Intuitive Surgical (ISRG)
Market Price (3/18/2026): $479.33 | Market Cap: $170.2 BilSector: Health Care | Industry: Health Care Equipment
Intuitive Surgical (ISRG)
Market Price (3/18/2026): $479.33Market Cap: $170.2 BilSector: Health CareIndustry: Health Care Equipment
Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.
| Attractive operating marginsOp Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is 29% | Weak multi-year price returns2Y Excs Rtn is -5.8% | Expensive valuation multiplesP/EBITPrice/EBIT or Price/(Operating Income) ratio is 58x, P/CFOPrice/(Cash Flow from Operations). CFO is cash before capital expenditures. is 57x, P/EPrice/Earnings or Price/(Net Income) is 60x |
| Attractive cash flow generationCFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 30%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 25%, CFO LTM is 3.0 Bil, FCF LTM is 2.5 Bil | Yield minus risk free rate is negativeERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -2.6% | |
| Low stock price volatilityVol 12M is 34% | Key risksISRG key risks include [1] intensifying competition from rival robotic surgery platforms threatening its dominant market share and [2] sales vulnerability to constrained hospital budgets given the high capital cost of its da Vinci systems. | |
| Megatrend and thematic driversMegatrends include Automation & Robotics, Precision Medicine, Digital Health & Telemedicine, and Aging Population & Chronic Disease. Show more. |
| Attractive operating marginsOp Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is 29% |
| Attractive cash flow generationCFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 30%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 25%, CFO LTM is 3.0 Bil, FCF LTM is 2.5 Bil |
| Low stock price volatilityVol 12M is 34% |
| Megatrend and thematic driversMegatrends include Automation & Robotics, Precision Medicine, Digital Health & Telemedicine, and Aging Population & Chronic Disease. Show more. |
| Weak multi-year price returns2Y Excs Rtn is -5.8% |
| Expensive valuation multiplesP/EBITPrice/EBIT or Price/(Operating Income) ratio is 58x, P/CFOPrice/(Cash Flow from Operations). CFO is cash before capital expenditures. is 57x, P/EPrice/Earnings or Price/(Net Income) is 60x |
| Yield minus risk free rate is negativeERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -2.6% |
| Key risksISRG key risks include [1] intensifying competition from rival robotic surgery platforms threatening its dominant market share and [2] sales vulnerability to constrained hospital budgets given the high capital cost of its da Vinci systems. |
Qualitative Assessment
AI Analysis | Feedback
1. Intuitive Surgical issued a tempered 2026 procedure growth outlook, signaling a deceleration from prior performance.
Despite exceeding Q4 2025 earnings and revenue estimates (EPS of $2.53 vs. $2.27 consensus, revenue of $2.87 billion vs. $2.72 billion consensus) and achieving robust worldwide procedure growth of approximately 18% in 2025, the company projected a lower worldwide da Vinci procedure growth of approximately 13% to 15% for the full year 2026. This outlook, a decrease from the 18% growth seen in 2025, created investor concern regarding the future trajectory of the company's core revenue driver.
2. Several analyst firms downgraded Intuitive Surgical and lowered their price targets during the period.
Following the Q4 2025 earnings report and the 2026 outlook, analysts adjusted their ratings and price targets. Notably, Citigroup downgraded ISRG to a "Neutral" rating and decreased its price target from $635.00 to $590.00 on January 23, 2026. This followed an earlier downgrade by Citigroup from "Buy" to "Neutral" on December 11, 2025. UBS also maintained a "Neutral" rating while lowering its price target from $600.00 to $570.00 on February 24, 2026. These downward revisions contributed to negative market sentiment.
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Stock Movement Drivers
Fundamental Drivers
The -15.8% change in ISRG stock from 11/30/2025 to 3/17/2026 was primarily driven by a -19.4% change in the company's P/E Multiple.| (LTM values as of) | 11302025 | 3172026 | Change |
|---|---|---|---|
| Stock Price ($) | 573.48 | 482.76 | -15.8% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 9,612 | 10,065 | 4.7% |
| Net Income Margin (%) | 28.6% | 28.4% | -0.7% |
| P/E Multiple | 74.4 | 60.0 | -19.4% |
| Shares Outstanding (Mil) | 357 | 355 | 0.4% |
| Cumulative Contribution | -15.8% |
Market Drivers
11/30/2025 to 3/17/2026| Return | Correlation | |
|---|---|---|
| ISRG | -15.8% | |
| Market (SPY) | -1.8% | 56.8% |
| Sector (XLV) | -5.1% | 39.1% |
Fundamental Drivers
The 2.0% change in ISRG stock from 8/31/2025 to 3/17/2026 was primarily driven by a 10.1% change in the company's Total Revenues ($ Mil).| (LTM values as of) | 8312025 | 3172026 | Change |
|---|---|---|---|
| Stock Price ($) | 473.30 | 482.76 | 2.0% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 9,145 | 10,065 | 10.1% |
