SITCSection 8
U.S. imports of medical, surgical, and veterinary instruments and appliances, n.e.s. (SITC 87229) totaled $1.7B in April 2026, traded with 79 countries.
Importers of Medical, Surgical, and Veterinary Instruments and Appliances, N.E.S. paid $93.6M in duties in April 2026 — an effective duty rate of 10% on $904.5M in dutiable value, based on actual customs collections rather than the published tariff schedule.
Last updated: April 2026 dataElectrosurgical units, endoscopes, patient monitoring accessories, and a wide array of specialized surgical tools that do not fit a more specific medical instrument heading are captured in this broad residual category, making it one of the most commercially significant N.E.S. headings in the medical device trade. FDA regulates virtually all articles here as medical devices, with risk-based classification spanning Class I through Class III; importers must confirm premarket authorization status for each product line. The heading's residual nature means classification disputes are common — particularly for combination instruments or novel technologies — and CBP binding rulings are a practical risk-management tool for high-value or high-volume product lines.
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For tariff classification, the importer should request a CBP binding ruling, submitting technical specifications, intended use documentation, and a classification analysis. Simultaneously, FDA classification should be confirmed through the De Novo pathway or a 510(k) submission if the device lacks a predicate. Both processes can run in parallel, but commercial importation cannot begin until FDA marketing authorization is in place.
For tariff classification purposes, veterinary and human medical instruments are treated identically under this heading — both are covered by the same description. However, regulatory pathways diverge: instruments intended solely for veterinary use are regulated by FDA's Center for Veterinary Medicine (CVM) rather than CDRH, and the applicable device standards and registration requirements differ accordingly.
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| Country | Imports | Exports | Balance |
|---|---|---|---|
| MEXICO | $606.5M | $228.7M | -$377.8M |
| NETHERLANDS | $3.7M | $297.4M | +$293.7M |
| GERMANY | $214.7M | $49.6M | -$165.2M |
| COSTA RICA | $178.8M | $38.3M | -$140.6M |
| CHINA | $72.5M | $144.1M | +$71.5M |
Monthly import values over time