Intuitive Surgical (ISRG Quick QuoteISRG - Free Report) reported first-quarter 2026 adjusted earnings per share (EPS) of $2.50, which beat the Zacks Consensus Estimate of $2.08 by 20.2%. The bottom line improved 38.1% year over year.

GAAP EPS was $2.28 versus $1.92 a year ago.

Revenue Details

Revenues rose 23% from the year-ago quarter to $2.77 billion, which exceeded the Zacks Consensus Estimate by 6.2%. The growth reflected higher global procedure volume and stronger system placements, led by da Vinci 5.

Intuitive Surgical, Inc. Price, Consensus and EPS Surprise

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Segmental Details

Instrument & Accessories: ISRG Procedure Growth Lifts High-Margin Recurring Mix

Revenues for this segment climbed 23.3% year over year to $1.69 billion, supported by procedure growth and customer buying patterns, alongside the sharp increase in Ion procedure volume.

Worldwide procedures (da Vinci and Ion combined) increased about 17% versus the first quarter of 2025, with da Vinci procedures up roughly 16% and Ion procedures up about 39%. ISRG’s strong momentum during the quarter reflects broad-based adoption across its platforms, with strength in the United States and Europe and mixed results in parts of Asia.

Systems: ISRG’s Placements Shift Further Toward da Vinci 5

This segment’s revenues totaled $650.7 million, up 24.5% year over year, driven by capital strength. Intuitive Surgical placed 431 da Vinci systems in the quarter, up from 367 a year earlier. The mix continued to move toward the latest da Vinci 5, with 232 placements compared with 147 in the prior-year quarter. The company also placed 52 Ion systems, modestly higher than 49 a year ago, as Ion adoption expanded alongside growing procedure demand.

Intuitive Surgical highlighted leasing as a meaningful part of placements, including usage-based arrangements, while trade-in activity rose as customers upgraded to da Vinci 5. The company ended the quarter with a da Vinci installed base of 11,395 systems, up 12% year over year, while Ion’s installed base rose 22% to 1,041 systems.

Services

Revenues from this segment improved 19% to $433.7 million, tracking the larger installed base and ongoing demand for support and maintenance.

ISRG Margin Profile Improves Despite Tariff Headwinds

Adjusted gross profit was $1.88 billion, up 25.6% year over year. As a percentage of revenues, the gross margin was 67.8%, up approximately 140 bps from the prior-year quarter’s figure.

Selling, general and administrative expenses totaled $613.3 million, up 8.9% year over year.

Research and development expenses totaled $361.9 million, up 14.6% on a year-over-year basis.

Adjusted operating income totaled $1.08 billion, up 40.3% year over year. As a percentage of revenues, the operating margin was 38.9%, up approximately 480 bps from the prior-year quarter’s figure.

ISRG’s Financial Position

Capital allocation remained active during the quarter. ISRG repurchased 2.3 million shares for $1.1 billion, reducing cash, cash equivalents, and investments to $7.98 billion at quarter-end from $9.03 billion at the end of fiscal 2025.

Management also pointed to continued investments in product and digital capabilities, including scaling da Vinci 5 globally and expanding the broader ecosystem that supports utilization and adoption.

ISRG’s Procedure & Margin Outlook for 2026

Following the quarter, Intuitive Surgical raised its full-year 2026 da Vinci procedure growth outlook to about 13.5-15.5%. The company also expects adjusted gross margin of 67.5% to 68.5%, a range that includes an estimated tariff impact of about 1% of revenues, and projects adjusted operating expense growth of 11-14%.

Wrapping Up

ISRG ended the first quarter on a strong note, with earnings and revenues beating the Zacks Consensus Estimate. Following this robust quarterly performance, the stock was up 0.1% during after-hours trading on April 21.

Shares of Intuitive Surgical have lost 20.3% so far this year compared with the industry’s 11.1% decline. The S&P 500 Index has increased 4% during the same time frame.

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Intuitive Surgical’s 2026 outlook continues to be supported by procedure-led growth, with mix and execution likely to play a key role. Management increased its full-year da Vinci procedure growth guidance, reflecting sustained strength in U.S. general surgery and accelerating international adoption outside urology.

The company is also leaning on platform and ecosystem upgrades, including the global rollout of da Vinci 5, expanded availability of Force Feedback instruments through 2026, and continued momentum in Ion and single-port (SP), where procedure growth remains strong and the SP stapler is moving into broader use.

Key challenges in 2026 center on regional and cost pressures. China remains difficult amid low tender activity, domestic competition and policy-driven pricing pressure, while Japan’s recovery is tied to capital placements even as new reimbursements begin in June 2026.

Intuitive Surgical expects adjusted gross margin expansion in 2026 but also highlights tariff headwinds and higher input costs, including freight and memory. GLP-1–related pressure in bariatrics and uncertainty around U.S. patient behavior due to ACA subsidy changes could weigh on 2026 sales.

ISRG Zacks Rank & Stocks to Consider

Intuitive Surgical currently carries a Zacks Rank #3 (Hold).

Some better-ranked stocks in the broader medical space are Globus Medical (GMED Quick QuoteGMED - Free Report) , Alcon (ALC Quick QuoteALC - Free Report) and DexCom (DXCM Quick QuoteDXCM - Free Report) . While GMED presently sports a Zacks Rank #1 (Strong Buy), ALC and DXCM carry a Zacks Rank #2 (Buy).

Estimates for Globus Medical’s 2026 EPS have improved 1 cent to $4.46 in the past 30 days. Shares of the company have risen 7.4% so far this year. GMED’s earnings surpassed estimates in three of the trailing four quarters and missed once, the average surprise being 18.79%. In the last reported quarter, it delivered an earnings surprise of 20.75%.

Alcon shares have lost 1.3% so far this year. Estimates for the company’s 2026 EPS have increased 1 cent to $3.46 in the past 30 days. ALC’s earnings beat estimates in two of the trailing four quarters and missed twice, delivering an average surprise of 1.11%. In the last reported quarter, it posted a negative earnings surprise of 1.27%.

DexCom shares have declined 5.7% so far this year. Estimates for the company’s 2026 EPS have remained stable at $2.49 in the past 30 days. DXCM’s earnings topped estimates in three of the trailing four quarters and matched on one occasion, delivering an average surprise of 3.82%. In the last reported quarter, it posted an earnings surprise of 4.62%.