Start here if you're new
what it is
It sells surgical robots and tools that help doctors do less invasive operations.
how it gets paid
Last year Intuitive Surgical made $10.1B in revenue. Instruments & accessories was the main engine at $6.1B, or 60% of sales.
why it's growing
Revenue grew 20.5% last year. In our view, recent investments in r&d and the da vinci 5 system, coupled with further overseas expansion, particularly in asia and europe, should remain.
what just happened
The quarter beat because $2.53 EPS topped $2.25 expected, while revenue hit $7.2B.
At a glance
A+ balance sheet — rock-solid finances — built to survive anything
70/100 earnings predictability — reasonably predictable
59.2x trailing p/e — you're paying up for this one
17.5% return on capital — nothing to write home about
xvary composite: 78/100 — average
What they do
It sells surgical robots and tools that help doctors do less invasive operations.
Hospitals have 9,000+ da Vinci systems in place. They also have 15M+ procedures behind them. Switching costs → the pain of replacing hardware, retraining teams, and rewriting workflow → your hospital usually stays put.
How they make money
$10.1B
annual revenue · their business grew +20.5% last year
Instruments & accessories
$6.1B
+18.0%
Systems
$2.0B
+22.0%
Services
$1.7B
+13.0%
Ion and other
$0.3B
+25.0%
The products that matter
robot-assisted surgery platform
da vinci surgical system
11,106 systems installed
the core platform ended 2025 with 11,106 systems in the field out of 12,101 total. that's the installed base driving instruments, accessories, and service demand.
category anchor
robotic lung biopsy platform
ion
995 systems installed
ion finished 2025 at 995 systems. it's smaller today, but it gives intuitive another procedure lane beyond the da vinci franchise.
next leg
Key numbers
59.2x
trailing p/e
You are paying 59.2 years of trailing earnings for one year of profit. That is the premium for a machine hospitals trust.
35.0%
operating margin
For every $100 of sales, $35 stays after operating costs. That is why this business gets a premium multiple.
17.5%
return on capital
Each $100 tied up in the business earned $17.50 back. That says the machine is still working hard.
$660
target price
That is about 25% above $528.81. Analysts still see room for the stock to move higher.
Financial health
A+
strength
- balance sheet grade A+ — near the highest rating possible
- risk rank 3 — safer than 50% of stocks
- price stability 55 / 100
- net profit margin 30.1% — keeps 30 cents of every dollar in revenue
- return on equity 18% — $0.18 profit for every $1 investors have put in
A+ — among the top-rated companies for balance sheet quality.
Total return vs. market
You invested $10,000 in ISRG 3 years ago → it's now worth $21,110.
The index would have given you $14,770.
source: institutional data · total return
What just happened
beat estimates
The quarter beat because $2.53 EPS topped $2.25 expected, while revenue hit $7.2B.
Worldwide procedure growth ran 18%. Management then guided 13%-15% growth in 2026, which is slower but still healthy.
$2.7B
revenue
$2.53
eps
65.8%
gross margin
the number that mattered
$2.53 EPS mattered because it beat the $2.25 estimate by 12.44%, which says demand still outruns the Street's model.
-
intuitive surgical posted better-than-expected fourth-quarter results.adjusted earnings of $2.53 a share and sales of $2.87 billion surpassed our estimates by $0.28 and about $160 million, respectively.
-
the performance was driven by a sharperthan-anticipated acceleration in worldwide procedure growth (+18%), which included 17% improvement in its core da vinci surgical base and a 44% gain from its smaller ion endoluminal system.continued adoption of its newest da vinci 5 robotic platform was a key catalyst, along with increased penetration across international markets. intuitive ended 2025 with an installed base of 12,101 systems, consisting of 11,106 da vincis and 995 ions, up from 10,707 systems at the end of 2024.
-
the setup in the year ahead appears favorable.
-
leadership’s initial outlook calls for worldwide procedure growth of 13%-15% in 2026, implying a bit of a slowdown versus the 18% uptick we saw in 2025.
-
that said, the company has developed a track record of providing conservative procedure forecasts of late (initial 2025 outlook called for 13%-16%), so we see some upside to these numbers.in our view, recent investments in r&d and the da vinci 5 system, coupled with further overseas expansion, particularly in asia and europe, should remain highly supportive of growth in the coming quarters. intuitive also maintains a healthy recurring revenue base from instruments and services, which should help better insulate the company from competitive pressures and lingering headwinds tied to healthcare budget constraints.
source: company earnings report, 2026
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What could go wrong
this story lives or dies on one operating line: procedure growth. the installed base is already at 12,101 systems, and the stock trades at 59.2x trailing earnings. if utilization slows, you feel it in the multiple fast.
med
procedure growth loses altitude
2025 procedure growth reached 18%, but management's first look at 2026 is 13%–15%. If growth lands at the low end and keeps slipping, the market will question how much recurring demand is still compounding.
A move from 18% to 13% cuts the pace by 5 percentage points. On a 59.2x trailing p/e, that matters fast.
med
hospital capital budgets slow system placements
The installed base climbed from 10,707 to 12,101 systems in 2025. If hospitals delay purchases, the next layer of recurring procedures shows up later too.
This is a timing risk more than a balance-sheet risk. New systems seed future instruments and service revenue.
med
safety, litigation, or regulatory scrutiny around robotic procedures
When you lead the category, every product or procedure headline points at you first. Any increase in scrutiny can slow surgeon adoption, hospital purchasing, or both.
This risk is hard to size from the data here, but it reaches across the full 12,101-system installed base, not just new sales.
The premium case assumes procedure growth stays healthy enough to justify the multiple. If it slips below 13% for long, the debate stops being about quality and starts being about price.
source: institutional data · regulatory filings · risk analysis
Pay attention to
earnings
next procedure growth print
Management guided 2026 procedure growth to 13%–15%. The next quarter tells you whether that was conservative or the start of a slower phase.
trend
da vinci 5 adoption
The company cited the newest platform as a catalyst. You want to see that show up in procedure volume, not just launch excitement.
risk
hospital purchasing appetite
The installed base grew from 10,707 to 12,101 in 2025. If new placements cool, future recurring revenue takes the slower path.
metric
fy2026 eps estimate
Consensus sits at $10.05. Revisions up help justify the premium. Revisions down force the multiple conversation.
Analyst rankings
short-term outlook
top 20%
Momentum score 2. Analysts expect above-average price performance in the year ahead. in human-speak, they still like the stock despite the valuation.
risk profile
average
Stability score 3. This is not a low-volatility utility and not a biotech rollercoaster either.
chart momentum
top 5%
Technical score 1. The chart says institutions have rewarded execution so far.
earnings predictability
70 / 100
Good, not perfect. You usually get a clear trend here, but quarterly beats and guides still move the stock.
source: institutional data
Institutional activity
968 buyers vs. 1,044 sellers in 3q2025. total institutional holdings: 0.3B shares.
source: institutional data
Price targets
3-5 year target range
$433
$886
$529
current price
$660
target midpoint · +25% from current · 3-5yr high: $795 (+50% · 11% ann'l return)
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