ISRG · Q1 2025 Earnings

Bullish

Intuitive Surgical

Reported April 21, 2026

30-second summary

Intuitive printed Q1 FY2026 revenue of $2.77B (+23% YoY) on da Vinci procedure growth of +16% YoY and 431 system placements (232 DV5, ~54% mix). The substantive disclosure is the FY2026 guide raise one quarter in: da Vinci procedure growth lifted to 13.5–15.5% (from 13–15%), non-GAAP gross margin raised to 67.5–68.5% (from 67–68%), OPEX growth upper bound cut to 14% (from 15%), and the tariff drag estimate trimmed to 1.0% of revenue (from 1.2% ±10bps). The Q4 cautious framing has reversed — tariff de-risking has resumed and operating leverage is being signaled into the guide.

Headline numbers

EPS

Q1 FY2025

$2.50

Revenue

Q1 FY2025

$2.77B

+23.0% YoY

Gross margin

Q1 FY2025

66.1%

Operating margin

Q1 FY2025

30.9%

Key financials

Q1 FY2025

Metric	Q1 FY2025	YoY	Q4 FY2024	QoQ
Revenue	$2.77B	+23.0%	$2.87B	-3.5%
EPS	$2.50	—	$2.53	-1.2%
Gross margin	66.1%	—	66.5%	-40bps
Operating margin	30.9%	—	30.1%	+80bps

Guidance

FY2026 guidance raised on procedure growth and margins while operating expense growth tightened; tariff impact revised down.

Guidance is issued for the full year only, refreshed each quarter. Prior and new below are the same FY updated this quarter.

Changes to prior guidance

Metric	Period	Prior guide	New guide	Δ	Result
Da Vinci procedure growth	FY 2026	13% to 15%	13.5% to 15.5%	+0.5pts midpoint (13.5% vs 14%)	Raised
Non-GAAP gross profit margin	FY 2026	67% to 68% of revenue	67.5% to 68.5% of revenue	+50bps at both low and high end	Raised
Non-GAAP operating expense growth	FY 2026	11% to 15%	11% to 14%	-100bps at high end	Lowered
Tariff impact on gross profit margin	FY 2026	1.2% of revenue, plus or minus 10 basis points	1.0% of revenue	-20bps (midpoint from 1.2% to 1.0%)	Lowered

Segment KPIs

Q1 FY2025

Segment	Q1 FY2025	YoY
Instruments and Accessories	$1.69B	+23.3%
Systems	$0.651B	+24.4%
Services	$0.434B	+19.3%

Other KPIs

Q1 FY2025

Segment	Q1 FY2025
da Vinci Procedures (YoY Growth)	16%
Ion Procedures (YoY Growth)	39%
da Vinci System Placements	431 units
da Vinci 5 System Placements	232 units
Ion Endoluminal System Placements	52 units
da Vinci Installed Base	11,395 systems
Ion Installed Base	1,041 systems
Non-GAAP Gross Margin	67.8%

Management tone

Q2 FY2025 anchor: "Q2 op margin not the new normal" → Q3 FY2025 anchor: confident raise on procedure growth and gross margin → Q4 FY2025 anchor: cautious FY2026 step-down with tariff drag widening → Q1 FY2026 anchor: tariff drag trimmed, guide raised across the board.

The Q4 framing was the most cautious print in the four-quarter sequence: procedure growth guided down to 13–15% vs. 18% delivered, tariff drag stepping from 65bps to 120bps, OPEX upper bound widening to 15%. One quarter later, three of those four lines have moved the other way. The tariff midpoint walked from 120bps to 100bps, OPEX upper bound came back from 15% to 14%, and the procedure-growth guide added 50bps at each end. Whether that reflects mitigation actions, supplier shifts, or a clearer read on policy implementation, management has chosen to communicate higher confidence than the Q4 print warranted — and is willing to raise gross margin against the remaining tariff line.

Q&A highlights

Robbie Marcus · JP Morgan

What gave management confidence to raise procedure growth guidance so early in the year, raising from 13-16% to 15-17% after just one quarter?

Day-adjusted Q1 procedure growth of 18.5% provided momentum. Management conducts routine forecasting incorporating customer input and bottom-up analysis. Low end of range (15%) requires only 14% growth in remaining quarters, providing reasonable buffer. Anecdotal feedback from the road suggests customers view Intuitive as part of the solution, continuing to adopt products and seeing economic and outcome benefits.

Day-adjusted Q1 procedure growth: 18.5%Revised full-year 2025 procedure growth guidance: 15-17% (raised from 13-16%)Low-end scenario requires 14% growth for remainder of year

Travis Steen · Bank of America Securities

How should tariff impact be understood on annualized basis; breakdown of China vs. Mexico impact; cadence of impact through 2025, particularly Q3 and Q4?

