Intuitive Surgical (ISRG) — Company Research

Last Updated: 25 June 2026

Intuitive Surgical is the company that created and still dominates robotic-assisted surgery. Its da Vinci systems and Ion endoluminal platform sit in more than 11,000 hospitals worldwide, and the razor-and-blade model behind them — placing systems, then earning recurring per-procedure revenue — has produced two decades of compounding growth. FY2025 was a record year, with revenue crossing $10bn and procedures up roughly 19%. Yet the shares have fallen by around a quarter in 2026 to near a 52-week low, as investors weigh Chinese competition, tariffs, weight-loss-drug effects on some procedures, and a still-rich valuation. This report lays out what the business does, the primary-source numbers, the risks, and what is scheduled next. For live pricing see our Live Charts and the macro backdrop on our Economic Calendar.

1. Company Snapshot

Field	Value
Company	Intuitive Surgical, Inc.
Ticker	NASDAQ: ISRG
Sector / Industry	Healthcare — Medical Devices (Robotic Surgery)
CEO	Dave Rosa (since July 2025); Gary Guthart is Executive Chair
Headquarters	Sunnyvale, California, USA
Employees	17,021 (31 December 2025)
Market cap	~$142.8bn (June 2026)
FY2025 revenue	$10.06bn
FY2025 net income (GAAP)	$2.86bn
FY2025 GAAP diluted EPS	$7.87
FY2025 non-GAAP diluted EPS	$8.93
Dividend	None

2. Bull & Bear Case

Bull Case

• Entrenched market leadership: Intuitive controls more than two-thirds of the soft-tissue robotic-surgery market, with an installed base of 11,106 da Vinci systems at year-end 2025 — each a long-lived source of recurring revenue.
• Recurring razor-and-blade model: Around 60% of revenue is recurring instruments and accessories that scale directly with procedure volume, which grew approximately 19% in 2025 and is guided to grow 13.5–15.5% in 2026.
• Record financials, fortress balance sheet: FY2025 revenue topped $10bn (+20.5%), non-GAAP EPS reached $8.93, and the company holds $9.0bn of cash and investments with zero debt.
• da Vinci 5 upgrade cycle: The next-generation da Vinci 5 is ramping fast (303 of 532 Q4 placements), driving higher system average selling prices and a multi-year replacement runway.
• Secular tailwind: The shift from open and laparoscopic surgery to robotic-assisted procedures is still early in most of the world, giving a long growth runway across new indications and geographies.

Bear Case

• China competition: Domestic Chinese robotic-surgery firms are gaining share quickly amid government-driven pricing pressure, and Intuitive's China procedure growth ran below the corporate average.
• Tariff margin drag: US and Chinese tariffs, plus higher memory and freight costs, are estimated to cut roughly 1.2% from 2026 gross margin.
• Premium valuation: At roughly 51x trailing GAAP earnings, the stock prices in years of high growth and is vulnerable to any deceleration.
• GLP-1 headwind: US bariatric procedures fell about 10% as GLP-1 weight-loss drugs reduce demand for some surgeries.
• New entrants and AI fears: Medtronic's Hugo, Johnson & Johnson's Ottava and others are scaling, and broader robotics/AI ambitions from large technology players have stoked long-term competitive concerns.

3. Business Segments

Intuitive reports revenue across three streams, all anchored to its installed base of da Vinci and Ion systems. The recurring instruments-and-accessories line is the largest and most prized by investors.

Segment	% of FY2025 revenue	What it is
Instruments & accessories	59.8% ($6.02bn)	Recurring, per-procedure consumables used with every da Vinci and Ion case — the core razor-blade revenue.
Systems	24.6% ($2.47bn)	Sales and operating leases of da Vinci surgical systems and Ion endoluminal systems.
Services	15.6% ($1.57bn)	Service contracts, training, software and customer support across the installed base.