| Net Income Margin (%) | 28.5% | 28.4% | -0.5% |
| P/E Multiple | 65.1 | 60.0 | -7.8% |
| Shares Outstanding (Mil) | 358 | 355 | 1.0% |
| Cumulative Contribution | 2.0% |
Market Drivers
8/31/2025 to 3/17/2026| Return | Correlation | |
|---|---|---|
| ISRG | 2.0% | |
| Market (SPY) | 4.3% | 36.5% |
| Sector (XLV) | 9.4% | 35.6% |
Fundamental Drivers
The -15.8% change in ISRG stock from 2/28/2025 to 3/17/2026 was primarily driven by a -31.8% change in the company's P/E Multiple.| (LTM values as of) | 2282025 | 3172026 | Change |
|---|---|---|---|
| Stock Price ($) | 573.15 | 482.76 | -15.8% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 8,352 | 10,065 | 20.5% |
| Net Income Margin (%) | 27.8% | 28.4% | 2.0% |
| P/E Multiple | 87.9 | 60.0 | -31.8% |
| Shares Outstanding (Mil) | 356 | 355 | 0.4% |
| Cumulative Contribution | -15.8% |
Market Drivers
2/28/2025 to 3/17/2026| Return | Correlation | |
|---|---|---|
| ISRG | -15.8% | |
| Market (SPY) | 13.9% | 65.2% |
| Sector (XLV) | 1.8% | 47.5% |
Fundamental Drivers
The 110.5% change in ISRG stock from 2/28/2023 to 3/17/2026 was primarily driven by a 61.8% change in the company's Total Revenues ($ Mil).| (LTM values as of) | 2282023 | 3172026 | Change |
|---|---|---|---|
| Stock Price ($) | 229.39 | 482.76 | 110.5% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 6,222 | 10,065 | 61.8% |
| Net Income Margin (%) | 21.3% | 28.4% | 33.5% |
| P/E Multiple | 60.9 | 60.0 | -1.5% |
| Shares Outstanding (Mil) | 351 | 355 | -1.1% |
| Cumulative Contribution | 110.5% |
Market Drivers
2/28/2023 to 3/17/2026| Return | Correlation | |
|---|---|---|
| ISRG | 110.5% | |
| Market (SPY) | 75.6% | 59.0% |
| Sector (XLV) | 23.1% | 44.9% |
Price Returns Compared
| 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | Total [1] | |
|---|---|---|---|---|---|---|---|
| Returns | |||||||
| ISRG Return | 32% | -26% | 27% | 55% | 9% | -15% | 77% |
| Peers Return | 1% | -3% | -1% | 12% | 12% | 2% | 24% |
| S&P 500 Return | 27% | -19% | 24% | 23% | 16% | -2% | 78% |
Monthly Win Rates [3] | |||||||
| ISRG Win Rate | 58% | 42% | 50% | 67% | 50% | 0% | |
| Peers Win Rate | 52% | 55% | 48% | 50% | 52% | 53% | |
| S&P 500 Win Rate | 75% | 42% | 67% | 75% | 67% | 33% | |
Max Drawdowns [4] | |||||||
| ISRG Max Drawdown | -16% | -49% | -15% | -5% | -18% | -17% | |
| Peers Max Drawdown | -11% | -21% | -17% | -7% | -12% | -5% | |
| S&P 500 Max Drawdown | -1% | -25% | -1% | -2% | -15% | -3% | |
[1] Cumulative total returns since the beginning of 2021
[2] Peers: MDT, JNJ, SYK, ZBH, GMED. See ISRG Returns vs. Peers.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2026 data is for the year up to 3/17/2026 (YTD)
How Low Can It Go
| Event | ISRG | S&P 500 |
|---|---|---|
| 2022 Inflation Shock | ||
| % Loss | -49.9% | -25.4% |
| % Gain to Breakeven | 99.6% | 34.1% |
| Time to Breakeven | 461 days | 464 days |
| 2020 Covid Pandemic | ||
| % Loss | -40.5% | -33.9% |
| % Gain to Breakeven | 68.1% | 51.3% |
| Time to Breakeven | 116 days | 148 days |
| 2018 Correction | ||
| % Loss | -24.3% | -19.8% |
| % Gain to Breakeven | 32.2% | 24.7% |
| Time to Breakeven | 87 days | 120 days |
| 2008 Global Financial Crisis | ||
| % Loss | -75.9% | -56.8% |
| % Gain to Breakeven | 314.7% | 131.3% |
| Time to Breakeven | 364 days | 1,480 days |
Compare to MDT, JNJ, SYK, ZBH, GMED
In The Past
Intuitive Surgical's stock fell -49.9% during the 2022 Inflation Shock from a high on 11/8/2021. A -49.9% loss requires a 99.6% gain to breakeven.
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About Intuitive Surgical (ISRG)
AI Analysis | Feedback
Here are 1-3 brief analogies for Intuitive Surgical (ISRG):
The Apple of robotic surgery.
The Tesla of surgical technology.
AI Analysis | Feedback
- da Vinci Surgical System: A robotic surgical system designed for complex, minimally invasive surgical procedures.
- Ion endoluminal system: A diagnostic system enabling minimally invasive biopsies in the lung.
- Surgical Instruments & Accessories: A suite of stapling, energy, and core instrumentation used with its surgical systems.
- Customer Support & Maintenance: Comprehensive services including installation, repair, maintenance, and ongoing support for its medical systems.
- Learning Pathways: Educational programs and training designed to support healthcare providers in using its technology effectively.
- Integrated Digital Capabilities: Digital offerings providing connected insights to optimize hospital program performance.
AI Analysis | Feedback
Intuitive Surgical (ISRG) sells primarily to other companies and institutions within the healthcare sector. Its major customers can be categorized as:
- Healthcare Systems and Hospitals
- Ambulatory Surgery Centers
- Other Healthcare Providers (e.g., specialized clinics)
These customers acquire the da Vinci Surgical System, Ion endoluminal system, associated instrumentation, and ongoing services to deliver minimally invasive care to their patients.
