ISRG

Fundamentals

Q1 2026: four straight beats, guidance raised — Best-in-class robotics franchise compounding its installed base while the stock sits near a 52-week low

Q1 2026 Revenue

$2.77B

+23% YoY · beat consensus

Q1 2026 EPS (non-GAAP)

$2.50

vs ~$2.20 est · 4th straight beat

Worldwide Procedure Growth

+17%

da Vinci +16% · Ion +39%

da Vinci Installed Base

11,395

+12% YoY · recurring-revenue engine

da Vinci 5 Placements

232 of 431

vs 147 in Q1 2025 · +58%

Forward P/E (FY2026)

38.8x

premium valuation · PEG 2.68

FY2026 EPS Estimate

$10.42

vs $8.00 GAAP in FY2025

2026 Procedure Guidance

13.5–15.5%

raised after strong Q1

Quarterly Revenue Trend

$2.44B

Q2 2025

$2.51B

Q3 2025

$2.87B

Q4 2025

$2.77B

Q1 2026

Growth Engine

Installed base compounding meets accelerating procedures

11,395

da Vinci Installed Base

+12% YoY · razor-and-blade recurring revenue

+39%

Ion Procedure Growth

lung-biopsy platform scaling fast

13.5–15.5%

2026 Procedure Guidance

raised after Q1 strength

FY2025

Record full year

Revenue $10.06B, GAAP EPS $8.00; da Vinci 5 ramp drives ~20% procedure growth in H2.

Jan 2026

Q4 2025 beats

Revenue $2.87B (+19%), non-GAAP EPS $2.53 vs $2.26 est; stock still slides on cautious outlook.

Apr 2026

Q1 2026 + guidance raise

$2.77B revenue (+23%), EPS $2.50; 2026 da Vinci procedure growth lifted to 13.5–15.5%.

May–Jun 2026

Shares hit 52-week low

Stock falls near $397 on valuation compression and macro/tariff worries despite clean fundamentals.

Jul 16, 2026

Next catalyst: Q2 print

Q2 2026 earnings confirmed for July 16 — the next test of procedure momentum and dV5 placements.

Earnings & Signals

Forward Estimates, Surprises & Insider Activity

Forward Earnings Estimates

FY+1 EPS Consensus10.42

FY+2 EPS Consensus12.20

PEG Ratio2.68

Forward P/E38.8

EPS Revisions (90d)↑9 ↓6 (Net upward on raised procedure guidance, partly offset by tariff/macro target cuts)

Guidance AccuracyHigh — consistently meets or beats and raised FY2026 procedure guidance

Earnings Surprise Track Record

Q2 2025 Est: 1.93 Act: 2.19 +13.5%

Q3 2025 Est: 1.99 Act: 2.40 +20.6%

Q4 2025 Est: 2.26 Act: 2.53 +11.9%

Q1 2026 Est: 2.20 Act: 2.50 +13.6%

Beat Rate100% (4 of 4)

Insider Activity (90 Days)

Net Buying/Selling-$0.7M

Sell/Buy Ratio3:0 sell

Neutral

March 2026 cluster of ~$706K was 3 stock sales plus 2 option conversions — routine 10b5-1 disposition with no open-market buying; no insider conviction signal either way.

Peer Comparison

Relative Valuation vs. Competitors

Company	P/E	EV/Rev	Rev Growth	Gross Margin
Intuitive Surgical	49x	13.1x	+21%	66%
Boston Scientific	26x	~7x	+12%	69%
Stryker	22x	~5.5x	+8%	64%
Medtronic	15x	~3.5x	+6%	65%

ISRG still commands a steep premium — ~49x trailing P/E and ~13x EV/Revenue, multiples of MDT, SYK and BSX — justified by category-leading ~21% revenue growth and a high-margin recurring instruments · accessories model. The trade-off: even after a ~22% YTD decline to ~$405, ISRG screens expensive on every multiple, leaving little room for execution slips, whereas BSX offers double-digit growth at half the multiple and MDT trades like a value name at ~15x.

Valuation

Price Targets & Scenarios

Scenario	Price Target	Assumptions	Probability
Bull Case	$700	da Vinci 5 adoption accelerates, procedure growth sustains mid-teens, margin leverage continues, multiple re-rates toward historical premium as macro/tariff fears fade.	30%
Base Case	$565	Procedure growth lands in 13.5–15.5% guidance band, installed base compounds ~12%, EPS reaches ~$10.40 in FY2026, forward P/E holds ~40x.	45%
Bear Case	$400	China weakness and tariff headwinds pressure system placements, premium multiple compresses toward 30x, procedure growth decelerates below guidance; Hugo/Ottava competition bites.	25%

Probability-Weighted Target: $564 (+39% upside)

$564

Weighted

Bull 70030%

Base 56545%

Bear 40025%

Analyst Consensus

Baird

$610

Raised from $575 · bullish

Piper Sandler

$580

Lowered from $620

BofA Securities

$515

Lowered from $520 · Travis Steed

Deutsche Bank

$366

Lowered from $440 · bear case

Consensus “Buy” across 33 analysts · average target ~$565, range $366–$750 · wide dispersion reflects the valuation debate after a ~33% drawdown from January highs.

