Intuitive Surgical — Financial Results

Revenue Crossed $10 Billion, Growing 21% in 2025

Intuitive crossed a significant milestone, with every major revenue category growing at a double-digit rate. The largest slice — instruments and accessories (consumables used in each procedure) — grew in lockstep with procedure volume, which is the healthiest sign for a business like this: more surgeries mean more recurring revenue from supplies, regardless of whether any new machines are sold.

Procedure Volume Accelerating, Especially Outside the U.S.

The number of surgeries performed on da Vinci systems grew 18%, slightly faster than 2024's 17%. International markets are a bright spot, growing 23%, with particular strength in South Korea (recovering from doctor strikes in 2024) and India. The Ion system — used for lung biopsies rather than surgery — grew procedures 51%, though it remains much smaller in scale.

da Vinci 5 Rollout Is Gaining Serious Traction

The da Vinci 5, Intuitive's newest and most advanced system (launched in the U.S. in early 2024), went from 362 units placed in 2024 to 870 in 2025. It now has 1,231 systems installed globally and is driving a higher average selling price (ASP) — the typical price per system rose from roughly $1.50M to $1.60M. The da Vinci 5 also received key regulatory approvals in Japan and Europe during 2025, opening up its international rollout, which management describes as still being in early stages.

Tariffs Added $63M in Costs and Margins Dipped Slightly

Gross margin (the percentage of revenue left after production costs) slipped 1.5 percentage points, primarily because of new U.S. tariffs on imported goods — notably endoscopes made in Germany and components from China. Higher depreciation from recent factory expansions also contributed. Management expects tariff costs to increase further in 2026 if current trade policies stay in place. The company is also watching potential restrictions on rare earth materials exported from China, which could affect manufacturing.

Operating Income Rose 25% as the Business Scaled Efficiently

Despite higher spending on headcount, R&D, and a $70M charitable contribution (up from $45M in 2024), operating income (profit from core business activity) grew faster than revenue — a sign of improving operating leverage. Selling and administrative costs fell as a share of revenue even as they grew in dollar terms, meaning the business is becoming more efficient at scale.

The Company Generated $3 Billion in Cash and Returned $2.3 Billion to Shareholders

Operating cash flow reached $3.03 billion in 2025, up from $2.42 billion in 2024. Intuitive used $2.30 billion of that to buy back 4.8 million of its own shares — a meaningful return of capital to shareholders. The company ended the year with $9.03 billion in cash and investments, essentially flat year-over-year despite the large buyback, because operations generated enough to offset it.

Ion System Placements Fell Sharply, but for a Telling Reason

Ion system placements dropped from 271 in 2024 to 195 in 2025 — a 28% decline. However, this appears to reflect a natural maturation of the market rather than lost demand: Intuitive notes that Ion has now reached roughly half of all lung biopsies performed in the U.S., and customers are shifting from buying new machines to using their existing ones more intensively. Procedure volume still grew 51%, suggesting the installed base of ~995 systems is being put to work.