Intuitive Surgical Q2 Earnings Call Highlights

Intuitive Surgical delivered strong Q2 results, with revenue up 19% year over year to $2.89 billion and non-GAAP EPS rising 28% to $2.80. Recurring revenue remained the core of the business, making up 85% of total sales. Procedure growth remained robust globally, as total procedures increased 16%, driven by 15% growth in da Vinci procedures and 36% growth in Ion procedures. U.S. growth slowed, but international da Vinci procedures rose 20% and expanded across Europe, Asia and other regions. Management kept its 2026 procedure outlook intact, maintaining da Vinci procedure growth guidance of 13.5% to 15.5% while raising its non-GAAP gross margin forecast to 68% to 69%. The company also highlighted continued demand for newer platforms like da Vinci 5, SP and Ion, plus plans for an Extended Use Program starting in 2027.

Intuitive Surgical NASDAQ: ISRG reported a solid second quarter of 2026, with management pointing to continued global adoption of its da Vinci, da Vinci SP and Ion platforms, even as U.S. procedure growth moderated and China remained challenging. Chief Executive Officer Dave Rosa said total procedures increased 16% in the quarter, driven by 15% growth in da Vinci procedures and 36% growth in Ion procedures. The installed base of da Vinci and Ion systems rose 12% and 21%, respectively, and the company ended the quarter with nearly 13,000 systems installed worldwide.

Chief Financial Officer Jamie Samath said second-quarter revenue increased 19% year over year to $2.89 billion, or 18% on a constant-currency basis. Recurring revenue rose 19% to $2.47 billion and represented 85% of total revenue. Non-GAAP operating margin was 42%, and non-GAAP earnings per share increased 28% from the prior year to $2.80. Non-GAAP net income was $1 billion, compared with $798 million a year earlier. On a GAAP basis, net income was $818 million, or $2.29 per share, compared with $658 million, or $1.81 per share, in the second quarter of last year. Samath said the quarter’s results included a $36 million pre-tax benefit tied to the refund of previously paid IEEPA tariffs. Non-GAAP gross margin was 70%, or 68.7% excluding that tariff refund benefit, compared with 67.9% in the prior-year period. The company ended the quarter with $8.6 billion in cash and investments, up from $8 billion in the prior quarter. Samath said the increase was driven by operating cash flow, partly offset by $379 million in stock repurchases and $112 million in capital expenditures. Free cash flow for the first half of 2026 was $1.8 billion, up 71% from the first six months of 2025.

In the U.S., da Vinci procedure growth was 12%, led by general surgery, while after-hours procedures increased 26%. Rosa said U.S. growth moderated from recent trends and from the company’s expectations at the start of the year, particularly in procedures that can be deferred. “In our customer conversations, some have said that changes in patient coverage and premium dynamics may be affecting when patients seek care and move forward with treatment,” Rosa said. Samath added that customer feedback suggested a “modest adverse impact” on U.S. da Vinci procedure growth from patients affected by the expiration of subsidies for ACA enhanced premiums. Samath also said U.S. da Vinci bariatric ...