Roughly 50% of 1.7% tariff impact relates to U.S.-China trade (both directions), ~40% from imports of components from OUS suppliers and endoscopes from European factories subject to 10% baseline and higher announced rates. Tariff impact increases each quarter through year with Q4 exit rate higher than 1.7% average. Beyond 2025, company wants tariff environment to stabilize before assessing further mitigation moves.

Total tariff impact estimate: 1.7% of revenue ±30 bpsU.S.-China tariffs: ~50% of impactOUS imports and endoscopes: ~40% of impactTariff impact increases sequentially; Q4 exit rate higher than full-year average

Rick Wise · Stifel

What are the drivers of strong 24% OUS procedure growth, sustainability of these drivers, key markets, and assumptions embedded in revised forecast?

Growth driven by early-stage markets (India, Taiwan) achieving strong adoption rates through KOL engagement and surgical society engagement across broader procedure sets. Taiwan benefited from incremental reimbursement. Europe showing solid sequential progress, UK leading with value case around resource savings and waiting list management. Distributor markets receiving incremental capital placements creating capacity. Watch-out: Germany, Japan, UK capacity constraints from capital limitations could limit future growth. Long-term OUS procedure growth historically in 20s range.

OUS procedure growth: 24% in Q1India and Taiwan showing particularly strong adoptionUK leading European growth; value case: resource savings and waiting listsDistributor markets receiving higher capital placement rates

David Roman · Goldman Sachs

How can Intuitive be 'part of the solution' given hospital capex environment constraints and potential Medicaid cuts, seemingly contradicting the capex pressure narrative?

Well-run da Vinci programs deliver best total cost-to-treat comparable to open and often better than laparoscopy, alongside better outcomes and provider/patient satisfaction. Hospitals face choice: stop providing care or provide it efficiently. For those with programs, economics are favorable. Primary near-term mitigation is maximizing utilization of existing capacity through Genesys resources and analytical tools showing total cost-of-care profitability. Leasing/usage-based arrangements help overcome capital budget constraints. Capex stress driven by operating vs. capital budget holder misalignment rather than program uneconomics.

Well-run da Vinci programs have competitive or superior total cost-to-treatPrimary mitigation strategy: maximize utilization of existing installed baseLeasing represented 54% of Q1 placements (vs. 51% prior year)Genesys teams provide utilization optimization support

Answers to last quarter's watch list

DV5 mix trajectory — Q1 DV5 mix was 54% (232/431), modestly below Q4's 57% (303/532). Q1 placements seasonality (431 total) explains some of the absolute step-down, but the mix percentage came in below the Q4 peak. Status: Continue monitoring

Whether tariff drag stays at ~1.2% or walks up — The FY2026 tariff midpoint walked down to 1.0% (from 1.2% ±10bps). The midpoint did not walk up. Status: Resolved positively

OPEX growth landing in the lower half of the 11–15% band in H1 — FY guide upper bound was cut to 14%. Q1 figures don't disclose a YoY OPEX growth comparable but the guide compression itself signals discipline; no specific H1 OPEX growth print was published. Status: Resolved positively on the guide architecture; H1 print Continue monitoring

Procedure growth at +15% or above in Q1 — Q1 da Vinci procedures grew 16% as reported, above the 15.5% raised top end. Status: Resolved positively

Ion placements — Q1 Ion placements were 52, above Q4's 42 and the sub-50 threshold flagged. Below Q1 FY2025's 49 only marginally; the sequential bounce suggests the Q4 trough is in. Status: Resolved positively

What to watch into next quarter

Whether the FY2026 tariff midpoint holds at 1.0% — A Q2 walk-up of the FY midpoint above 1.0%, or commentary that 2027 tariff drag will exceed 2026, would signal the de-risking is a timing benefit rather than structural.

DV5 mix recovery above 57% in Q2 — Q1 came in at 54%; without sequential expansion, the Q4 DV5 mix peak risks becoming the year's high.

OPEX growth print landing closer to 11% than 14% in H1 — the upper-bound cut to 14% only matters if H1 prints below 13%. An H1 print at or above 13% would suggest the upper bound is again the realistic anchor.

OUS procedure growth durability — OUS has been doing the heavy lifting in the guide-raise math. A Q2 deceleration would put more weight on a U.S. recovery.

Whether DV5 force-feedback Europe clearance lands by end of 2026 as previously guided — Q4 framing committed to Europe before end of 2026. A slip past 2026 would mark a guidance credibility break on a multi-year catalyst.

Ion placements sustaining above 50 — Q1 at 52 confirmed the Q4 trough is in; a Q2 print below 50 would reopen the utilization-over-placements concern.

Sources

Intuitive Surgical Q1 FY2026 earnings press release, filed with SEC (https://www.sec.gov/Archives/edgar/data/1035267/000103526726000029/q126ex-991earningsrelease.htm)

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