table Text Block]

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Three Months Ended June 30, 2023
Forward currency contracts
Cash flow hedges	$	74	$	(17)	$	58	Cost of products sold	$	1,058	$	(55)	$	12	$	(43)
Net investment hedges(2)	22		(5)		17		Interest expense	70		(2)		1		(2)
Foreign currency-denominated debt
Net investment hedges(3)	1		—		1		Other, net	18		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest expense	70		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Three Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges	$	213	$	(48)	$	165	Cost of products sold	$	1,011	$	(41)	$	9	$	(32)
Net investment hedges(2)	34		5		39		Interest expense	64		(3)		1		(2)
Foreign currency-denominated debt
Net investment hedges(3)	62		(14)		48		Other, net	14		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest Expense	64		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Six Months Ended June 30, 2023
Forward currency contracts
Cash flow hedges	$	87	$	(20)	$	67	Cost of products sold	$	2,098	$	(125)	$	28	$	(97)
Net investment hedges (2)	28		(6)		22		Interest expense	135		(5)		1		(4)
Foreign currency-denominated debt
Net investment hedges (3)	(18)		4		(14)		Other, net	61		—		—		—
Interest rate derivative contracts
Cash flow hedges					—		Interest expense	135		1		—		1

	Effect of Hedging Relationships on Accumulated Other Comprehensive Income
	Amount Recognized in OCI on Hedges						Unaudited Consolidated Statements of Operations(1)			Amount Reclassified from AOCI into Earnings
(in millions)	Pre-Tax Gain (Loss)		Tax Benefit (Expense)		Gain (Loss) Net of Tax		Location of Amount Reclassified and Total Amount of Line Item			Pre-Tax (Gain) Loss		Tax (Benefit) Expense		(Gain) Loss Net of Tax
Six Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges	$	259	$	(58)	$	200	Cost of products sold	$	1,966	$	(71)	$	16	$	(55)
Net investment hedges (2)	49		2		50		Interest expense	343		(5)		1		(4)
Foreign currency-denominated debt
Net investment hedges (3)	86		(19)		66		Other, net	46		—		—		—
Interest rate derivative contracts
Cash flow hedges	—		—		—		Interest expense	343		15		(3)		11

(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 period, 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 [Table Text Block]

As of June 30, 2023, pre-tax net gains or losses for our derivative instruments designated, or previously designated, as cash flow and net investment hedges under FASB ASC Topic 815 that may be reclassified from AOCI to earnings within the next twelve months are presented below:

(in millions)	FASB ASC Topic 815 Designation	Location on Unaudited Consolidated Statements of Operations	Amount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings
Designated Hedging Instrument
Forward currency contracts	Cash flow hedge	Cost of products sold	$	209
Forward currency contracts	Net investment hedge	Interest expense	9
Interest rate derivative contracts	Cash flow hedge	Interest expense	(2)

Derivatives Not Designated as Hedging Instruments [Table Text Block]

Net gains and losses on currency hedge contracts not designated as hedging instruments offset by net gains and losses from currency transaction exposures are presented below:

	Location on Unaudited Consolidated Statements of Operations	Three Months Ended June 30,				Six Months Ended June 30,
(in millions)		2023		2022		2023		2022
Net gain (loss) on currency hedge contracts	Other, net	$	11	$	(34)	$	2	$	(63)
Net gain (loss) on currency transaction exposures	Other, net	(20)		35		(26)		56
Net currency exchange gain (loss)		$	(9)	$	1	$	(24)	$	(7)

Schedule of Derivative Instruments in Statement of Financial Position, Fair Value [Table Text Block]

The following are the balances of our derivative and nonderivative assets and liabilities:

	Location on Unaudited Consolidated Balance Sheets(1)	As of
(in millions)		June 30, 2023		December 31, 2022
Derivative and Nonderivative Assets:
Designated Hedging Instruments
Forward currency contracts	Other current assets	$	188	$	196
Forward currency contracts	Other long-term assets	155		149
		342		345
Non-Designated Hedging Instruments
Forward currency contracts	Other current assets	46		36
Total Derivative and Nonderivative Assets		$	388	$	381
Derivative and Nonderivative Liabilities:
Designated Hedging Instruments
Forward currency contracts	Other current liabilities	$	1	$	—
Forward currency contracts	Other long-term liabilities	2		1
Foreign currency-denominated debt(2)	Long-term debt	971		952
		974		953
Non-Designated Hedging Instruments
Forward currency contracts	Other current liabilities	48		52
Total Derivative and Nonderivative Liabilities		$	1,021	$	1,005

(1)    We classify derivative and nonderivative assets and liabilities as current when the settlement date of the contract is one year or less.

(2)    Foreign currency-denominated debt is the €900 million debt principal 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.

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]

Assets and liabilities measured at fair value on a recurring basis consist of the following:

	As of
	June 30, 2023								December 31, 2022
(in millions)	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Assets
Money market funds and time deposits	$	17	$	—	$	—	$	17	$	673	$	—	$	—	$	673
Publicly-held equity securities	29		—		—		29		2		—		—		2
Hedging instruments	—		388		—		388		—		381		—		381
Licensing arrangements	—		—		102		102		—		—		127		127
	$	46	$	388	$	102	$	535	$	674	$	381	$	127	$	1,182
Liabilities
Hedging instruments	$	—	$	1,021	$	—	$	1,021	$	—	$	1,005	$	—	$	1,005
Contingent consideration liability	—		—		107		107		—		—		149		149
Licensing arrangements	—		—		115		115		—		—		159		159
	$	—	$	1,021	$	222	$	1,244	$	—	$	1,005	$	308	$	1,313

The recurring Level 3 fair value measurements of our licensing arrangements recognized in our accompanying unaudited consolidated balance sheets as of June 30, 2023 include the following significant unobservable inputs:

Licensing Arrangements	Fair Value as of June 30, 2023	Valuation Technique	Unobservable Input	Range				Weighted Average (1)
Financial Asset	$102 million	Discounted Cash Flow	Discount Rate	15%				15%
			Projected Year of Payment	2023		-	2025	2024
Financial Liability	$115 million	Discounted Cash Flow	Discount Rate	12	%	-	15%	13%
			Projected Year of Payment	2023		-	2026	2024

(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, 2022	$	127
Proceeds from royalty rights	(31)
Fair value adjustment (expense) benefit	6
Balance as of June 30, 2023	$	102

Changes in the fair value of our licensing arrangements' financial liability were as follows:

(in millions)
Balance as of December 31, 2022	$	159
Payments for royalty rights	(50)
Fair value adjustment expense (benefit)	6
Balance as of June 30, 2023	$	115

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Contractual Obligations and Commitments (Tables)

6 Months Ended

Jun. 30, 2023

Short-term Debt [Line Items]

Schedule of Long-term Debt Instruments [Table Text Block]

The debt maturity schedule for our long-term debt obligations is presented below:

(in millions, except interest rates)	Issuance Date	Maturity Date	As of				Coupon Rate(1)
			June 30, 2023		December 31, 2022
March 2024 Senior Notes	February 2019	March 2024	—		504		3.450%
March 2025 Senior Notes(3)	March 2022	March 2025	1,087		1,067		0.750%
June 2025 Senior Notes	May 2020	June 2025	500		500		1.900%
March 2026 Senior Notes	February 2019	March 2026	255		255		3.750%
December 2027 Senior Notes(3)	November 2019	December 2027	978		960		0.625%
March 2028 Senior Notes(3)	March 2022	March 2028	815		800		1.375%
March 2028 Senior Notes	February 2018	March 2028	344		344		4.000%
March 2029 Senior Notes	February 2019	March 2029	272		272		4.000%
June 2030 Senior Notes	May 2020	June 2030	1,200		1,200		2.650%
March 2031 Senior Notes(3)	March 2022	March 2031	815		800		1.625%
March 2034 Senior Notes(3)	March 2022	March 2034	543		534		1.875%
November 2035 Senior Notes(2)	November 2005	November 2035	350		350		6.500%
March 2039 Senior Notes	February 2019	March 2039	450		450		4.550%
January 2040 Senior Notes	December 2009	January 2040	300		300		7.375%
March 2049 Senior Notes	February 2019	March 2049	650		650		4.700%
Unamortized Debt Issuance Discount and Deferred Financing Costs		2023 - 2049	(70)		(76)
Finance Lease Obligation		Various	5		5
Long-term debt			$	8,494	$	8,915

Note: The table above does not include unamortized amounts related to interest rate contracts designated as cash flow hedges.

(1)    Coupon rates are semi-annual, except for the euro-denominated senior 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 if the lowest credit ratings assigned to these senior notes is either A- or A3 or higher. Effective May 2023, the interest rate payable decreased by 0.25 percent and began accruing at a rate of 6.50 percent following recent upgrades to our credit ratings.

(3)    These notes are euro-denominated and presented in U.S. dollars based on the exchange rate in effect as of June 30, 2023 and December 31, 2022, respectively.

Summary Of Term Loan And Revolving Credit Facility Agreement Compliance With Debt Covenants [Table Text Block]

As of June 30, 2023, we were in compliance with the financial covenant required by the 2021 Revolving Credit Facility, as amended.

	Covenant Requirement	Actual
	as of June 30, 2023	as of June 30, 2023
Maximum permitted leverage ratio(1)	3.75 times	2.48 times

(1)Ratio of total debt to consolidated EBITDA, as defined by the credit agreements, as amended.

Transfer of Financial Assets Accounted for as Sales [Table Text Block]

Factoring Arrangements	As of June 30, 2023				As of December 31, 2022
	Amount De-recognized		Weighted Average Interest Rate		Amount De-recognized		Weighted Average Interest Rate
Euro denominated	$	217	5.4	%	$	161	2.4	%
Yen denominated	179		0.7	%	194		0.6	%
Renminbi denominated	17		2.9	%	13		3.1	%

Commercial Paper [Member]

Short-term Debt [Line Items]

Schedule of Short-term Debt [Table Text Block]

We had $41 million of commercial paper outstanding as of June 30, 2023 and none as of December 31, 2022.

	As of
(in millions, except maturity and yield)	June 30, 2023			December 31, 2022
Commercial paper outstanding (at par)	$	41		$	—
Maximum borrowing capacity	2,750			2,750
Borrowing capacity available	2,709			2,750
Weighted average maturity	5 days			0 days
Weighted average yield	5.30		%	—		%

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Supplemental Balance Sheet Information (Tables)

6 Months Ended

Jun. 30, 2023

Supplemental Balance Sheet Information [Abstract]

Trade accounts receivable, net [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Trade accounts receivable	$	2,261	$	2,079
Allowance for credit losses	(127)		(109)
	$	2,134	$	1,970

	Three Months Ended June 30,				Six Months Ended June 30,
(in millions)	2023		2022		2023		2022
Beginning balance	$	118	$	113	$	109	$	108
Credit loss expense	19		9		35		20
Write-offs	(10)		(5)		(16)		(11)
Ending balance	$	127	$	117	$	127	$	117

Inventory Disclosure [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Finished goods	$	1,372	$	1,171
Work-in-process	175		147
Raw materials	703		548
	$	2,250	$	1,867

Schedule of Other Current Assets [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Restricted cash and restricted cash equivalents	$	135	$	149
Derivative assets	234		232
Licensing arrangements	53		60
Other	353		290
	$	773	$	731

Property, plant and equipment, net [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Land	$	141	$	137
Buildings and improvements	1,790		1,695
Equipment, furniture and fixtures	3,427		3,297
Capital in progress	604		598
	5,962		5,728
Less: accumulated depreciation	3,428		3,282
	$	2,534	$	2,446

Schedule of Other Assets [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Restricted cash equivalents	$	60	$	48
Operating lease right-of-use assets	445		386
Derivative assets	156		149
Investments	422		407
Licensing arrangements	49		67
Indemnification asset	168		172
Other	295		271
	$	1,595	$	1,500

Schedule of Accrued Liabilities [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Legal reserves	$	209	$	231
Payroll and related liabilities	843		830
Rebates	363		352
Contingent consideration	97		74
Other	653		674
	$	2,164	$	2,160

Other Current Liabilities [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Deferred revenue	$	242	$	220
Licensing arrangements	55		79
Taxes payable	400		232
Other	242		230
	$	940	$	761

Other long-term liabilities [Table Text Block]

	As of
(in millions)	June 30, 2023		December 31, 2022
Accrued income taxes	$	489	$	597
Legal reserves	210		212
Contingent consideration	10		75
Licensing arrangements	60		80
Operating lease liabilities	401		347
Deferred revenue	295		289
Other	460		434
	$	1,926	$	2,035

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Income Taxes (Tables)

6 Months Ended

Jun. 30, 2023

Schedule of Income Tax Rate Reconciliation [Line Items]

Schedule of Effective Income Tax Rate from Continuing Operations [Table Text Block]

	Three Months Ended June 30,				Six Months Ended June 30,
	2023		2022		2023		2022
Effective tax rate from continuing operations	36.6	%	24.7	%	32.9	%	26.1	%

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Weighted Average Shares Outstanding (Tables)

6 Months Ended

Jun. 30, 2023

Earnings Per Share [Abstract]

Schedule of Weighted Average Number of Shares [Table Text Block]

	Three Months Ended June 30,		Six Months Ended June 30,
(in millions)	2023	2022	2023	2022
Weighted average shares outstanding — basic	1,446.2	1,429.7	1,441.0	1,428.8
Net effect of common stock equivalents	10.1	8.1	10.1	9.3
Weighted average shares outstanding - diluted	1,456.2	1,437.8	1,451.1	1,438.1

Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share

The following securities were excluded from the calculation of diluted weighted average shares outstanding because their effect in the periods presented below would have been anti-dilutive:

	Three Months Ended June 30,		Six Months Ended June 30,
(in millions)	2023	2022	2023	2022
Stock options outstanding(1)	—	7	0	6
MCPS(2)	16	24	20	24

(1)    Represents stock options outstanding pursuant to our employee stock-based compensation plans with exercise prices that were greater than the average fair market value of our common stock for the related periods.

