tapebrief
ISRG · Q4 2025
ISRG · Q1 2025

ISRG · Q4 2024 Earnings

Cautious

Intuitive Surgical

Reported January 22, 2026

30-second summary

Intuitive printed Q4 FY2025 revenue of $2.87B (+19% YoY) and FY2025 revenue of $10.06B (+20.5%) on da Vinci procedure growth of +17% YoY and 532 system placements, of which 303 were DV5 (~57% mix). The substantive disclosure is the FY2026 guide: da Vinci procedure growth of 13–15% (vs. 18% in 2025), non-GAAP gross margin 67–68% (vs. 67.6% in 2025), tariff drag of ~1.2% of revenue ±10bps embedded in that margin range, and non-GAAP OPEX growth 11–15% (vs. 12% in 2025). The press release explicitly cautions that additional or modified tariffs "could be material" to the 2026 result.

Headline numbers

EPS

Q4 FY2024

$2.53

Revenue

Q4 FY2024

$2.87B

+19.0% YoY

Gross margin

Q4 FY2024

66.5%

Operating margin

Q4 FY2024

30.1%

Key financials

Q4 FY2024
MetricQ4 FY2024YoYQ4 FY2025QoQ
Revenue$2.87B+19.0%$2.87B+0.1%
EPS$2.53———
Gross margin66.5%———
Operating margin30.1%———

Guidance

Intuitive Surgical provided comprehensive FY2026 guidance with procedure growth of 13–15%, Non-GAAP gross margin of 67–68%, and OpEx growth of 11–15%, offset by 1.2% tariff impact on margin.

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

New guidance

MetricPeriodGuideYoY
Da Vinci procedure growthFY 202613% to 15%13% to 15%
Non-GAAP gross profit marginFY 202667% to 68% of revenue—
Non-GAAP operating expense growthFY 202611% to 15%—
Tariff impact on gross profit marginFY 20261.2% of revenue, plus or minus 10 basis points—

Segment KPIs

Q4 FY2024
SegmentQ4 FY2024YoY
Instruments and Accessories$1.66B+17.5%
Systems$0.786B+20.1%
Services$0.422B+21.5%

Other KPIs

Q4 FY2024
SegmentQ4 FY2024
da Vinci Procedures Growth17%
Ion Procedures Growth44%
da Vinci System Placements532
da Vinci 5 System Placements303
Ion System Placements42
da Vinci Installed Base11,106
Ion Installed Base995
Non-GAAP Operating Margin37.3%

Management tone

The formal FY2026 procedure guide of 13–15% — against FY2025's 18% actual — is the headline framing change of this print. The midpoint of 14% implies ~400bps of deceleration off the year just reported. Against Q4's +17% YoY procedure print, the guide implies meaningful step-down through 2026.

On gross margin, the FY2026 range of 67–68% sits around FY2025's 67.6% actual, but the composition has shifted: the press release explicitly carves out ~1.2% of revenue (±10bps) as embedded tariff drag. The language that additional or modified tariffs "could be material" puts the cost line on watch even before any policy change lands.

On OPEX, the FY2026 11–15% growth band sits above the 12% delivered in 2025, with the upper bound of 15% the wider end of the operating envelope.

Q&A highlights

Larry Bickleson · Wells Fargo

Asked whether strong US system placements (35%+ growth in H2 2024) with low utilization growth (2%) indicates upcoming procedure growth or a digestion period. Also asked Jamie to quantify gross margin drivers from 69.1% in 2024 to 67-68% guidance for 2025.

Gary explained that not all new placements will be high-volume accounts as the market moves down adoption curves, and new platform features can create temporary utilization waves. Jamie identified three main gross margin drivers: ~100bps from depreciation/fixed cost deleverage, product mix dilution from DV5/ION/SP, and FX headwinds. Path back to 70% requires depreciation cycling through and product margin improvements.

69.1% gross margin in 202467-68% gross margin guidance for 2025~100bps impact from depreciationMultiport utilization grew 3% in 2024

Robbie Marcus · J.P. Morgan

Asked about DV5 vs XI placement mix expectations, upgrade cycle speed, and trading dynamics both in US and OUS. Also requested commentary on global capital equipment environment, particularly China.

Gary emphasized DV5 upgrade cycle depends on perceived differential value (analytics, force feedback, ergonomics, imaging). Jamie noted trade-in activity won't meaningfully appear until mid-year broad launch, and XI refurbished opportunities could serve price-sensitive markets. On capital environment: US strong due to DV5 interest and leasing; UK/Germany constrained by government budgets; Japan delayed due to customer profitability pressures; China characterized as 'dynamic and challenging' with domestic competition.