AI Analysis | Feedback
nullAI Analysis | Feedback
David J. Rosa, Chief Executive Officer and Member of the Board of Directors
David J. Rosa joined Intuitive Surgical in March 1996 as its ninth employee. He has held various leadership positions within the company, including in engineering, clinical and product development, marketing, regulatory and quality affairs, and the commercial organization. Rosa is credited with founding Intuitive’s first clinical engineering and endoluminal groups, which led to the development and commercialization of the da Vinci SP and Ion robotic systems. Prior to becoming CEO, effective July 1, 2025, he served as President, Chief Strategy and Growth Officer, Executive Vice President and Chief Business Officer, Executive Vice President and Chief Commercial Officer, Executive Vice President and Chief Scientific Officer, Senior Vice President, Scientific Affairs, and Senior Vice President, Emerging Procedures and Technology. Before joining Intuitive, he contributed to the development of trans-esophageal transducers for Acuson Corporation. He serves on the board of directors' compensation committee for Kardium, a private company, and as chairman of the board of the joint venture between Intuitive Surgical and Fosun Pharma. Rosa holds multiple patents.
Jamie E. Samath, Executive Vice President, Chief Financial Officer and Enterprise Technology Leader
Jamie E. Samath joined Intuitive Surgical in April 2013 as Vice President and Corporate Controller, and he became the Chief Financial Officer on January 1, 2022. Prior to his tenure at Intuitive, Samath held senior finance roles at Atmel Corporation, where he served as Vice President Finance and Corporate Controller, and Principal Accounting Officer from October 2011 to April 2013. Before Atmel, he worked at National Semiconductor Corporation from 1991 to 2011 in various finance capacities, including Principal Accounting Officer and Corporate Controller from 2005 to 2011. National Semiconductor was acquired by Texas Instruments in 2011. Samath also serves as an independent director at KLA Corp.
Gary S. Guthart, PhD, Executive Chair of the Board of Directors
Gary S. Guthart joined Intuitive Surgical in 1996 as part of the first engineering team. He served as the company's Chief Executive Officer from 2010 until July 1, 2025, when he transitioned to Executive Chair of the Board of Directors. His previous roles at Intuitive include Vice President of Engineering, Senior Vice President of Product Operations, and President and Chief Operating Officer. Before joining Intuitive, Guthart was a key member of the team developing foundational technology for computer-enhanced surgery at SRI International. He also gained scientific experience at NASA. Guthart is also on the Board of Directors for Illumina.
Brian E. Miller, PhD, Executive Vice President & Chief Digital Officer
Brian E. Miller, PhD, leads Intuitive Surgical's digital and artificial intelligence (AI) strategy. He joined Intuitive in 2003 as part of the merger with Computer Motion, where he developed software for early robotic surgical systems like AESOP and ZEUS. During his time at Intuitive, Miller has been instrumental in key innovations in robotic surgical systems and surgeon simulation capabilities, holding patents for technologies such as tele-robotic motion control, 3D telestration, adaptive video streaming, video content searching, and virtual reality simulation for surgeon training. His career at Intuitive has included roles such as director of engineering, simulation & networking; director of advanced development; vice president, system engineering; and senior vice president and general manager of Systems, Imaging, and Digital.
Myriam J. Curet, MD, FACS, Executive Vice President and Chief Medical Officer
Myriam J. Curet, MD, FACS, joined Intuitive Surgical as Chief Medical Advisor in 2005 or 2006, initially on a part-time basis. She was promoted to Senior Vice President & CMO in 2014 and Executive Vice President & CMO in 2017. In her role, she has been responsible for developing clinical evidence, physician education, and managing reimbursement and regulatory activities. Dr. Curet earned her M.D. from Harvard Medical School and completed her general surgery residency at the University of Chicago. She served with the Indian Health Service for four years and completed a surgical endoscopy fellowship at the University of New Mexico, where she was a faculty member for six years. In 2000, she joined the Stanford University Department of Surgery and has served as a Clinical Professor of Surgery at Stanford University School of Medicine for over 20 years, with a part-time clinical appointment at the Palo Alto Veteran’s Administration Medical Center. She also sits on the boards of Stereotaxis and Inspire Medical Systems.
AI Analysis | Feedback
Intuitive Surgical (ISRG) faces several key risks to its business, primarily stemming from intensifying competition, ongoing regulatory and legal challenges, and macroeconomic factors impacting healthcare spending. * Intensifying Competition: Intuitive Surgical, while maintaining a dominant position, is experiencing increased competition in the surgical robotics market. Major medical device companies like Medtronic with its Hugo system and Johnson & Johnson with Ottava are entering the field, leading to potential market share erosion, pricing pressures, and slower placements of its da Vinci systems, particularly in cost-sensitive and emerging markets. Specialized competitors, such as Stryker's Mako system in orthopedics, also pose a threat in specific surgical segments. * Regulatory and Legal Risks: The company faces ongoing scrutiny and potential liabilities related to product safety, regulatory compliance, and allegations of inadequate surgeon training. There have been numerous lawsuits concerning complications, injuries, and even deaths associated with the da Vinci surgical system. Intuitive Surgical has also received FDA warning letters in the past regarding its recall and design processes. Additionally, cybersecurity threats and breaches impacting IT systems introduce further regulatory and operational risks. * Macroeconomic and Healthcare Policy/Spending Risks: External factors such as changes in healthcare policies, uncertainty in hospital capital expenditure budgets, and international trade tariffs can significantly impact Intuitive Surgical's financial performance. Tariffs, in particular, have been explicitly cited as headwinds contributing to pressure on gross margins. Broad shifts in healthcare spending and reimbursement models can also challenge the company's traditional capital sales approach for its systems.AI Analysis | Feedback
The clear emerging threats to Intuitive Surgical (ISRG) are:
- The active global launch and increasing market presence of Medtronic's Hugo RAS System, which directly competes with Intuitive's da Vinci Surgical System in multi-specialty robot-assisted surgery.