(2)    Represents common stock issuable upon the conversion of MCPS. Refer to Note I – Stockholders' Equity for additional information.

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Segment Reporting (Tables)

6 Months Ended

Jun. 30, 2023

Segment Reporting [Abstract]

Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Table Text Block]

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 June 30,				Six Months Ended June 30,
Net Sales	2023		2022		2023		2022
MedSurg	$	1,331	$	1,217	$	2,582	$	2,322
Cardiovascular	2,179		1,926		4,228		3,695
Total net sales of reportable segments	3,509		3,143		6,810		6,016
Impact of foreign currency fluctuations	91		101		179		254
	$	3,599	$	3,244	$	6,988	$	6,270

Income (loss) before income taxes
MedSurg	$	448	$	359	$	847	$	689
Cardiovascular	566		454		1,106		843
Total operating income of reportable segments	1,013		812		1,954		1,531
Unallocated amounts:
Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments	(49)		6		(124)		68
Goodwill and 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	(241)		(192)		(351)		(308)
Amortization expense	(210)		(204)		(412)		(402)
Operating income (loss)	514		423		1,066		889
Other expense, net	(88)		(78)		(195)		(388)
Income (loss) before income taxes	$	426	$	345	$	870	$	501

	Three Months Ended June 30,				Six Months Ended June 30,
Operating income margin of reportable segments	2023		2022		2023		2022
MedSurg	33.6	%	29.5	%	32.8	%	29.7	%
Cardiovascular	26.0	%	23.6	%	26.2	%	22.8	%

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Revenue (Tables)

6 Months Ended

Jun. 30, 2023

Disaggregation of Revenue [Abstract]

Disaggregation of Revenue [Table Text Block]

The following tables disaggregate our revenue from contracts with customers by component and geographic region (in millions). We allocate revenue from contracts with customers to geographic regions based on the location where the sale originated.

	Three Months Ended June 30,
	2023						2022
Businesses	U.S.		Int'l		Total		U.S.		Int'l		Total
Endoscopy	$	384	$	246	$	631	$	338	$	221	$	560
Urology	340		146		485		320		130		450
Neuromodulation	183		61		244		186		53		239
MedSurg	907		453		1,360		844		404		1,248
Interventional Cardiology Therapies	189		440		629		192		382		574
Watchman	286		30		317		225		25		250
Cardiac Rhythm Management	356		209		566		342		199		541
Electrophysiology	85		108		193		73		79		152
Cardiology	917		787		1,704		832		685		1,517
Peripheral Interventions	285		250		535		257		221		478
Cardiovascular	1,202		1,037		2,239		1,089		906		1,996
Total Net Sales	$	2,110	$	1,490	$	3,599	$	1,933	$	1,311	$	3,244

	Six Months Ended June 30,
	2023						2022
Businesses	U.S.		Int'l		Total		U.S.		Int'l		Total
Endoscopy	$	735	$	472	$	1,207	$	650	$	441	$	1,091
Urology	666		289		954		606		257		863
Neuromodulation	356		123		478		346		101		448
MedSurg	1,757		883		2,640		1,602		799		2,402
Interventional Cardiology Therapies	372		848		1,220		378		740		1,118
Watchman	552		55		607		428		48		476
Cardiac Rhythm Management	702		412		1,114		667		394		1,061
Electrophysiology	170		199		370		123		147		270
Cardiology	1,796		1,514		3,310		1,596		1,329		2,925
Peripheral Interventions	560		478		1,039		513		430		944
Cardiovascular	2,356		1,993		4,349		2,109		1,760		3,868
Total Net Sales	$	4,113	$	2,876	$	6,988	$	3,711	$	2,559	$	6,270

Refer to Note K- Segment Reporting for information on our reportable segments.

	Three Months Ended June 30,				Six Months Ended June 30,
Geographic Regions	2023		2022		2023		2022
U.S.	$	2,110	$	1,933	$	4,113	$	3,711
Europe, Middle East and Africa	723		660		1,435		1,284
Asia-Pacific	626		530		1,174		1,047
Latin America and Canada	140		120		267		228
Total Net Sales	$	3,599	$	3,244	$	6,988	$	6,270
Emerging Markets(1)	$	592	$	498	$	1,121	$	938

(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. We have revised prior year amounts to conform to the current year's presentation.

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Changes in Other Comprehensive Income (Tables)

6 Months Ended

Jun. 30, 2023

Other Comprehensive Income (Loss), Net of Tax, Period Change [Abstract]

Changes in Other Comprehensive Income [Table Text Block]

The following tables provide the reclassifications out of Other comprehensive income (loss), net of tax:

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of March 31, 2023	$	(43)	$	225	$	(4)	$	178
Other comprehensive income (loss) before reclassifications	17		58		—		74
(Income) loss amounts reclassified from accumulated other comprehensive income	(2)		(42)		(0)		(44)
Total other comprehensive income (loss)	15		15		(0)		30
Balance as of June 30, 2023	$	(28)	$	241	$	(4)	$	208

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of March 31, 2022	$	29	$	229	$	(36)	$	222
Other comprehensive income (loss) before reclassifications	79		165		—		245
(Income) loss amounts reclassified from accumulated other comprehensive income	(2)		(31)		0		(34)
Total other comprehensive income (loss)	77		134		—		211
Balance as of June 30, 2022	$	106	$	363	$	(36)	$	433

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of December 31, 2022	$	(1)	$	269	$	1	$	269
Other comprehensive income (loss) before reclassifications	(24)		67		(5)		39
(Income) loss amounts reclassified from accumulated other comprehensive income	(4)		(95)		(1)		(100)
Total other comprehensive income (loss)	(28)		(28)		(5)		(61)
Balance as of June 30, 2023	$	(28)	$	241	$	(4)	$	208

(in millions)	Foreign Currency Translation Adjustments		Net Change in Derivative Financial Instruments		Net Change in Defined Benefit Pensions and Other Items		Total
Balance as of December 31, 2021	$	93	$	206	$	(36)	$	263
Other comprehensive income (loss) before reclassifications	17		200		0		217
(Income) loss amounts reclassified from accumulated other comprehensive income	(4)		(43)		0		(47)
Total other comprehensive income (loss)	13		157		—		170
Balance as of June 30, 2022	$	106	$	363	$	(36)	$	433

R

XML

Basis of Presentation (Details)	6 Months Ended
	Jun. 30, 2023 reportablesegments
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of reportable segments	2

