Two of medtech’s most closely watched names — Intuitive Surgical (ISRG Quick QuoteISRG - Free Report) and Boston Scientific (BSX Quick QuoteBSX - Free Report) — reported strong third-quarter results that underline their very different paths to growth. Intuitive Surgical continues to cement its dominance in robotic-assisted surgery, rolling out the next-generation da Vinci 5 system and expanding newer platforms like Ion and SP.

Boston Scientific, on the other hand, is flexing its scale in cardiovascular and electrophysiology, with WATCHMAN and FARAPULSE propelling double-digit growth. Both companies are leaders in their fields, but their strategies — one focused on deepening a surgical robotics franchise, the other on building a diversified cardiovascular ecosystem — make them distinct investment stories.

Fundamentals: Different Growth Engines

Intuitive Surgical posted third-quarter revenues of about $2.5 billion, up nearly 20% year over year. With procedure being the primary growth engine, da Vinci procedures rose 19%, while Ion lung biopsy procedures surged 52%. With nearly 85% of its business now coming from recurring instruments and accessories, Intuitive Surgical enjoys enviable visibility and margins. Operating income remains strong, providing plenty of firepower for reinvestment and share buybacks.

Boston Scientific, by contrast, delivered more than $5 billion in revenues for the third quarter, up around 15% organically. While margins were lower than Intuitive Surgical’s, BSX’s adjusted gross margin improved to about 71%, thanks to mix benefits from high-growth categories like electrophysiology. The company is using this scale to fund an active tuck-in M&A strategy and international expansion, ensuring a steady stream of pipeline products and market entries.

Estimate Comparison for ISRG & BSX

The Zacks Consensus Estimate for ISRG’s 2025 sales and EPS implies a year-over-year improvement of 18.6% and 17.3%, respectively. EPS estimates for 2025 and 2026 have moved north 45 cents and 38 cents, respectively, over the past 30 days.

ISRG Estimate Movement

Image Source: Zacks Investment Research

The Zacks Consensus Estimate for BSX’s 2025 sales and EPS implies a year-over-year improvement of 19.8% and 20.7%, respectively. EPS estimates for 2025 and 2026 have north 6 cents and 7 cents, respectively, over the past 30 days.

BSX Estimate Movement

Image Source: Zacks Investment Research

Products: Robotic platforms vs. device ecosystems

The star of Intuitive Surgical’s quarter was the da Vinci 5, which accounted for more than half of its 427 system placements. Hospitals are gravitating to the system’s new features — stronger computing power, enhanced ergonomics and force feedback.

Notably, Intuitive Surgical isn’t relying on hardware alone. Its Ion platform is scaling rapidly, with nearly 1,000 systems now placed globally, and its single-port SP system almost doubled its procedure count. Refurbished Xi systems and leasing options are widening access, especially in cost-sensitive markets. Together, these moves reinforce Intuitive Surgical’s model — grow the installed base, then drive utilization and recurring instrument revenues.

Boston Scientificis taking a broader approach. Its electrophysiology business grew a whopping 63%, thanks to FARAPULSE pulsed-field ablation, where it holds a clear first-mover advantage. WATCHMAN, its left atrial appendage closure device, also rose 35% with expanding adoption and new product iterations like FLX Pro now approved in China.

Meanwhile, its OPAL mapping system and Cortex AI integration are setting up a next-generation mapping ecosystem. Beyond cardiology, Boston Scientific is pushing launches across endoscopy and peripheral interventions, creating multiple growth lanes at once.

Strategy: Focused Platform vs. Diversified Pipeline

Intuitive Surgical’s strategy is about depth rather than breadth. The company is channeling investment into enhancing its robotic platforms, expanding internationally, and scaling production to support global demand. The da Vinci 5 rollout is not just a new product cycle but an opportunity to refresh its installed base, create new upgrade revenue, and lock in long-term instrument demand. Its SP and Ion systems, meanwhile, open new clinical frontiers in single-port and thoracic procedures.

Boston Scientificis playing a different game. Its strategy leans on diversification, multiple franchises growing simultaneously, from WATCHMAN to PFA, supported by tuck-in acquisitions like Nalu and Elutia assets. By creating procedural adjacencies — for instance, combining WATCHMAN with AF ablation — BSX is driving not just device adoption but entire workflow integration. International expansion, especially in China, and software-driven upgrades in mapping further broaden the horizon.

ISRG & BSX: Price Performance

The year-to-date price performance of Intuitive Surgical has not been impressive, likely due to tariff concerns and rising competition from Chinese robotic device makers. Meanwhile, the robust third-quarter results led to an upsurge in ISRG shares. However, BSX has outperformed ISRG likely due to its diversified business as well as strong U.S. demand. Shares of ISRG have risen 4.5% year to date, while those of BSX have gained 13%.

Image Source: Zacks Investment Research

What Are the Prospects?

For Intuitive Surgical, the next few years will likely be defined by how quickly da Vinci 5 is adopted worldwide and whether its new features deliver measurable clinical benefits. Leasing and refurbished programs could also unlock hospitals that previously found robotic surgery cost-prohibitive. With such a high share of recurring revenues, every incremental procedure adds to the annuity-like model. But Intuitive Surgical remains heavily dependent on sustaining innovation in robotics — a single category that it must defend against new entrants.

Boston Scientific’s future is tied to its ability to scale multiple growth engines at once. If it sustains its lead in PFA and grows concomitant WATCHMAN-ablation procedures, the revenue opportunity could be massive. Positive clinical data, such as the CHAMPION trial, could expand the addressable market even further. Yet, managing so many launches and geographies brings complexity, and pricing pressure in markets like China remains a headwind.

ISRG Expensive Compared to BSX

Although shares of Intuitive Surgical have declined for most of 2025, the stock has become cheaper, with the forward 12-month price-to-earnings ratio falling below its 5-year median. The company’s valuation has declined along with falling share prices, but it still trades above the industry. Despite the rise in stock price so far this year, Boston Scientific’s valuation has remained relatively stable, though it continues to trade at a premium to the industry average. While ISRG is overvalued as suggested by the Value Scoreof ‘F’, BSX looks attractive with a Value score of ‘C’.

ISRG 5-year P/E F12M vs Industry

Image Source: Zacks Investment Research

BSX 5-year P/E F12M vs Industry

Image Source: Zacks Investment Research

The Verdict: Two Leaders, Two Paths

Intuitive Surgicalis a classic platform story — a company that has built a formidable moat in robotic surgery and continues to monetize it through procedure growth and system upgrades. It is best suited for investors who want exposure to a high-margin, recurring-revenue engine with a narrow but deep focus.

Boston Scientificis the diversified operator — less reliant on a single product, but harnessing multiple categories like electrophysiology, structural heart, and endoscopy. Its expanding scale, clinical pipeline, and series of tuck-in acquisitions add complexity—but also enhance strategic flexibility.

Currently, ISRG and BSX carry a Zacks Rank #2 (Buy) each. Although both companies hold strong prospects over the long-term, Boston Scientific represents a better opportunity currently based on its attractive valuation.