Intuitive Surgical, Inc.

Q3 2026 revenue grew 22% to just over $3 billion, with 84% recurring revenue. Non-GAAP EPS increased 25% to $3 per share. Non-GAAP operating margin was 42% of revenue, or 41% excluding a one-time pretax tariff refund of $28 million. Non-GAAP gross margin was 69.9%, or 68.9% excluding that tariff refund, versus 68% a year ago. GAAP net income was $523 million, or $1.49 per share, versus $704 million, or $1.95 per share last year, with results reflecting a $450 million litigation settlement. Procedures grew 15% overall, da Vinci procedures 14%, and Ion procedures 31%; U.S. da Vinci procedures grew 10% and outside the U.S. da Vinci procedures grew 20%. The company placed 546 da Vinci systems, up 28% year over year. For 2026, Intuitive now expects da Vinci procedure growth of 14% to 15% and non-GAAP gross margin of 68.7% to 69.3%. It still expects non-GAAP operating expense growth of 11% to 13%, non-GAAP other income of $300 million to $310 million, and a Q4 non-GAAP tax rate of 22% plus or minus 50 basis points.

Dave Rosa said Q3 showed broad-based adoption across multiport, single-port and Ion, and he framed the business as still early in a long runway of expanding access to robotic surgery. He emphasized segmentation in customer needs and said Intuitive is tailoring commercial approaches, including pricing, to broaden adoption in high-volume benign procedures and different geographies. His tone was confident and strategic, with repeated emphasis on innovation, evidence generation, training and long-term expansion of indications and markets.

Jamie Samath highlighted durable recurring revenue, strong placement activity and improving cost performance. He said total procedures grew 15%, installed base growth was 13%, average system utilization rose 2%, and revenue per procedure for da Vinci I&A was about $1,860 versus $1,800 last year. He also quantified the pricing actions: once fully implemented, they are expected to reduce da Vinci I&A revenue per procedure by about 3% to 5% on a mix-constant basis, with the China reduction starting in Q4 and the broader extended-use rollout beginning in the first half of 2027. Cash and investments ended at $6.8 billion after $2.9 billion of share repurchases at an average price of $377 per share and $113 million of capex.

Analysts focused on the slowdown in U.S. procedure growth, the timing and impact of extended-use pricing actions, ASC strategy, and whether the company needs a modular competitor response. Management said U.S. growth remains durable over the long term, citing stronger capacity additions, ASC expansion, early-stage growth in cardiac and breast, and future R&D-driven indications. On pricing, Jamie said there may be some order volatility, but the impact on gross and operating margin should be modest and the company believes the actions will create elasticity and expand the addressable market over time. On ASCs and competition, Dave said customers want repeatable, easy-to-use, reliable systems and that Intuitive believes its cart-based architecture plus ecosystem remains the best fit, while Jamie said ASC penetration is still low and largely tied to existing IDN relationships.