XML

Acquisitions and Divestitures (Details) $ in Millions					6 Months Ended
	Apr. 04, 2023 USD ($)	Feb. 20, 2023 USD ($)	Feb. 20, 2023 KRW (₩)	Feb. 14, 2022 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Jun. 15, 2023	Dec. 31, 2022 USD ($)
Business Acquisition [Line Items]
Payments to Acquire Businesses, Net of Cash Acquired					$ 1,018	$ 1,471
Goodwill					13,659			$ 12,920
Cash					409			$ 256
Acotec
Business Acquisition [Line Items]
Noncontrolling Interest, Ownership Percentage by Noncontrolling Owners		35.00%
M.I. Tech Co., Ltd
Business Acquisition [Line Items]
Business Acquisition, Percentage of Voting Interests Acquired							9.90%
Apollo
Business Acquisition [Line Items]
Payments to Acquire Businesses, Net of Cash Acquired					636
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value	$ 636
Business Combination, Consideration Transferred, Including Equity Interest in Acquiree Held Prior to Combination					636
Goodwill					374
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets					50
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities					(26)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Liabilities					(9)
Business Combination, Acquisition of Less than 100 Percent, Noncontrolling Interest, Fair Value					0
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Intangible Assets, Other than Goodwill					248
Business Acquisition, Percentage of Voting Interests Acquired	100.00%
Apollo | Technology-Based Intangible Assets [Member]
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 | 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 | Weighted Average [Member] | Technology-Based Intangible Assets [Member]
Business Acquisition [Line Items]
Discount Rate, Fair Value Input					12.00%
Apollo | Weighted Average [Member] | Customer Relationships
Business Acquisition [Line Items]
Discount Rate, Fair Value Input					12.00%
Acotec
Business Acquisition [Line Items]
Payments to Acquire Businesses, Net of Cash Acquired					$ 381
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value		$ 519	₩ 20.00
Business Combination, Consideration Transferred, Including Equity Interest in Acquiree Held Prior to Combination					381
Goodwill					340
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets					93
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities					(48)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Liabilities					(79)
Business Combination, Acquisition of Less than 100 Percent, Noncontrolling Interest, Fair Value					(259)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Intangible Assets, Other than Goodwill					334
Business Acquisition, Percentage of Voting Interests Acquired		65.00%
Cash		$ 140
Acotec | Technology-Based Intangible Assets [Member]
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles					$ 308
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life					11 years
Acotec | Other Intangible Assets [Member]
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles					$ 11
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life					13 years
Acotec | Customer Relationships
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles					$ 15
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life					11 years
Acotec | Weighted Average [Member] | Technology-Based Intangible Assets [Member]
Business Acquisition [Line Items]
Discount Rate, Fair Value Input					14.00%
Acotec | Weighted Average [Member] | Other Intangible Assets [Member]
Business Acquisition [Line Items]
Discount Rate, Fair Value Input					14.00%
Acotec | Weighted Average [Member] | Customer Relationships
Business Acquisition [Line Items]
Discount Rate, Fair Value Input					14.00%
Baylis Medical
Business Acquisition [Line Items]
Payments to Acquire Businesses, Net of Cash Acquired				$ 1,463
Business Combination, Consideration Transferred, Including Equity Interest in Acquiree Held Prior to Combination					$ 1,463
Goodwill					988
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles					657
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets					112
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities					(287)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Liabilities					(7)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Intangible Assets, Other than Goodwill					657
Baylis Medical | Technology-Based Intangible Assets [Member]
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles					$ 622
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life					11 years
Baylis Medical | Other Intangible Assets [Member]
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles					$ 36
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life					11 years
Baylis Medical | Weighted Average [Member] | Technology-Based Intangible Assets [Member]
Business Acquisition [Line Items]
Discount Rate, Fair Value Input					11.00%
Baylis Medical | Weighted Average [Member] | Other Intangible Assets [Member]
Business Acquisition [Line Items]
Discount Rate, Fair Value Input					11.00%

XML

Contingent Consideration (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability Beginning Balance			$ 149
Contingent consideration net expense (benefit)	$ 19	$ 36	31	$ 48
Payment of contingent consideration			(73)
Business Combination, Contingent Consideration, Liability Ending Balance	107		107
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Business Combination, Contingent Consideration, Liability	107		107
All Business Acquisitions
Business Combination, Contingent Consideration Arrangements [Abstract]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	364		364
Valuation Technique, Discounted Cash Flow [Member] | R&D, Regulatory and Commercialization-based Milestone [Member]
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability Ending Balance	13		13
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Business Combination, Contingent Consideration, Liability	13		13
Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability Ending Balance	94		94
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Business Combination, Contingent Consideration, Liability	$ 94		$ 94
contingent consideration liability, probability of payment	100.00%		100.00%
Minimum [Member] | Valuation Technique, Discounted Cash Flow [Member] | R&D, Regulatory and Commercialization-based Milestone [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
contingent consideration liability, probability of payment	10.00%		10.00%
Discount Rate, Fair Value Input	1.00%		1.00%
Minimum [Member] | Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Discount Rate, Fair Value Input	6.00%		6.00%
Maximum [Member] | Valuation Technique, Discounted Cash Flow [Member] | R&D, Regulatory and Commercialization-based Milestone [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
contingent consideration liability, probability of payment	25.00%		25.00%
Discount Rate, Fair Value Input	2.00%		2.00%
Maximum [Member] | Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
Discount Rate, Fair Value Input	14.00%		14.00%
Weighted Average [Member] | Valuation Technique, Discounted Cash Flow [Member] | R&D, Regulatory and Commercialization-based Milestone [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
contingent consideration liability, probability of payment	22.00%		22.00%
Discount Rate, Fair Value Input	1.00%		1.00%
Weighted Average [Member] | Valuation Technique, Discounted Cash Flow [Member] | revenue-based payments [Member]
Fair Value, Assets and Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Abstract]
contingent consideration liability, probability of payment	100.00%		100.00%
Discount Rate, Fair Value Input	6.00%		6.00%

XML

Strategic Investments (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Schedule of Investments [Line Items]
Equity method investments	$ 206	$ 188
Measurement alternative investments(1, 2)	215	219
Investments	422	$ 407
Equity Method Investment, Difference Between Carrying Amount and Underlying Equity	$ 230

XML

Goodwill and Other Intangible Assets (Details) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($) reportablesegments	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	$ 15,459		$ 15,459		$ 14,843
Finite-Lived Intangible Assets, Accumulated Amortization	(9,571)		(9,571)		(9,173)
Indefinite-lived Intangible Assets (Excluding Goodwill)	174		174		232
Goodwill [Roll Forward]
Goodwill Beginning Balance			12,920
Goodwill, Translation and Purchase Accounting Adjustments			25
Goodwill, Acquired During Period			714
Goodwill Ending Balance	13,659		$ 13,659
Number of reportable segments | reportablesegments			2
Intangible asset impairment charges	57	$ 7	$ 57	$ 7
MedSurg [Member]
Goodwill [Roll Forward]
Goodwill Beginning Balance			4,237
Goodwill, Translation and Purchase Accounting Adjustments			(3)
Goodwill, Acquired During Period			374
Goodwill Ending Balance	4,607		4,607
Cardiovascular [Member]
Goodwill [Roll Forward]
Goodwill Beginning Balance			8,684
Goodwill, Translation and Purchase Accounting Adjustments			28
Goodwill, Acquired During Period			340
Goodwill Ending Balance	9,052		9,052
Goodwill [Member]
Intangible Assets and Goodwill [Line Items]
Goodwill, Gross	23,559		23,559		22,820
Goodwill, Impaired, Accumulated Impairment Loss	(9,900)		(9,900)		(9,900)
In Process Research and Development [Member]
Intangible Assets and Goodwill [Line Items]
Indefinite-lived Intangible Assets (Excluding Goodwill)	54		54		112
Technology-Based Intangible Assets [Member]
Intangible Assets and Goodwill [Line Items]
Indefinite-lived Intangible Assets (Excluding Goodwill)	120		120		120
Technology-Based Intangible Assets [Member]
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	12,932		12,932		12,397
Finite-Lived Intangible Assets, Accumulated Amortization	(7,737)		(7,737)		(7,378)
Patents [Member]
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	478		478		486
Finite-Lived Intangible Assets, Accumulated Amortization	(385)		(385)		(394)
Other Intangible Assets [Member]
Intangible Assets and Goodwill [Line Items]
Finite-Lived Intangible Assets, Gross	2,050		2,050		1,960
Finite-Lived Intangible Assets, Accumulated Amortization	$ (1,448)		$ (1,448)		$ (1,400)