- The growing adoption and international expansion of CMR Surgical's Versius System, another direct competitor offering a modular robot-assisted surgical platform.
- The established market presence of Johnson & Johnson's Monarch Platform, which directly competes with Intuitive's Ion endoluminal system for robotic-assisted bronchoscopy in lung diagnostics.
- The resulting increase in competitive intensity, which is expected to lead to greater pricing pressure on Intuitive Surgical's systems, instruments, accessories, and services.
AI Analysis | Feedback
Intuitive Surgical, Inc. (ISRG) operates in several significant addressable markets for its main products, the da Vinci Surgical System and the Ion endoluminal system.
da Vinci Surgical System (Robotic-Assisted Surgery)
The da Vinci Surgical System addresses the global robotic-assisted surgery market and the broader minimally invasive surgery market. Several estimates highlight the substantial size and growth of this market:
- The global robotic surgery market is projected to increase from USD 8.28 billion in 2025 to USD 16.40 billion by 2032, at a compound annual growth rate (CAGR) of 10.25%.
- Another projection estimates the global robotic surgery market size to be USD 13.79 billion in 2025, growing to approximately USD 63.73 billion by 2035, with a CAGR of 16.54%.
- The global surgical robots market was estimated at USD 4.31 billion in 2024 and is projected to reach USD 9.60 billion by 2033, growing at a CAGR of 9.3%.
- North America held the largest share of the global surgical robots market, accounting for 50.90% in 2024.
- Intuitive Surgical estimates its total addressable market (TAM) for soft tissue surgical procedures at 6 million, with a long-term global TAM of 20 million procedures. The company's management currently defines the "line of sight" TAM for da Vinci at 9 million operations.
- A recent FDA clearance for the da Vinci 5 in certain cardiac procedures, including mitral valve repair, is estimated to expand the total addressable market by approximately 160,000 procedures annually.
- The broader global minimally invasive surgery market, which includes robotic-assisted surgery, was valued at USD 486.72 billion in 2024 and is projected to reach USD 946.50 billion by 2033. Within this, robotic-assisted surgery held a leading market share in 2024, specifically capturing 33.57% of the method segment.
Ion Endoluminal System (Minimally Invasive Biopsies in the Lung)
The Ion endoluminal system targets the global lung biopsy systems market, which is characterized by various projections:
- The global lung biopsy systems market size was over USD 5.03 billion in 2025 and is projected to reach USD 20.89 billion by 2035, growing at a CAGR of approximately 15.3%. In 2026, the market size is evaluated at USD 5.72 billion.
- Another estimate indicates the lung biopsy systems market is projected to grow from USD 3.0 billion in 2025 to USD 7.4 billion by 2035, with a CAGR of 9.4%.
- The global lung biopsy systems market is expected to grow from USD 3.3 billion in 2026 to USD 5.4 billion by 2033, with a CAGR of 5.9%.
- North America is expected to hold the largest revenue share of 42% in the lung biopsy systems market by 2035.
- Analysts estimate that the Ion platform has penetrated 4.7% of the bronchoscopy market.
AI Analysis | Feedback
Intuitive Surgical (ISRG) is anticipated to drive future revenue growth over the next 2-3 years through several key strategies and market trends: * Accelerating Adoption and Placement of the da Vinci 5 Platform: The company's next-generation da Vinci 5 system, featuring advanced capabilities like force feedback technology, is a significant driver. Strong placements and positive feedback in late 2025 are expected to continue ramping up in 2026, indicating an ongoing upgrade cycle within hospitals seeking enhanced surgical precision and patient outcomes. * Growth in Procedure Volumes and Expansion into New Clinical Areas: Overall procedure growth across da Vinci, Ion, and SP platforms remains the foundation of Intuitive Surgical's revenue model. Specifically, new FDA clearances, such as for the da Vinci 5 in certain cardiac procedures (e.g., mitral valve repair), are expected to significantly expand the total addressable market by approximately 160,000 procedures annually. Continued growth in general surgery and thoracic procedures also contributes to this driver. * International Market Expansion: Intuitive Surgical is strategically focused on expanding its global footprint. International da Vinci procedures demonstrated strong growth in 2025 and are projected to continue their upward trajectory, particularly in regions like Europe and Asia. Strategic acquisitions of distribution businesses in countries such as Italy, Spain, and Portugal, coupled with potential reimbursement for additional robotic procedures in Japan by mid-2026, are set to enhance the company's competitiveness and drive sustained international growth. * Increased Utilization of the Ion Endoluminal System: The Ion endoluminal system, which facilitates minimally invasive lung biopsies, is a key growth area outside of traditional surgery. Despite some fluctuations in system placements, Ion procedure volumes have shown robust growth (e.g., 44-51% in 2025), indicating increasing utilization of the installed base and extending Intuitive's commercial offerings into diagnostic procedures. * Recurring Revenue from Instruments, Accessories, and Services: A substantial portion of Intuitive Surgical's revenue comes from the sale of instruments, accessories, and services, which scales directly with the utilization of its installed systems. As the installed base of da Vinci and Ion systems continues to grow and procedure volumes increase, the recurring revenue stream is expected to expand, providing a stable and predictable component of overall revenue growth. Additionally, the expansion into U.S. ambulatory surgery centers (ASCs) and the offering of refurbished da Vinci XiR systems present a long-term opportunity to broaden access to da Vinci surgery, further supporting recurring revenue growth.AI Analysis | Feedback
Share Repurchases
- On May 1, 2025, Intuitive Surgical's Board authorized an increase in its stock repurchase program to $4 billion.