4. Business Model

How Intuitive makes money: The company places da Vinci systems with hospitals — increasingly via leases — then earns high-margin recurring revenue every time a procedure is performed, because each operation consumes proprietary instruments and accessories. Services on the installed base add a third, predictable revenue layer.

Unit economics: Recurring instruments, accessories and services made up roughly three-quarters of FY2025 revenue, and non-GAAP gross margin ran at about 67.6%. As the installed base and procedure volumes compound, the recurring mix improves the quality and predictability of earnings.

The moat: Intuitive's advantage comes from surgeon training and switching costs, two decades of clinical evidence, a vast global installed base, deep regulatory clearances, and an integrated ecosystem of instruments, imaging and digital tools — a combination newer robotic platforms have so far struggled to dislodge.

5. Financial Health

All figures below come from Intuitive's audited annual results and quarterly earnings releases; FY2025 ended 31 December 2025. EPS figures are split-adjusted for the three-for-one split distributed on 4 October 2021. Intuitive carries no debt, so the long-term debt column is nil throughout.

Fiscal Year	Revenue	YoY %	GAAP EPS	Adjusted EPS	Dividend/share	Long-term debt (YE)
2021	$5.71bn	+31.0%	$4.66	$4.94	$0.00	$0m
2022	$6.22bn	+9.0%	$3.65	$4.68	$0.00	$0m
2023	$7.12bn	+14.5%	$5.03	$5.71	$0.00	$0m
2024	$8.35bn	+17.2%	$6.42	$7.34	$0.00	$0m
2025	$10.06bn	+20.5%	$7.87	$8.93	$0.00	$0m

Note: GAAP EPS is net income attributable to Intuitive Surgical, Inc. on a diluted basis. Adjusted (non-GAAP) EPS excludes share-based compensation, intangible amortisation and certain tax and one-off items. Intuitive pays no dividend and carries no debt.

Quarter	Revenue	Adjusted EPS	GAAP EPS
Q1 FY2026	$2.77bn	$2.50	$2.28
Q4 FY2025	$2.87bn	$2.53	$2.21
Q3 FY2025	$2.51bn	$2.40	$1.95
Q2 FY2025	$2.44bn	$2.19	$1.81
Q1 FY2025	$2.25bn	$1.81	$1.92
FY2025 total	$10.06bn	$8.93	$7.87

The balance sheet is exceptionally strong: $9.03bn of cash, cash equivalents and investments, no debt, and $3.03bn of operating cash flow in FY2025.

6. Valuation

Raw metrics, June 2026. Not opinions on whether the stock is cheap or expensive.

Metric	Value
Market cap	~$142.8bn (≈356m shares × $401.09)
Enterprise value	~$133.8bn (market cap $142.8bn + debt $0 − cash & investments $9.03bn per FY2025 balance sheet)
Trailing P/E (GAAP)	~51.0x ($401.09 / FY2025 GAAP EPS $7.87)
P/E (forward)	n/a — Intuitive does not issue EPS guidance
P/S (TTM)	~13.5x (market cap / TTM revenue ~$10.58bn)
EV/EBITDA (TTM)	~37.6x (EV $133.8bn / EBITDA ~$3.56bn; EBITDA = FY2025 operating income $2,945m + D&A ~$613m)
P/FCF	~57.3x (market cap $142.8bn / FCF $2.49bn; FCF = FY2025 operating cash flow $3,030m − capex $540m)
52-week high	$603.88
52-week low	$396.68
Short interest (% of float)	~1.9% (≈6.75m shares)
Days to cover	~3 days

7. What Are They Building

Intuitive's roadmap is centred on the da Vinci 5 upgrade cycle, which brings force-feedback sensing, far greater computing power and a foundation for data and AI-assisted surgery. The company is expanding the Ion endoluminal platform for minimally invasive lung biopsy, growing its installed base 24% in 2025, and pushing into new clinical indications and geographies. Longer term, management is investing in digital tools, surgeon analytics and machine-learning capabilities that turn its vast procedure dataset into a defensible software layer, while broadening the instrument menu that drives recurring revenue. Capital spending stepped down sharply in 2025 as major manufacturing build-outs completed, improving free-cash-flow conversion.