Technical

Key Levels & Options Intelligence

S/RSupport & Resistance

52-Week High

$603.88

200-Day MA

$489.25

Key Resistance

$451.29

50-Day MA

$433.98

Key Support

$420.06

Current Price

$404.70

52-Week Low

$396.68

OptOptions & Sentiment

Implied Volatility: ~37% — elevated vs. its own history after a ~22% YTD drawdown
Short Interest: 7.8M shares (2.2% of float) — modest, up slightly from ~6.75M in March
Max Pain: $400 for the Sep 18, 2026 expiry — near the current ~$405 price
Options Positioning: Call-dominant — peak call OI at the $545 strike vs. peak put OI at $440
30-Day IV Rank: Mid-to-high — IV remains bid as price sits just above 52-week lows
Realized Volatility: ~30.6% annualized — IV trading at a premium to realized
Options Skew: Downside puts bid relative to calls, reflecting hedging into the weak technical trend
Technical Signal: Strong Sell on MA stack (price below both 50-day $434 and 200-day $489)

Conviction Analysis

Systematic Conviction Score: 74/100 (Med-High)

Analyst Alignment

30%

100

FCF Visibility

25%

Catalyst Clarity

20%

Valuation Safety

15%

Mgmt Quality

10%

Elite fundamentals (100% beat rate, strong FCF, raised guidance) and consensus Buy support the thesis, but a premium ~39x multiple and the widest analyst dispersion in years ($366–$750) cap conviction below High.

Risk & Ownership

Risk Assessment & Insider Signals

OOwnership & Insider Signals

Institutional Ownership ~82%: Institutions held roughly 81.8% of ISRG as of late 2025 (down from 84.4% in mid-2025), reflecting deep, stable institutional sponsorship typical of a large-cap quality-compounder.
Vanguard Largest Holder (~7.5%): Vanguard Group disclosed beneficial ownership of ~26.6M shares (7.49% of the class) as of 03/31/2026 — the single largest holder, primarily index-driven.
BlackRock & State Street Core Index Holders: BlackRock (~31.5M shares) and State Street (~15.5M shares) round out the passive big three, together with Vanguard controlling a large block of the float through index funds.
Active Managers: T. Rowe Price & Capital Group: T. Rowe Price (~12.8M shares) and Capital World Investors (~7.7M shares) are top active holders, alongside Geode, Morgan Stanley, FMR (Fidelity), BNY Mellon and AllianceBernstein in the top 10.
Low Insider Ownership: Insider ownership is minimal (well under 1%), common for a long-public mega-cap; founder/long-tenured management influence is operational rather than via large equity stakes.
Routine Insider Selling, No Open-Market Buying: Recent insider activity (March 6–10, 2026) totaled ~$706K across 5 transactions — 3 sales and 2 option conversions — consistent with scheduled 10b5-1 plans rather than conviction signals.

Risk Heatmap

Quantified Risk Assessment

Severity Risk Factor Prob. PT Impact

High Intensifying Competition (Hugo & Ottava)

Medtronic's Hugo won FDA approval in Dec 2025 and J&J submitted Ottava for de novo clearance in Jan 2026, ending two decades of effective da Vinci monopoly. Hugo's modular arms and open-instrument strategy directly target ISRG's installed base — the core long-term threat to pricing and share.

40% -18%

High Premium Valuation / Multiple Compression

ISRG trades at an elevated multiple (~39x forward P/E, PEG 2.68) that prices in sustained high-teens procedure growth. Any growth wobble or competitive headline can trigger sharp de-rating despite strong fundamentals; analysts widely flag valuation as the key overhang.

45% -20%

Medium Procedure Growth Deceleration

Da Vinci procedure growth guidance of 13.5–15.5% for 2026 is healthy but below recent highs. GLP-1 weight-loss drugs pressure bariatric volumes, and tougher comps plus hospital capital-budget caution could decelerate the recurring instrument & accessory engine.

35% -12%

Medium Tariffs & China / Supply Chain Exposure

ISRG carries meaningful China revenue and import/component exposure. Renewed tariff regimes and Chinese localization mandates (domestic robotic-surgery push) can pressure both gross margin and overseas placement growth.

30% -9%

Medium da Vinci 5 Rollout Execution

Intuitive is staging more than 100 updates via measured launches starting June 2026 before full US and overseas expansion. A constrained or delayed dV5 ramp could slow capital placements and create a near-term placement air-pocket as customers wait for the new platform.

25% -8%

Low Reimbursement & Regulatory Pressure

Hospital reimbursement scrutiny and any adverse clinical/safety data on robotic-assisted surgery economics could slow adoption. Regulatory pathways for new indications are long and gating to TAM expansion.

20% -6%

Recommendation

Summary

Rating

BUY

Conviction

Med-High

Price Target

$564

Timeframe

12 mo

Upside

+39%

Position Size

3%-5%

Entry Strategy

Tranche 1 — 40%

~$405

Initiate near the 52-week low and current price; the stock already trades ~33% off its January peak with fundamentals intact.

Tranche 2 — 35%

~$385

Add on a break below 52-week support toward the bear-case zone, improving cost basis if macro/tariff fears intensify into the July 16 print.

Tranche 3 — 25%

~$360

Reserve final tranche for a capitulation flush below bear-case ($400) levels — a deep-value entry on a wide-moat compounder.

1-Year Price & Key Levels