- The company repurchased 4 million shares for $1.92 billion in Q3 2025.
- Intuitive Surgical executed $3.023 billion in share repurchases during fiscal years 2022 and 2023.
Share Issuance
- Intuitive Surgical's shares outstanding increased by 0.19% to 0.363 billion in 2025 from 2024, and by 1.29% to 0.362 billion in 2024 from 2023.
- In May 2025, shareholders approved an amendment to the 2010 Incentive Award Plan, increasing the number of shares reserved for issuance by 5 million, from 115.35 million to 120.35 million.
- As of June 30, 2025, approximately 22.1 million shares were reserved for future issuance under the company's stock plans.
Outbound Investments
- On March 2, 2026, Intuitive Surgical completed the acquisition of the da Vinci and Ion distribution business operated by ab medica, Abex, Excelencia Robótica, and their affiliates, expanding its direct operations in Europe.
Capital Expenditures
- Intuitive Surgical's capital expenditures averaged $717.4 million annually for fiscal years ending December 2021 to 2025.
- Capital expenditures reached a peak of $1.111 billion in December 2024.
- The company's capital expenditures rose to $1.11 billion in FY2024, primarily focused on expanding manufacturing capacity and developing new technologies.
Latest Trefis Analyses
Trade Ideas
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| Date | Ticker | Company | Category | Trade Strategy | 6M Fwd Rtn | 12M Fwd Rtn | 12M Max DD |
|---|---|---|---|---|---|---|---|
| 02282026 | QDEL | QuidelOrtho | Insider | Insider Buys 45DStrong Insider BuyingCompanies with multiple insider buys in the last 45 days | 0.0% | 0.0% | 0.0% |
| 02272026 | CHE | Chemed | Dip Buy | DB | FCFY OPMDip Buy with High FCF Yield and High MarginBuying dips for companies with high FCF yield and meaningfully high operating margin | 0.0% | 0.0% | 0.0% |
| 02272026 | LLY | Eli Lilly | Monopoly | MY | Getting CheaperMonopoly-Like with P/S DeclineLarge cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple | 0.0% | 0.0% | 0.0% |
| 02202026 | HAE | Haemonetics | Dip Buy | DB | FCFY OPMDip Buy with High FCF Yield and High MarginBuying dips for companies with high FCF yield and meaningfully high operating margin | 3.5% | 3.5% | 0.0% |
| 02132026 | IQV | IQVIA | Dip Buy | DB | P/E OPMDip Buy with Low PE and High MarginBuying dips for companies with tame PE and meaningfully high operating margin | 7.1% | 7.1% | -3.0% |
| 09052025 | ISRG | Intuitive Surgical | Monopoly | MY | Getting CheaperMonopoly-Like with P/S DeclineLarge cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple | 7.9% | 7.9% | -8.0% |
| 10312022 | ISRG | Intuitive Surgical | Monopoly | MY | Getting CheaperMonopoly-Like with P/S DeclineLarge cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple | 22.9% | 6.4% | -8.8% |
| 04302022 | ISRG | Intuitive Surgical | Monopoly | MY | Getting CheaperMonopoly-Like with P/S DeclineLarge cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple | 2.0% | 25.9% | -23.5% |
| 03312020 | ISRG | Intuitive Surgical | Monopoly | MY | Getting CheaperMonopoly-Like with P/S DeclineLarge cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple | 39.9% | 49.2% | -7.5% |
| 08312019 | ISRG | Intuitive Surgical | Monopoly | MY | Getting CheaperMonopoly-Like with P/S DeclineLarge cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple | 4.4% | 42.2% | -28.1% |
Research & Analysis
Invest in Strategies
Wealth Management
Peer Comparisons
| Peers to compare with: |
Financials
| Median | |
|---|---|
| Name | |
| Mkt Price | 165.31 |
| Mkt Cap | 123.5 |
| Rev LTM | 17,590 |
| Op Inc LTM | 4,002 |
| FCF LTM | 3,387 |
| FCF 3Y Avg | 2,575 |
| CFO LTM | 4,037 |
| CFO 3Y Avg | 3,376 |
Growth & Margins
| Median | |
|---|---|
| Name | |
| Rev Chg LTM | 9.2% |
| Rev Chg 3Y Avg | 8.3% |
| Rev Chg Q | 11.2% |
| QoQ Delta Rev Chg LTM | 2.9% |
| Op Mgn LTM | 19.4% |
| Op Mgn 3Y Avg | 19.3% |
| QoQ Delta Op Mgn LTM | 0.2% |
| CFO/Rev LTM | 23.1% |
| CFO/Rev 3Y Avg | 20.7% |
| FCF/Rev LTM | 18.5% |
| FCF/Rev 3Y Avg | 16.0% |
Valuation
| Median | |
|---|---|
| Name | |
| Mkt Cap | 123.5 |
| P/S | 4.7 |
| P/EBIT | 20.1 |
| P/E | 25.2 |
| P/CFO | 19.5 |
| Total Yield | 4.7% |
| Dividend Yield | 1.0% |
| FCF Yield 3Y Avg | 4.1% |
| D/E | 0.1 |