XML

Hedging Activities and Fair Value Measurements (Details) € in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023 USD ($) units derivative_instrument	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($) units derivative_instrument	Jun. 30, 2022 USD ($)	Jun. 30, 2023 EUR (€) units derivative_instrument	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($) derivative_instrument	Mar. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Derivative Instruments, Gain (Loss) [Line Items]
AOCI, Cash Flow Hedge, Cumulative Gain (Loss), after Tax	$ 241,000,000	$ 363,000,000	$ 241,000,000	$ 363,000,000		$ 225,000,000	$ 269,000,000	$ 229,000,000	$ 206,000,000
Derivative, Notional Amount	7,360,000,000		7,360,000,000				8,321,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	58,000,000	165,000,000	67,000,000	200,000,000
Cost of Goods and Services Sold	1,058,000,000	1,011,000,000	2,098,000,000	1,966,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	42,000,000	31,000,000	95,000,000	43,000,000
Interest Expense	70,000,000	64,000,000	135,000,000	343,000,000
Other Operating Income (Expense), Net	18,000,000	14,000,000	61,000,000	46,000,000
Derivative Asset, Fair Value, Gross Asset	388,000,000		388,000,000				381,000,000
Derivative Liability, Fair Value, Gross Liability	1,021,000,000		1,021,000,000				1,005,000,000
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative Asset	156,000,000		156,000,000				149,000,000
Licensing arrangements, asset	49,000,000		49,000,000				67,000,000
Business Combination, Contingent Consideration, Liability	107,000,000		107,000,000				149,000,000
Licensing arrangements, liability	60,000,000		60,000,000				80,000,000
Cash	409,000,000		409,000,000				256,000,000
Non-cash impact of transferred royalty rights	(16,000,000)	(36,000,000)	(16,000,000)	(36,000,000)
Debt Instrument, Fair Value Disclosure	8,441,000,000		8,441,000,000				8,203,000,000
Accumulated Foreign Currency Adjustment Attributable to Parent
Derivative Instruments, Gain (Loss) [Line Items]
Reclassification from AOCI, Current Period, Net of Tax, Attributable to Parent	0	0	0	0
December 2027 Notes [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Long-term Debt	$ 978,000,000		$ 978,000,000		€ 900		960,000,000
Debt Instrument, Interest Rate, Stated Percentage	0.625%		0.625%		0.625%
Licensing arrangement assets [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	15.00%		15.00%		15.00%
Proceeds from Royalties Received			$ (31,000,000)
Increase (Decrease) in Fair Value Adjustments on Other Assets (Liabilities) Carried at Fair Value under Fair Value Option			6,000,000
Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Payments for Royalties			(50,000,000)
Increase (Decrease) in Fair Value Adjustments on Other Assets (Liabilities) Carried at Fair Value under Fair Value Option			6,000,000
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Licensing arrangements, asset	$ 102,000,000		102,000,000
Licensing arrangements, liability	115,000,000		115,000,000
Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	17,000,000		17,000,000				673,000,000
Equity Securities, FV-NI	29,000,000		29,000,000				2,000,000
Derivative Asset	388,000,000		388,000,000				381,000,000
Licensing arrangements, asset	102,000,000		102,000,000				127,000,000
Assets, Fair Value Disclosure	535,000,000		535,000,000				1,182,000,000
Derivative Liability	1,021,000,000		1,021,000,000				1,005,000,000
Business Combination, Contingent Consideration, Liability	107,000,000		107,000,000				149,000,000
Licensing arrangements, liability	115,000,000		115,000,000				159,000,000
Financial and Nonfinancial Liabilities, Fair Value Disclosure	1,244,000,000		1,244,000,000				1,313,000,000
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	17,000,000		17,000,000				673,000,000
Equity Securities, FV-NI	29,000,000		29,000,000				2,000,000
Derivative Asset	0		0				0
Licensing arrangements, asset	0		0				0
Assets, Fair Value Disclosure	46,000,000		46,000,000				674,000,000
Derivative Liability	0		0				0
Business Combination, Contingent Consideration, Liability	0		0				0
Licensing arrangements, liability	0		0				0
Financial and Nonfinancial Liabilities, Fair Value Disclosure	0		0				0
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	0		0				0
Equity Securities, FV-NI	0		0				0
Derivative Asset	388,000,000		388,000,000				381,000,000
Licensing arrangements, asset	0		0				0
Assets, Fair Value Disclosure	388,000,000		388,000,000				381,000,000
Derivative Liability	1,021,000,000		1,021,000,000				1,005,000,000
Business Combination, Contingent Consideration, Liability	0		0				0
Licensing arrangements, liability	0		0				0
Financial and Nonfinancial Liabilities, Fair Value Disclosure	1,021,000,000		1,021,000,000				1,005,000,000
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money Market Funds, at Carrying Value	0		0				0
Equity Securities, FV-NI	0		0				0
Derivative Asset	0		0				0
Licensing arrangements, asset	102,000,000		102,000,000				127,000,000
Assets, Fair Value Disclosure	102,000,000		102,000,000				127,000,000
Derivative Liability	0		0				0
Business Combination, Contingent Consideration, Liability	107,000,000		107,000,000				149,000,000
Licensing arrangements, liability	115,000,000		115,000,000				159,000,000
Financial and Nonfinancial Liabilities, Fair Value Disclosure	222,000,000		222,000,000				308,000,000
Designated as Hedging Instrument [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	342,000,000		342,000,000				345,000,000
Derivative Instruments in Hedges, Liabilities, at Fair Value	974,000,000		974,000,000				953,000,000
Designated as Hedging Instrument [Member] | Other Noncurrent Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	$ 971,000,000		$ 971,000,000				952,000,000
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Forward Currency Contracts, Time to Maturity | units	36		36		36
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Prepaid Expenses and Other Current Assets [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	$ 188,000,000		$ 188,000,000				196,000,000
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Noncurrent Assets [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Assets, at Fair Value	155,000,000		155,000,000				149,000,000
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Current Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	1,000,000		1,000,000				0
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Noncurrent Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments in Hedges, Liabilities, at Fair Value	2,000,000		2,000,000				1,000,000
Not Designated as Hedging Instrument [Member] | Other Nonoperating Income (Expense) [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	11,000,000	(34,000,000)	2,000,000	(63,000,000)
Foreign Currency Transaction Gain (Loss), before Tax	(20,000,000)	35,000,000	(26,000,000)	56,000,000
Net currency exchange gain (loss)	(9,000,000)	1,000,000	(24,000,000)	(7,000,000)
Not Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	3,575,000,000		3,575,000,000				4,235,000,000
Not Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Prepaid Expenses and Other Current Assets [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments Not Designated as Hedging Instruments, Asset, at Fair Value	46,000,000		46,000,000				36,000,000
Not Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Other Current Liabilities [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments Not Designated as Hedging Instruments, Liability, at Fair Value	$ 48,000,000		$ 48,000,000				$ 52,000,000
Not Designated as Hedging Instrument [Member] | Foreign Exchange Forward
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Term of Contract (less than)			1 year
Derivative, Remaining Maturity	1 year		1 year		1 year
Weighted Average [Member] | Licensing arrangement assets [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	15.00%		15.00%		15.00%
Weighted Average [Member] | Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	13.00%		13.00%		13.00%
Minimum [Member] | Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	12.00%		12.00%		12.00%
Maximum [Member] | Licensing arrangement liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Discount Rate, Fair Value Input	15.00%		15.00%		15.00%
Cash Flow Hedging [Member] | Foreign Exchange Contract [Member] | Cost of Sales [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 209,000,000		$ 209,000,000
Cash Flow Hedging [Member] | Interest Rate Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	$ (2,000,000)		$ (2,000,000)
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Number of Interest Rate Derivatives Held | derivative_instrument	0		0		0		0
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	$ 2,454,000,000		$ 2,454,000,000				$ 2,725,000,000
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Cost of Sales [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	74,000,000	213,000,000	87,000,000	259,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	(17,000,000)	(48,000,000)	(20,000,000)	(58,000,000)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	58,000,000	165,000,000	67,000,000	200,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	(55,000,000)	(41,000,000)	(125,000,000)	(71,000,000)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	12,000,000	9,000,000	28,000,000	16,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	(43,000,000)	(32,000,000)	(97,000,000)	(55,000,000)
Cash Flow Hedging [Member] | Designated as Hedging Instrument [Member] | Interest Rate Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	0	0		0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	0	0		0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	0	0	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	1,000,000	1,000,000	1,000,000	15,000,000
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	0	0	0	(3,000,000)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	1,000,000	1,000,000	1,000,000	11,000,000
Net Investment Hedging [Member] | Foreign Exchange Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Used in Net Investment Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	9,000,000		9,000,000
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	333,000,000		333,000,000				365,000,000
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax	22,000,000	34,000,000	28,000,000	49,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax	(5,000,000)	5,000,000	(6,000,000)	2,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax	17,000,000	39,000,000	22,000,000	50,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, before Tax	(2,000,000)	(3,000,000)	(5,000,000)	(5,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, Tax	1,000,000	1,000,000	1,000,000	1,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), Adjustments, after Tax	(2,000,000)	(2,000,000)	(4,000,000)	(4,000,000)
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | foreign currency denominated in debt [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Notional Amount	997,000,000		997,000,000				$ 997,000,000
Net Investment Hedging [Member] | Designated as Hedging Instrument [Member] | foreign currency denominated in debt [Member] | Interest Expense [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Net Investment Hedge, Gain (Loss), before Reclassification and Tax	1,000,000	62,000,000	(18,000,000)	86,000,000
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, Tax	0	(14,000,000)	4,000,000	(19,000,000)
Other Comprehensive Income (Loss), Derivative, Excluded Component, Increase (Decrease), before Adjustments, after Tax	1,000,000	48,000,000	(14,000,000)	66,000,000
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