362 DV5 systems placed in 2024; 174 in Q4Over 2,500 surgeons performed 32,000+ DV5 procedures in 202420 systems placed in China in Q4 (not characterized as strong)Broad launch expected mid-2025

Travis Steed · Bank of America Securities

Asked about R&D investment crossing $1B annually and opportunities to expand into new categories (cardio, geographic expansion, new sites of care, new green spaces). Also asked Jamie about OPEX growth drivers across 10-15% range and potential tariff impacts.

Gary indicated R&D strategy balances technology innovation, additional indications on existing platforms, and support for competitive latecomers across multi-year, multi-specialty, geographically diverse horizon. Jamie explained 10-15% OPEX growth split roughly equally between R&D and SG&A; procedure growth drives the range. On tariffs: significant instruments manufacturing in Mexico could face material impact; company evaluating responses including potential pricing.

~$1B annual R&D investment10-15% OPEX growth guidance for 2025R&D and SG&A growth roughly similar ratesHigher legal expenses expected in 2025

Rick Wise · Piper Sandler

Asked about specific types of DV5 digital features (hardware/software) coming in 2025—whether they open new procedures, improve productivity, enable different care settings. Also asked Jamie when ION and SP cease to be margin drags.

Gary described digital feature strategy in three buckets: (1) real-time OR tools to drive confidence and faster care team onboarding; (2) accelerated learning capabilities; (3) customer analytics/value analysis. Emphasized these increase patient access rather than necessarily creating new procedure categories. Jamie outlined ION path: finish US adoption, launch internationally, then new indications (lung-focused, potential body expansion); cost reduction work ongoing mid-term. SP: international launches in Europe/Japan with broad indications, US additional indications (thoracic, colorectal) phased in; margin improvement mid-term, less challenging than ION.

28,000 ION procedures in Q4 (~100,000+ annualized run rate)ION and SP currently carry margins below corporate averageION margin improvement characterized as multi-year effortSP margin improvement also mid-term but less difficult than ION

David Roman · Goldman Sachs

Asked whether competition and selling cycle lengthening is observed today or theoretical risk. Also asked about instruments/accessories ecosystem capture and TAM opportunities, particularly around force feedback and insufflation.

Jamie confirmed competition is observable in China with clear impact on selling cycles; US competitors increasing with new entrant submission expected. Gary articulated principle-driven approach to ecosystem expansion: only pursue if clinically or economically value-creating with integration/design advantages. Jamie noted force feedback instruments won't reach broad supply until end of 2025; insufflation already high penetration on DV5. INA per procedure expected to drift down slowly due to higher proportion of benign procedures (lower INA mix) offsetting force feedback upside.

Clear competition-driven selling cycle effects in ChinaMultiple competitors in US market; one larger company submission expected in 2021 (likely typo for 2025)Force feedback instruments broader supply expected by end of 2025INA per procedure expected to drift down slowly over next couple of years

What to watch into next quarter

DV5 mix trajectory — Q4 FY2025 ran ~57% (303/532). Pace of DV5 share gains through H1 FY2026 will inform both system ASP and product-margin mix.

Whether tariff drag stays at ~1.2% of revenue or walks up — the press release flagged Mexico (instruments and accessories), Germany (endoscopes), and China (imported materials) as the principal exposure points. Any midpoint walk-up on the next call would confirm the "could be material" caveat is converting to base case.

OPEX growth landing in the lower half of the 11–15% band in H1 — a Q1 print above 13% would suggest the upper bound is the realistic anchor.

Procedure growth at +15% or above in Q1 — a Q1 print at the top of the 13–15% FY2026 band or above would preserve credibility of the deceleration framing.

Ion placements — 42 systems in Q4 FY2025 vs. 69 in Q4 FY2024; a continued sub-50 print would test the utilization-over-placements framing.

Sources

  1. Intuitive Surgical Q4 FY2025 earnings press release, filed with SEC (https://www.sec.gov/Archives/edgar/data/1035267/000103526726000006/q425ex-991earningsrelease.htm)

Get the next brief, free.

We publish analyst-grade earnings briefs the same day or morning after every call — headline numbers, segment KPIs, Q&A highlights, and tone analysis. Free during beta.

This is not investment advice.