| Net D/E | 0.1 |
Returns
| Median | |
|---|---|
| Name | |
| 1M Rtn | -2.9% |
| 3M Rtn | 0.8% |
| 6M Rtn | 3.2% |
| 12M Rtn | -1.8% |
| 3Y Rtn | 50.5% |
| 1M Excs Rtn | -1.1% |
| 3M Excs Rtn | 1.7% |
| 6M Excs Rtn | 2.1% |
| 12M Excs Rtn | -20.3% |
| 3Y Excs Rtn | -25.2% |
Comparison Analyses
Price Behavior
| Market Price | $482.76 | |
| Market Cap ($ Bil) | 171.4 | |
| First Trading Date | 06/16/2000 | |
| Distance from 52W High | -18.6% | |
| 50 Days | 200 Days | |
| DMA Price | $512.16 | $510.60 |
| DMA Trend | down | down |
| Distance from DMA | -5.7% | -5.5% |
| 3M | 1YR | |
| Volatility | 24.4% | 34.2% |
| Downside Capture | 171.50 | 104.77 |
| Upside Capture | 101.26 | 84.07 |
| Correlation (SPY) | 61.2% | 64.6% |
| 1M | 2M | 3M | 6M | 1Y | 3Y | |
|---|---|---|---|---|---|---|
| Beta | 1.62 | 1.34 | 1.22 | 1.00 | 1.20 | 1.19 |
| Up Beta | 0.80 | 1.30 | 1.38 | 1.47 | 1.40 | 1.31 |
| Down Beta | 1.79 | 0.87 | 0.85 | 0.94 | 1.21 | 1.17 |
| Up Capture | 176% | 101% | 91% | 90% | 74% | 153% |
| Bmk +ve Days | 9 | 20 | 31 | 70 | 142 | 431 |
| Stock +ve Days | 11 | 16 | 25 | 58 | 123 | 405 |
| Down Capture | 184% | 203% | 170% | 92% | 108% | 102% |
| Bmk -ve Days | 12 | 21 | 30 | 54 | 109 | 320 |
| Stock -ve Days | 10 | 25 | 36 | 66 | 127 | 346 |
[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with ISRG | |
|---|---|---|---|---|
| ISRG | 0.8% | 34.1% | 0.07 | - |
| Sector ETF (XLV) | 4.6% | 17.5% | 0.11 | 48.3% |
| Equity (SPY) | 20.3% | 18.8% | 0.85 | 64.6% |
| Gold (GLD) | 68.2% | 26.2% | 1.97 | 2.7% |
| Commodities (DBC) | 19.1% | 17.3% | 0.89 | 22.0% |
| Real Estate (VNQ) | 7.6% | 16.1% | 0.27 | 44.6% |
| Bitcoin (BTCUSD) | -10.5% | 44.3% | -0.12 | 23.5% |
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Based On 5-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with ISRG | |
|---|---|---|---|---|
| ISRG | 15.3% | 33.0% | 0.49 | - |
| Sector ETF (XLV) | 7.3% | 14.5% | 0.32 | 55.3% |
| Equity (SPY) | 13.0% | 17.0% | 0.60 | 66.1% |
| Gold (GLD) | 23.4% | 17.2% | 1.11 | 9.5% |
| Commodities (DBC) | 11.0% | 19.0% | 0.47 | 11.1% |
| Real Estate (VNQ) | 4.8% | 18.8% | 0.16 | 47.6% |
| Bitcoin (BTCUSD) | 6.1% | 56.7% | 0.33 | 25.5% |
Smart multi-asset allocation framework can stack odds in your favor. Learn How
Based On 10-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with ISRG | |
|---|---|---|---|---|
| ISRG | 22.7% | 32.1% | 0.71 | - |
| Sector ETF (XLV) | 10.2% | 16.5% | 0.50 | 63.0% |
| Equity (SPY) | 14.8% | 17.9% | 0.71 | 69.1% |
| Gold (GLD) | 14.4% | 15.6% | 0.76 | 7.9% |
| Commodities (DBC) | 8.5% | 17.6% | 0.40 | 20.0% |
| Real Estate (VNQ) | 5.8% | 20.7% | 0.24 | 50.1% |
| Bitcoin (BTCUSD) | 68.3% | 66.8% | 1.07 | 16.4% |
Smart multi-asset allocation framework can stack odds in your favor. Learn How
Returns Analyses
Earnings Returns History
Expand for More| Forward Returns | |||
|---|---|---|---|
| Earnings Date | 1D Returns | 5D Returns | 21D Returns |
| 1/14/2026 | -2.7% | -6.8% | -14.8% |
| 10/21/2025 | 13.9% | 17.9% | 22.0% |
| 7/22/2025 | -1.8% | -2.8% | -6.0% |
| 4/22/2025 | 1.9% | 7.6% | 14.3% |
| 1/15/2025 | 7.7% | 13.3% | 9.7% |
| 10/17/2024 | 10.0% | 8.0% | 11.4% |
| 7/18/2024 | 9.3% | 5.0% | 15.1% |
| 4/18/2024 | -1.7% | 0.1% | 7.0% |
| ... | |||
| SUMMARY STATS | |||
| # Positive | 14 | 16 | 18 |
| # Negative | 10 | 8 | 6 |
| Median Positive | 8.3% | 5.6% | 9.6% |
| Median Negative | -2.5% | -6.2% | -12.8% |
| Max Positive | 13.9% | 22.8% | 35.8% |
| Max Negative | -14.3% | -17.4% | -25.6% |
SEC Filings
Expand for More| Report Date | Filing Date | Filing |
|---|---|---|
| 12/31/2025 | 02/03/2026 | 10-K |
| 09/30/2025 | 10/22/2025 | 10-Q |
| 06/30/2025 | 07/23/2025 | 10-Q |
| 03/31/2025 | 04/23/2025 | 10-Q |
| 12/31/2024 | 01/31/2025 | 10-K |
| 09/30/2024 | 10/18/2024 | 10-Q |
| 06/30/2024 | 07/19/2024 | 10-Q |
| 03/31/2024 | 04/19/2024 | 10-Q |
| 12/31/2023 | 01/31/2024 | 10-K |
| 09/30/2023 | 10/20/2023 | 10-Q |
| 06/30/2023 | 07/24/2023 | 10-Q |
| 03/31/2023 | 04/20/2023 | 10-Q |
| 12/31/2022 | 02/10/2023 | 10-K |
| 09/30/2022 | 10/21/2022 | 10-Q |
| 06/30/2022 | 07/22/2022 | 10-Q |
| 03/31/2022 | 04/22/2022 | 10-Q |
Insider Activity