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Contractual Obligations and Commitments (Details) € in Millions		3 Months Ended		6 Months Ended		12 Months Ended
	May 10, 2021 USD ($)	Mar. 31, 2023 USD ($)	Mar. 31, 2022 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)	Jun. 30, 2023 EUR (€)	Jun. 30, 2023	Jun. 30, 2023 Rate
Debt Instrument [Line Items]
Total debt				$ 9,053,000,000.000		$ 8,935,000,000
Debt, Current				559,000,000		20,000,000
Long-term Debt and Capital Lease Obligations				8,494,000,000		8,915,000,000
Exclusion from EBITDA for Restructuring Charges				500,000,000
Restructuring charges remaining to be excluded from calculation of consolidated EBITDA				416,000,000
Litigation and Debt Exclusion from EBITDA				1,443,000,000
Legal payments remaining to be excluded from calculation of consolidated EBITDA				1,413,000,000
Letters of Credit Outstanding, Amount				148,000,000		135,000,000
Qualified Acquisition Consideration				1,000,000,000
Gain (Loss) on Extinguishment of Debt			$ 194,000,000	0	$ 194,000,000
Proceeds from Issuance of Senior Long-Term Debt				0	$ 3,270,000,000
Supplier Finance Program Obligation. current				124,000,000		129,000,000
Litigation payment exclusion from EBITDA				1,000,000,000
Proceeds from Issuance of Senior Long-Term Debt		$ 3,270,000,000
Licensing arrangement assets [Member]
Debt Instrument [Line Items]
Proceeds from Royalties Received				31,000,000
Licensing arrangement liabilities [Member]
Debt Instrument [Line Items]
Payments for Royalties				50,000,000
Commercial Paper [Member]
Debt Instrument [Line Items]
Commercial Paper				41,000,000		0
Maximum Commercial Paper Outstanding				2,750,000,000		2,750,000,000
Line of Credit Facility, Remaining Borrowing Capacity				2,709,000,000		$ 2,750,000,000
Short-term Debt, Weighted Average Interest Rate, at Point in Time						0.00%		5.30%
Current Requirement [Member]
Debt Instrument [Line Items]
Maximum Leverage Ratio								3.75
Actual, Covenant [Member]
Debt Instrument [Line Items]
Maximum Leverage Ratio								2.48
Requirement, as of December 31, 2021 and through remaining term of facility
Debt Instrument [Line Items]
Maximum Leverage Ratio								3.75
Requirement, four succeeding quarters following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio								4.75
Requirement, fifth quarter following qualified acquisition [Member]
Debt Instrument [Line Items]
Maximum Leverage Ratio								4.50
Requirement, sixth quarter following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio								4.25
Requirement, seventh quarter following qualified acquisition
Debt Instrument [Line Items]
Maximum Leverage Ratio								4.00
Requirement, eighth quarter following qualified acquisition and through remaining term of facility
Debt Instrument [Line Items]
Maximum Leverage Ratio								3.75
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term Debt				0		$ 0
Line of Credit Facility, Maximum Borrowing Capacity	$ 2,750,000,000
Debt Instrument, Extension Option, Term	1 year
March 2024 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				0		504,000,000
Debt Instrument, Interest Rate, Stated Percentage								3.45%
March 2025 Notes
Debt Instrument [Line Items]
Long-term Debt				1,087,000,000		1,067,000,000	€ 1,000
Debt Instrument, Interest Rate, Stated Percentage								0.75%	0.75%
June 2025 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				500,000,000		500,000,000
Debt Instrument, Interest Rate, Stated Percentage								1.90%
March 2026 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				255,000,000		255,000,000
Debt Instrument, Interest Rate, Stated Percentage								3.75%
December 2027 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				978,000,000		960,000,000	900
Debt Instrument, Interest Rate, Stated Percentage								0.625%
March 2028 Senior Notes
Debt Instrument [Line Items]
Long-term Debt				815,000,000		800,000,000	750
Debt Instrument, Interest Rate, Stated Percentage								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								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								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								2.65%
March 2031 Notes
Debt Instrument [Line Items]
Long-term Debt				815,000,000		800,000,000	750
Debt Instrument, Interest Rate, Stated Percentage								1.625%	1.625%
March 2034 Notes
Debt Instrument [Line Items]
Long-term Debt				543,000,000		534,000,000	500
Debt Instrument, Interest Rate, Stated Percentage								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								6.50%
March 2039 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				450,000,000		450,000,000
Debt Instrument, Interest Rate, Stated Percentage								4.55%
January 2040 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				300,000,000		300,000,000
Debt Instrument, Interest Rate, Stated Percentage								7.375%
March 2049 Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				650,000,000		650,000,000
Debt Instrument, Interest Rate, Stated Percentage								4.70%
Senior Notes [Member]
Debt Instrument [Line Items]
Long-term Debt				9,063,000,000.000		8,986,000,000
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net				(70,000,000)		(76,000,000)
Finance Lease Obligation
Debt Instrument [Line Items]
Long-term Debt				5,000,000		5,000,000
the Offering
Debt Instrument [Line Items]
Long-term Debt | €							€ 3,000
the Offering - early redemption of combined aggregate principal SN
Debt Instrument [Line Items]
Long-term Debt			$ 3,275,000,000
Euro Denominated Factoring Arrangements [Member]
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized				$ 217,000,000		$ 161,000,000
Average interest rate of de-recognized receivables				5.40%		2.40%
Yen Denominated Factoring Arrangements [Member]
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized				$ 179,000,000		$ 194,000,000
Average interest rate of de-recognized receivables				0.70%		0.60%
Renminbi Denominated Factoring Arrangements [Member]
Debt Instrument [Line Items]
Transfer of Financial Assets Accounted for as Sales, Amount Derecognized				$ 17,000,000		$ 13,000,000
Average interest rate of de-recognized receivables				2.90%		3.10%

