Intuitive Surgical reported fourth‑quarter 2025 revenue of $2.87 billion, a 19% year‑over‑year increase that exceeded the consensus estimate of $2.73 billion by $140 million. The company’s earnings per share of $0.21 beat the $0.17 estimate by $0.04, reflecting disciplined cost management and a favorable mix of high‑margin instruments and accessories.
Segment‑level data show instruments and accessories revenue rose 17% to $1.66 billion, up from $1.41 billion in Q4 2024, while systems revenue grew 26% to $786 million from $655 million. The stronger systems performance was driven by a record 532 da Vinci placements, including 303 units of the new da Vinci 5 platform, compared with 493 placements and 174 da Vinci 5 units in the prior year. The mix shift toward the higher‑margin da Vinci 5 helped lift overall revenue despite modest growth in legacy systems.
The company performed 3.15 million da Vinci procedures in 2025, an 18% increase over 2.68 million in 2024. International markets contributed 23% of that growth, with the largest gains in Europe and Asia‑Pacific, while U.S. volume grew 16%. The rapid adoption of the da Vinci 5—870 placements in 2025 versus 362 in 2024—underscores the platform’s expanding reach into new specialties such as cardiac and nipple‑sparing mastectomy, and signals a shift toward higher‑value procedures.
Intuitive guided analysts to a 2026 worldwide procedure growth of 13%–15%, below the 15.2% consensus expectation and the 18% growth seen in 2025. The company also noted a slowdown in Ion endoluminal placements, which fell from 1,200 to 1,050 units, adding a headwind to its broader surgical portfolio. The lower guidance reflects management’s assessment of a more competitive landscape, including Medtronic’s recent FDA clearance of its Hugo system, and a cautious view of macro demand in the U.S. market.
CEO Dave Rosa emphasized that the company remains focused on expanding the da Vinci 5’s capabilities, noting that the platform’s AI‑enabled imaging and precision controls are expected to open new surgical indications. He also highlighted a $70 million contribution to the Intuitive Foundation, up from $45 million in Q4 2024, and reiterated the firm’s commitment to patient‑care outcomes. The company’s investment in AI and digital tools positions it to capture emerging opportunities in robotic surgery and to maintain pricing power in high‑margin segments.
Investors reacted negatively to the guidance, citing the lower procedure growth forecast as a primary concern. The market’s focus on the 2026 outlook, rather than the Q4 earnings beat, illustrates the importance investors place on sustainable growth trajectories and the competitive pressures from new entrants such as Medtronic’s Hugo system.
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