Expand for More| # | Owner | Title | Holding | Action | Filing Date | Price | Shares | Transacted Value | Value of Held Shares | Form |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Brosius, Mark | See Remarks | Direct | Sell | 12172025 | 548.49 | 464 | 254,499 | 71,852 | Form |
| 2 | Brosius, Mark | SVP & Chief Mfg and Supply Cha | Direct | Sell | 12152025 | 547.36 | 4,500 | 2,463,120 | 496,456 | Form |
| 3 | Brosius, Mark | SVP & Chief Mfg and Supply Cha | Direct | Sell | 12152025 | 548.49 | 464 | 254,499 | 242,981 | Form |
| 4 | Curet, Myriam | EVP & Chief Medical Officer | Direct | Sell | 12102025 | 559.90 | 104 | Form | ||
| 5 | Curet, Myriam | EVP & Chief Medical Officer | Direct | Sell | 12022025 | 568.99 | 125 | Form |
ISRG Trade Sentinel
OVERWEIGHT (Score 9-10)
CONVICTION RATIONALE
The probability-adjusted skew is highly attractive at 3.73x. The analysis assigns a high probability to the upside scenario because the company's competitive moat is actively widening in its most important markets. The primary risk of decelerating growth is viewed as a manageable headwind for a superior business model, not a thesis-breaker, leading to a favorable risk/reward profile.
STOCK ARCHETYPE
Type A: 'High-Beta Compounder'The company exhibits durable, high-teens procedure growth, a defensible competitive moat built on switching costs, and commands a premium valuation. The investment debate centers on the sustainability of this growth and the integrity of the moat, which are the core focal points for a High-Beta Compounder.
INVESTMENT THESIS
The core long thesis rests on the compounding effect of Intuitive Surgical's high-margin, recurring revenue stream, which accounts for approximately 85% of total revenue. This is driven by the non-discretionary, per-procedure sale of instruments and accessories into a growing installed base of da Vinci systems. The current upgrade cycle to the new, higher-spec da Vinci 5 system further solidifies this ecosystem and drives system placement growth.
- Recurring revenue grew 19% and now constitutes ~85% of total revenue.
- Worldwide da Vinci procedures grew by a robust 17% in the most recently reported quarter.
- High gross margins of approximately 67.5% in 2024, driven by the high-margin Instruments and Accessories segment.
- The installed base of da Vinci systems grew 12% year-over-year, providing a larger base for recurring revenue.
PRIMARY RISK
The primary friction on the stock is the company's own guidance for a deceleration in its key growth metric. A slowdown in procedure volume growth could cause a compression in the stock's high valuation multiple, as the narrative shifts from hypergrowth to a more mature growth profile.
- Company guidance for FY2026 projects worldwide da Vinci procedure growth of 13% to 15%, a material slowdown from the 18% achieved in FY2025.
- Management's 2026 guidance cites headwinds from 'China tender volumes and competitive intensity' and 'capital pressure in parts of Europe' and 'Japan', suggesting external factors are contributing to the slowdown.
| KPI | Threshold | Rationale |
|---|---|---|
| da Vinci Procedure Growth YoY | Consistently >15% | This is the primary driver of high-margin recurring revenue. Beating the high end of the 13-15% guidance is the most direct way to invalidate the bear thesis on deceleration. |
| da Vinci 5 System Placements (Absolute Number) | Sequential growth QoQ | This is the leading indicator for the health of the current product upgrade cycle. Strong placements confirm continued capital investment by hospitals and fuel the future installed base for recurring revenue. |
| Gross Margin % | Maintained within 67%-68% guided range | This KPI is the most direct way to monitor the impact of the primary risk from competition and pricing pressure, particularly from government tenders in China. |
Growth Deceleration vs. Market Dominance
BULL VIEW
Bulls are betting the da Vinci 5 upgrade cycle and Ion platform will re-accelerate growth, proving the 13-15% 2026 guidance is conservative.
CORE TENSION
Can Intuitive's dominant ecosystem and new da Vinci 5 cycle offset the clear trend of decelerating procedure growth and rising competition?
PREVAILING SENTIMENT
Company guidance for 2026 projects 13-15% procedure growth, a notable deceleration from 18% in 2025, suggesting the growth story is maturing.
