This year’s top medical device companies report re-establishes a dynasty—Medtronic once again topped the list of the medtech elite with sales nearing $34 billion, a record high for the number one spot. However, Big Blue may find itself further down the list in upcoming years because it plans to spin off its Diabetes business into MiniMed, the original name of the business when Medtronic acquired it.

Spinoffs and divestments once again took center stage as several Top 30 inhabitants sought to streamline their portfolios. Baxter sold its Vantive kidney care business to Carlyle Group for a cool $3.8 billion, and Stryker began the deal to sell its U.S. Spine Implants franchise to Viscogliosi Brothers to create VB Spine. Edwards transferred its Critical Care business to BD to the tune of $4.2 billion. BD itself entered what may be the largest deal of this year—merging its Biosciences and Diagnostic Solutions business with Waters Corp. for a blockbuster $17.5 billion.

That’s not to say the Top 30 shied away from inorganic growth, however. In typical fashion, Stryker executed a string of acquisition deals: SERF SAS, mfPHD, Artelon, MOLLI Surgical, care.ai, Vertos, NICO, and Inari. Johnson & Johnson MedTech closed a $13.5 billion deal for Shockwave Medical and its intravascular lithotripsy, and bought V-Wave and its interatrial shunt. Boston Scientific grabbed Intera Oncology, Cortex, Silk Road Medical, and Axonics. Alcon stacked its lineup with Belkin Vision, LENSAR, Aurion Biotech, and LumiThera. Edwards padded its portfolio with JenaValve, Endotronix, Innovalve, Genesis MedTech, and Kephalios.

Debuting in the Top 30 this year—perhaps years too late—were Mindray and Nipro. The former is the first Chinese company to join the medtech elite and the latter was welcomed due to near-double-digit percentage growth. Stryker, Cardinal Health, Boston Scientific, Intuitive, Terumo, Resmed, and Dexcom also enjoyed double-digit percentage increases to cement their places on the list. Old friend Hologic rejoined the Top 30 this year, with revenues topping $4 billion.

Sales overall for the Top 30 were positive—only two companies on the list had flat revenues or posted losses. If anything, this year’s report confirms the medical technology industry is as healthy as ever.

We hope you enjoy reading this year’s Top 30 reports.

Editors’ note: As you read our report, please take note that while the companies are ranked according to sales reported for their most recent fiscal year, some may include non-device sales within a division, such as combination products, drug delivery, software, or device-related services. Not all companies explicitly break out the device portion of total revenues. We consulted numerous public documents and contacted company officials as needed to arrive at the best estimates. Also note that foreign currency conversions were done based on the exchange rate at the end of the fiscal reporting period being discussed.