How Does Intuitive Surgical Stock Stack Up Against Its Peers?
Intuitive Surgical (ISRG) stock has underperformed many peers over the past year, recently experiencing an -11% decline after its 2026 procedure growth guidance disappointed, despite reporting strong Q4 2025 earnings on January 22, 2026. But how does it truly measure up in the rapidly evolving med-tech space, characterized by accelerating AI and robotics? A closer look reveals robust revenue growth and industry-leading operating and free cash flow margins. Yet, a premium PE ratio signals a stretched valuation, implying limited upside potential despite strong underlying fundamentals.
- ISRG’s 29.3% operating margin leads peers, driven by high-margin recurring revenue from instruments/accessories and da Vinci system utilization.
- ISRG’s 22.2% revenue growth outpaces peers, fueled by rising da Vinci system placements, procedure volumes, and new platform adoption.
- ISRG’s stock is down 13.9% with a P/E of 68.3, underperforming peers due to a demanding valuation reflecting high growth expectations.
Here’s how Intuitive Surgical stacks up across size, valuation, and profitability versus key peers.
| ISRG | MDT | JNJ | SYK | ZBH | GMED | |
|---|---|---|---|---|---|---|
| Market Cap ($ Bil) | 187.5 | 129.9 | 526.2 | 137.2 | 17.3 | 12.7 |
| Revenue ($ Bil) | 9.6 | 34.8 | 92.1 | 24.4 | 8.0 | 2.8 |
| PE Ratio | 68.3 | 27.3 | 20.9 | 46.6 | 21.5 | 30.0 |
| LTM Revenue Growth | 22.2% | 5.3% | 5.1% | 11.0% | 5.5% | 11.7% |
| LTM Operating Margin | 29.3% | 19.3% | 26.2% | 19.6% | 18.7% | 15.7% |
| LTM FCF Margin | 23.6% | 15.0% | 20.3% | 16.7% | 17.6% | 20.6% |
| 12M Market Return | -13.9% | 19.0% | 55.0% | -7.3% | -19.4% | 1.4% |
For more details on Intuitive Surgical, read Buy or Sell ISRG Stock. Below we compare ISRG’s growth, margin, and valuation with peers across years
Revenue Growth Comparison
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| LTM | 2025 | 2024 | 2023 | 2022 | |
|---|---|---|---|---|---|
| ISRG | 22.2% | – | 17.2% | 14.5% | 9.0% |
| MDT | 5.3% | 3.6% | 3.6% | -1.4% | |
| JNJ | 5.1% | – | 4.3% | 6.5% | 1.6% |
| SYK | 11.0% | – | 10.2% | 11.1% | 7.8% |
| ZBH | 5.5% | – | 3.8% | 6.5% | 1.6% |
| GMED | 11.7% | – | 60.6% | 53.3% | 6.8% |
Operating Margin Comparison
| LTM | 2025 | 2024 | 2023 | 2022 | |
|---|---|---|---|---|---|
| ISRG | 29.3% | – | 28.1% | 24.8% | 25.3% |
| MDT | 19.3% | 19.5% | 17.1% | 18.7% | |
| JNJ | 26.2% | – | 24.9% | 27.5% | 26.3% |
| SYK | 19.6% | – | 20.7% | 19.1% | 16.9% |
| ZBH | 18.7% | – | 19.9% | 19.6% | 17.2% |
| GMED | 15.7% | – | 8.7% | 12.9% | 23.1% |
PE Ratio Comparison
| LTM | 2025 | 2024 | 2023 | 2022 | |
|---|---|---|---|---|---|
| ISRG | 68.3 | – | 86.6 | 102.0 | 90.8 |
| MDT | 27.3 | 26.5 | 28.9 | 29.2 | |
| JNJ | 20.9 | – | 35.4 | 10.4 | 22.9 |
| SYK | 46.6 | – | 44.7 | 43.2 | 48.0 |
| ZBH | 21.5 | – | 20.2 | 21.5 | 110.2 |
| GMED | 30.0 | – | 115.1 | 76.1 | 28.2 |
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