BEAR VIEW
Bears see the 13-15% 2026 procedure growth guidance, down from 18% in 2025, as the start of a structural slowdown due to market saturation and new viable competitors.
| Timeline | Event & Metric To Watch |
|---|---|
Late April 2026 | Q1 2026 Earnings Call Watch: Q1 procedure growth relative to the 13-15% full-year guided range. Any commentary on da Vinci 5 adoption vs. hospital capex caution is critical. |
Anytime (Submitted Jan 2026) | FDA Decision on J&J's OTTAVA System Watch: FDA granting of De Novo classification for general surgery procedures. This would validate OTTAVA as a direct, broad competitor in ISRG's core market. |
Ongoing (Q1 2026) | Major Hospital Systems' Earnings Calls (e.g., HCA, Tenet) Watch: Commentary on capital expenditure budgets. Specific mentions of delaying or prioritizing robotic system purchases will be a key leading indicator for system sales. |
| Date | Event | Stock Impact |
|---|---|---|
10/8/2025 | Competitor Clinical Trial Launch Details: Medtronic initiated its U.S. clinical study (IDE) for the Hugo RAS system in gynecological procedures, expanding its competitive threat beyond urology. | Stock gained 1.6% on Oct 8, 2025 $440.94 -> $448.09 |
10/21/2025 | Q3 2025 Earnings Details: Reported stronger-than-expected Q3 results, with revenue up 23% and procedure growth of 19%. The company also raised full-year 2025 procedure growth guidance. | Stock Surged 13.9% on Oct 21, 2025 $462.74 -> $527.03 |
12/3/2025 | Key Competitor FDA Clearance Details: Medtronic announced it received FDA clearance for its Hugo robotic-assisted surgery (RAS) system for use in urologic procedures, a direct competitor to da Vinci. | Stock was flat (0.3%) on Dec 3, 2025 $567.72 -> $569.71 |
1/7/2026 | Key Competitor FDA Submission Details: Johnson & Johnson announced it submitted its OTTAVA Robotic Surgical System to the FDA for De Novo classification, signaling a major competitive entry into the U.S. market. | Stock changed little (-0.1%) on Jan 7, 2026 $592.85 -> $592.27 |
1/22/2026 | Q4 2025 Earnings & FY2026 Guidance Details: Despite beating Q4 estimates, the stock reaction was muted as the company guided for FY2026 procedure growth of 13-15%, a deceleration from 18% in 2025. | Stock was flat (0.4%) on Jan 22, 2026 $523.69 -> $525.81 |
2/3/2026 | Form 10-K Filing Details: Company filed its 2025 annual report, detailing risks including tariffs impacting costs by $63.0 million in 2025 and competitive intensity in China. | Stock Fell 3.6% on Feb 3, 2026 $496.73 -> $478.88 |
Position Sizing
4% - 6%
NORMAL
The stock is in an Explosive Volatility regime (3.0x S&P) with Spiking near-term volatility. While fundamentals would normally qualify for a larger size, the high valuation and explosive vol cap our exposure to a Normal (4-6%) position to manage drawdown risk.
Diversification Alternatives
LLY
SECTORLLY possesses a clearer, hyper-growth narrative driven by its Mounjaro/Zepbound duopoly in the massive obesity market, offering higher growth visibility than ISRG's decelerating profile.
HALO
SECTORHALO offers a differentiated, high-margin royalty model on blockbuster drugs, providing a less capital-intensive growth profile without the direct competitive pressure ISRG is now facing.
Intuitive Surgical is evolving from a single-product monopoly in surgical robotics to a multi-platform ecosystem, defending its ~80% market share via a vast installed base and high switching costs while expanding into new, lower-acuity procedures and digital services.
Filter all news through the lens of procedure growth durability and competitive moat reinforcement.
Worldwide procedure growth >15% YoY; da Vinci 5 system placements exceeding 50% of total placements; regulatory approvals for new instruments or procedures (e.g., cardiac); announcements of new hospital system-wide partnerships.
Sustained procedure growth guidance below 13%; significant hospital system choosing a competitor's platform (Medtronic's Hugo or J&J's Ottava) for a major robotics program; pricing pressure in China leading to share loss.
Single-quarter fluctuations in system placements (leases vs. sales); initial competitive product launches without significant adoption data; GLP-1 drug impact discussions without quantifiable procedure impact.
Repricing Catalyst
The successful global launch and adoption of the da Vinci 5 system, which accounted for 57% of systems placed in Q4 2025, is driving an upgrade cycle and expanding the addressable market with new indications like cardiac procedures, aiming to sustain mid-teens procedure growth.
Instruments & Accessories
$6.6B TTM (58% of Total) · 68% MarginWhat It Is
Proprietary EndoWrist instruments, graspers, scissors, scalpels, and other single-use or limited-use tools required for da Vinci procedures.
Who Pays & How
Hospitals pay on a per-procedure basis for instruments. They are locked into using Intuitive's proprietary tools due to the closed ecosystem of the da Vinci system, representing a high switching cost.
Competition
Surgical Systems (Robots)
$3.1B TTM (27% of Total) · 68% MarginWhat It Is
da Vinci 5, da Vinci Xi, da Vinci X, and da Vinci SP surgical systems. Ion endoluminal system for lung biopsy.
Who Pays & How
Hospitals and Ambulatory Surgery Centers (ASCs) pay a large upfront capital cost ($0.5M - $2.5M) for the systems to offer minimally invasive surgery, attract top surgeons, and improve patient outcomes.
Competition
Services
$1.7B TTM (15% of Total) · 68% MarginWhat It Is
Service and maintenance contracts for the installed base of da Vinci and Ion systems.
Who Pays & How
Hospitals with installed da Vinci systems pay for annual service contracts to ensure system uptime and receive technical support.
Competition
External Quote Links
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| CNBC | Etrade |
| MarketWatch | Unusual Whales |
| YCharts | Perplexity Finance |
| FinViz |
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