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Supplemental Balance Sheet Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022	Dec. 31, 2021
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Line Items]
Cash and Cash Equivalents	$ 426	$ 276	$ 426	$ 276	$ 928
Restricted Cash and Cash Equivalents in Other current assets	135	132	135	132	149
Restricted Cash Equivalents in Other long-term assets	60	50	60	50	48
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	620	458	620	458	1,126	$ 2,168
Depreciation	88	80	170	156
Trade accounts receivable, net
Accounts receivable	2,261		2,261		2,079
Less: allowance for doubtful accounts	(127)		(127)		(109)
Trade accounts receivable, net	2,134		2,134		1,970
Allowance for doubtful accounts
Beginning balance	118	113	109	108
Charges to expenses	19	9	35	20
Utilization of allowances	(10)	(5)	(16)	(11)
Ending balance	127	117	127	117
Inventories
Inventory, Finished Goods, Net of Reserves	1,372		1,372		1,171
Inventory, Work in Process, Net of Reserves	175		175		147
Inventory, Raw Materials, Net of Reserves	703		703		548
Inventories	2,250		2,250		1,867
Other Current Assets [Abstract]
Restricted Cash and Cash Equivalents in Other current assets	135	132	135	132	149
Derivative Asset, Current	234		234		232
Licensing arrangements	53		53		60
Other Assets, Miscellaneous, Current	353		353		290
Other Assets, Current	773		773		731
Property, plant and equipment, net
Land	141		141		137
Buildings and improvements	1,790		1,790		1,695
Equipment, furniture and fixtures	3,427		3,427		3,297
Capital in progress	604		604		598
Property, plant and equipment	5,962		5,962		5,728
Less: accumulated depreciation	3,428		3,428		3,282
Property, plant and equipment, net	2,534		2,534		2,446
Other Assets, Noncurrent [Abstract]
Restricted cash equivalents included in Other long-term assets	60	$ 50	60	$ 50	48
Operating Lease, Right-of-Use Asset	445		445		386
Derivative Asset	156		156		149
Investments	422		422		407
Licensing arrangements, asset	49		49		67
Indemnification asset	168		168		172
Other, Other Long-term Assets	295		295		271
Other Assets, Noncurrent	1,595		1,595		1,500
Accrued expenses
Legal reserves, current	209		209		231
Payroll and related liabilities	843		843		830
Accrued Rebates, Current	363		363		352
Business Combination, Contingent Consideration, Liability, Current	97		97		74
Other	653		653		674
Accrued Liabilities, Current	2,164		2,164		2,160
Other Liabilities, Current [Abstract]
Deferred Revenue, Current	242		242		220
Licensing Arrangements	55		55		79
Taxes Payable, Current	400		400		232
Other	242		242		230
Other Liabilities, Current	940		940		761
Other long-term liabilities
Accrued income taxes	489		489		597
Estimated Litigation Liability, Noncurrent	210		210		212
Business Combination, Contingent Consideration, Liability, Noncurrent	10		10		75
Licensing arrangements, liability	60		60		80
Operating Lease, Liability, Noncurrent	401		401		347
Deferred Revenue	295		295		289
Other Accrued Liabilities, Noncurrent	460		460		434
Other long-term liabilities	$ 1,926		$ 1,926		$ 2,035

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Income Taxes (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Effective Income Tax Rate Reconciliation, Percent [Abstract]
Effective tax rate from continuing operations	36.60%	24.70%	32.90%	26.10%
Unrecognized Tax Benefits	$ 471		$ 471		$ 492
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	406		406		$ 410
Decrease in Unrecognized Tax Benefits is Reasonably Possible	$ 61		$ 61

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Commitments and Contingencies (Details) $ in Millions		3 Months Ended		6 Months Ended
	Jan. 31, 2023 USD ($)	Jun. 30, 2023 USD ($) units	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($) units	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Loss Contingencies [Line Items]
Accrual for legal matters that are probable and estimable		$ 419		$ 419		$ 443
Restricted Cash and Cash Equivalents in Other current assets		$ 135	$ 132	$ 135	$ 132	$ 149
Brazil CADE - # of individuals for alleged anti-competitive behavior | units		29		29
Litigation Settlement, Amount Awarded to Other Party	$ 42
Litigation Settlement, Amount Awarded from Other Party				$ 158
Litigation-related net charges (credits)		$ 0	$ 42	$ 0	$ 42

