Intuitive Surgical’s fourth quarter saw results above Wall Street’s expectations, driven by increased global procedure volumes and demand for the new da Vinci 5 system. Management highlighted continued adoption across multiple specialties, particularly in international markets, and noted that procedure growth was especially robust in Europe and Asia. CEO David Rosa pointed to the expansion of the da Vinci 5 in new geographies and indications as a key contributor, as well as growing use in ambulatory surgery centers (ASCs). While the company benefitted from broader system placements and higher recurring revenue, management also acknowledged ongoing pressures from tariffs and a more competitive landscape in China.
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Intuitive Surgical (ISRG) Q4 CY2025 Highlights:
- Revenue: $2.87 billion vs analyst estimates of $2.74 billion (18.8% year-on-year growth, 4.6% beat)
- Adjusted EPS: $2.53 vs analyst estimates of $2.27 (11.6% beat)
- Adjusted EBITDA: $1.26 billion vs analyst estimates of $1.15 billion (43.8% margin, 9.3% beat)
- Operating Margin: 30.2%, in line with the same quarter last year
- Sales Volumes rose 7.9% year on year (18.8% in the same quarter last year)
- Market Capitalization: $185.1 billion
While we enjoy listening to the management's commentary, our favorite part of earnings calls are the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention.
Our Top 5 Analyst Questions From Intuitive Surgical’s Q4 Earnings Call
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Travis Steed (Bank of America) asked about the FDA approval for cardiac procedures on da Vinci 5 and whether this signals broader expansion into new disease states. CEO David Rosa explained the measured rollout in cardiac and plans for additional regulatory clearances.
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Steed (BofA) also inquired about advanced imaging integration. Rosa clarified that new imaging features, including hyperspectral imaging, will leverage both software and hardware upgrades and may create new revenue streams as they are commercialized.
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Larry Biegelsen (Wells Fargo) questioned the scale and key procedures for ASC adoption. Rosa and CFO Jamie Samath highlighted the opportunity in cholecystectomy and hernia repairs, with the XiR system tailored to ASC economics and workflow.
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Robert Marcus (JPMorgan) sought clarity on gross margin dynamics and the impact of XiR ramping. Samath detailed the balancing effects of mix shifts, tariffs, and cost reduction initiatives, noting that margins would remain relatively stable.
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Patrick Wood (Morgan Stanley) asked about the strategy for addressing cost competition with lower-acuity procedures. Rosa and Samath emphasized the flexibility of Intuitive’s current ecosystem and the potential for further platform optimization, but did not disclose specific new form factor plans.
Catalysts in Upcoming Quarters
In upcoming quarters, the StockStory team will closely watch (1) the adoption trajectory of the da Vinci 5 system and Force Feedback instruments in newly cleared indications and geographies; (2) expansion of the company’s footprint in ASCs, particularly through refurbished system offerings; and (3) Intuitive’s ability to mitigate intensifying competition and navigate regulatory and reimbursement changes in key international markets. Progress on digital subscription renewals and further clinical validation for new procedures will also be important areas for scrutiny.
Intuitive Surgical currently trades at $520.96, in line with $525.81 just before the earnings. Is there an opportunity in the stock?The answer lies in our full research report (it’s free).
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