8. Competitive Landscape

Intuitive remains the dominant force in soft-tissue robotic surgery, but large medical-device peers are investing heavily to challenge it.

Peer	Market cap (June 2026)	Key 2025 metric / position
Johnson & Johnson (JNJ)	~$550bn	MedTech giant; developing the Ottava soft-tissue robotic system to compete directly with da Vinci.
Stryker (SYK)	~$118bn	Leader in orthopedic robotics via the Mako platform; adjacent rather than direct soft-tissue rival.
Medtronic (MDT)	~$104bn	Scaling the Hugo RAS soft-tissue robot globally — Intuitive's most direct large-cap challenger.

Smaller challengers (CMR Surgical's Versius, plus fast-growing domestic Chinese systems) add pressure at the margins, particularly in international markets.

9. Leadership & Ownership

Intuitive is led by CEO Dave Rosa, who succeeded long-serving chief executive Gary Guthart in July 2025; Guthart now serves as Executive Chair. Recent insider activity has been a mix of routine compensation vesting and some option-exercise sales by the chairman.

Name	Date	Type	Shares	Price	Value	Plan Type
Gary Guthart (Exec Chair)	27 Jan 2026	Option exercise & sale	27,300	~$530.10–531.53	~$14.48m	10b5-1 / option exercise
Gary Guthart (Exec Chair)	28 Feb 2026	PSU/RSU vesting & tax	28,840 vested	$503.51	n/a	Performance/RSU
David Rosa (CEO)	10 Jun 2026	RSU vesting & tax withholding	1,358 vested	$426.61	~$0.29m	RSU

The chairman's January sale was an option-exercise-and-sell; no material insider open-market buying has been reported in 2026.

10. Key Risks

• China competition (Operational): Domestic Chinese robotic-surgery firms are taking share amid government pricing pressure, dragging Intuitive's China growth below the corporate average.
• Tariffs (Macro): US and Chinese tariffs, plus higher memory and freight costs, are estimated to cut about 1.2% from 2026 gross margin, with risk of escalation.
• Valuation (Financial): A trailing P/E above 50x leaves little room for a procedure-growth or margin disappointment.
• GLP-1 substitution (Operational): Weight-loss drugs have cut US bariatric procedure demand by roughly 10%, removing one growth pocket.
• Competitive entrants (Operational): Medtronic's Hugo, J&J's Ottava and longer-term AI/robotics ambitions from large technology players threaten Intuitive's share over time.
• Hospital capital cycles (Macro): System placements depend on hospital capital budgets, which can be deferred in tighter economic conditions.
• Regulatory (Regulatory): Product approvals, clearances and any device recalls or safety issues can affect launches and reputation.

11. Recent Developments

• 21 Apr 2026 — Q1 2026 results. Revenue rose 23% to $2.77bn, total procedures grew about 17%, and Intuitive placed 431 da Vinci systems; management lifted its full-year da Vinci procedure-growth guidance.
• Jun 2026 — Shares near a 52-week low. The stock has fallen roughly 26% in 2026 to near $397, pressured by China competition, tariffs and GLP-1 concerns despite raised operating guidance.
• 22 Jan 2026 — Q4/FY2025 results. Q4 revenue of $2.87bn (+19%) and full-year revenue of $10.06bn (+20.5%), with FY procedures up about 19%.
• 1 Jul 2025 — CEO transition. Dave Rosa became Chief Executive Officer, succeeding Gary Guthart, who moved to Executive Chair.

12. Key Dates to Watch

• 16 Jul 2026 — Q2 2026 earnings release (expected, after close)
• Expected Oct 2026 — Q3 2026 earnings release
• Expected Jan 2027 — Q4 and full-year FY2026 results

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