Intuitive Surgical reported adjusted earnings per share of $2.53 for the fourth quarter of 2025, surpassing the analyst consensus of $2.26 by 12%. Revenue climbed 19% year-over-year to $2.87 billion, topping forecasts of $2.75 billion. Instrument and accessory sales rose 17% to $1.66 billion, while systems revenue increased from $655 million to $786 million, reflecting strong demand across the company’s portfolio.

Global da Vinci procedures grew 17% in Q4, supporting the placement of 532 new systems versus 493 in the year-ago period. This expansion pushed the installed base to 11,106 systems, a 12% increase. Ion procedures surged 44% as utilization improved, although system placements fell from 69 in Q4 2024 to 42 in Q4 2025, indicating a shift toward maximizing existing equipment before new deployments.

In Japan, procedure growth remained below expectations pending new reimbursement guidelines expected in June 2026. In China, provincial tenders have increasingly favored domestic suppliers, eroding Intuitive’s pricing power. For full year 2026, the company projects a non-GAAP gross profit margin of 67% to 68%, including an estimated 1.2 percentage-point impact from tariffs, down from 70.6% in the latest quarter.

Looking ahead, worldwide da Vinci procedure growth is forecast at 13% to 15% in 2026, below the 18% achieved in 2025 due to capital constraints in parts of Europe and potential changes to U.S. reimbursement. Offseting this, a November 2025 Annals of Surgery study covering 20 years of data found robotic-assisted surgeries halve the likelihood of patients requiring subsequent open procedures compared with laparoscopy, underscoring the long-term clinical advantages that support market expansion.