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Stockholders' Equity (Details) $ / shares in Units, $ in Millions		3 Months Ended
	May 27, 2020 USD ($) $ / shares shares	Jun. 30, 2023 $ / shares shares	Dec. 31, 2022 shares
Class of Stock [Line Items]
Preferred Stock, Shares Authorized		50,000,000	50,000,000
Preferred Stock, Shares Issued		0	10,062,500
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, Dividends, Per Share, Cash Paid | $ / shares		$ 1.375
Preferred Stock, Convertible, Conversion Ratio		2.3834
Common Stock [Member]
Class of Stock [Line Items]
Conversion of Stock, Shares Converted		24,000,000

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Weighted Average Shares Outstanding (Details) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 14, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Weighted Average Number of Shares Outstanding, Basic	1,446,200	1,429,700	1,441,000	1,428,800
Weighted Average Number Diluted Shares Outstanding Adjustment	10,100	8,100	10,100	9,300
Weighted Average Number of Shares Outstanding, Diluted	1,456,200	1,437,800	1,451,100	1,438,100
Shares Issued, Shares, Share-based Payment Arrangement, after Forfeiture	25,000	1,000,000,000	29,000	4,000,000,000
Stock Repurchase Program, Authorized Amount					$ 1,000,000
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	7,000	0	6,000
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	16,000	24,000	20,000	24,000

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Segment Reporting (Details) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($) reportablesegments	Jun. 30, 2022 USD ($)
Segment Reporting [Abstract]
Number of reportable segments | reportablesegments			2
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Amortization expense	$ (210)	$ (204)	$ (412)	$ (402)
Operating income (loss)	514	423	1,066	889
Other expense, net	(88)	(78)	(195)	(388)
Income (loss) before income taxes	426	345	870	501
Impact of Foreign Currency Fluctuations on Net Sales	91	101	179	254
Net sales	3,599	3,244	6,988	6,270
MedSurg [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating Income Allocated to Reportable Segments	448	359	847	689
Revenues from contracts with customers, disaggregated - performance measurement	$ 1,331	$ 1,217	$ 2,582	$ 2,322
Segment operating income as percentage of net sales	33.60%	29.50%	32.80%	29.70%
Net sales	$ 1,360	$ 1,248	$ 2,640	$ 2,402
Cardiovascular [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating Income Allocated to Reportable Segments	566	454	1,106	843
Revenues from contracts with customers, disaggregated - performance measurement	$ 2,179	$ 1,926	$ 4,228	$ 3,695
Segment operating income as percentage of net sales	26.00%	23.60%	26.20%	22.80%
Net sales	$ 2,239	$ 1,996	$ 4,349	$ 3,868
BSX Reportable Segments [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Revenues from contracts with customers, disaggregated - performance measurement	3,509	3,143	6,810	6,016
Total allocated to reportable segments [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating income (loss)	1,013	812	1,954	1,531
Corporate expenses and currency exchange [Member]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Abstract]
Operating Income Unallocated to Segment	(49)	6	(124)	68
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	$ (241)	$ (192)	$ (351)	$ (308)

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Revenue (Details) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023 USD ($) business	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($) business	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	$ 3,599	$ 3,244	$ 6,988	$ 6,270
Number Of Businesses | business	5		5
Contract with Customer, Liability [Abstract]
Contract with Customer, Liability	$ 537		$ 537		$ 509
Change in Contract with Customer, Liability [Abstract]
Contract with Customer, Liability, Revenue Recognized	35
United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	2,110	1,933	4,113	3,711
International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,490	1,311	2,876	2,559
Emerging Markets [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	592	498	1,121	938
Endoscopy [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	631	560	1,207	1,091
Endoscopy [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	384	338	735	650
Endoscopy [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	246	221	472	441
Urology [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	485	450	954	863
Urology [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	340	320	666	606
Urology [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	146	130	289	257
Neuromodulation [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	244	239	478	448
Neuromodulation [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	183	186	356	346
Neuromodulation [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	61	53	123	101
Interventional Cardiology Therapies
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	629	574	1,220	1,118
Interventional Cardiology Therapies | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	189	192	372	378
Interventional Cardiology Therapies | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	440	382	848	740
Watchman
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	317	250	607	476
Watchman | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	286	225	552	428
Watchman | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	30	25	55	48
Cardiac Rhythm Management [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	566	541	1,114	1,061
Cardiac Rhythm Management [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	356	342	702	667
Cardiac Rhythm Management [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	209	199	412	394
Electrophysiology [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	193	152	370	270
Electrophysiology [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	85	73	170	123
Electrophysiology [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	108	79	199	147
Cardiology [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,704	1,517	3,310	2,925
Cardiology [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	917	832	1,796	1,596
Cardiology [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	787	685	1,514	1,329
Peripheral Interventions [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	535	478	1,039	944
Peripheral Interventions [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	285	257	560	513
Peripheral Interventions [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	250	221	478	430
BSX Reportable Segments [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	2,110	1,933	4,113	3,711
BSX Reportable Segments [Member] | EMEA [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	723	660	1,435	1,284
BSX Reportable Segments [Member] | APAC [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	626	530	1,174	1,047
BSX Reportable Segments [Member] | Latin America and Canada [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	140	120	267	228
MedSurg [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,360	1,248	2,640	2,402
MedSurg [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	907	844	1,757	1,602
MedSurg [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	453	404	883	799
Cardiovascular [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	2,239	1,996	4,349	3,868
Cardiovascular [Member] | United States
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	1,202	1,089	2,356	2,109
Cardiovascular [Member] | International [Member]
Disaggregation of Revenue [Line Items]
Revenue from Contract with Customer, Excluding Assessed Tax	$ 1,037	$ 906	$ 1,993	$ 1,760

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Changes in Other Comprehensive Income (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other Comprehensive Income (Loss), before Reclassifications, Net of Tax	$ 74	$ 245	$ 39	$ 217
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax	(44)	(34)	(100)	(47)
Other comprehensive income (loss)	30	211	(61)	170
Accumulated Other Comprehensive Income (Loss), Net of Tax	208	433	208	433	$ 178	$ 269	$ 222	$ 263
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Gain (Loss) Arising During Period, Net of Tax	17	79	(24)	17
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Reclassification Adjustment from AOCI, Realized upon Sale or Liquidation, Net of Tax	(2)	(2)	(4)	(4)
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Adjustment, Net of Tax	15	77	(28)	13
Accumulated Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Net of Tax	(28)	106	(28)	106	(43)	(1)	29	93
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	58	165	67	200
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	(42)	(31)	(95)	(43)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification and Tax	15	134	(28)	157
AOCI, Cash Flow Hedge, Cumulative Gain (Loss), after Tax	241	363	241	363	225	269	229	206
Other Comprehensive (Income) Loss, Defined Benefit Plan, before Reclassification Adjustment, after Tax	0	0	(5)	0
Other Comprehensive (Income) Loss, Defined Benefit Plan, Reclassification Adjustment from AOCI, after Tax	0	0	(1)	0
Other Comprehensive (Income) Loss, Defined Benefit Plan, after Reclassification Adjustment, after Tax	0	0	(5)	0
Accumulated Other Comprehensive (Income) Loss, Defined Benefit Plan, after Tax	$ (4)	$ (36)	$ (4)	$ (36)	$ (4)	$ 1	$ (36)	$ (36)