Intuitive Surgical outlook for 2026 da Vinci procedure growth narrowed to 14%–15% on October 20, with management expecting growth near the midpoint. Shares fell approximately 7% in after-hours trading following the announcement, even as third-quarter revenue increased 22% to $3.05 billion.
Key Takeaways
- The procedure-growth range narrowed from 13.5%–15.5%, leaving its midpoint unchanged at 14.5%.
- Instruments and accessories revenue rose 18%, supported by higher da Vinci and Ion procedure volumes.
- A $450 million antitrust settlement charge reduced reported profit; the proposed settlement still requires court approval.
Table of Contents
- Intuitive Surgical outlook narrows without a midpoint cut
- Procedure growth supports recurring revenue
- Settlement charge separates reported and adjusted profit
- Conclusion
Intuitive Surgical outlook narrows without a midpoint cut
The revised forecast raises the lower end of the previous procedure-growth range by half a percentage point and lowers the upper end by the same amount. It therefore reduces the range of expected outcomes rather than cutting the numerical midpoint.
Intuitive Surgical’s third-quarter earnings release says management expects worldwide da Vinci procedure growth to finish 2026 close to the midpoint of the new range. That is guidance for the full year, not a completed result.
For the quarter ended September 30, worldwide da Vinci procedures increased approximately 14% from a year earlier. U.S. growth was 10%, compared with 20% in international markets. Including the company’s Ion platform, total worldwide procedure growth was approximately 15%.
| Item | Details |
|---|---|
| Da Vinci installed base | 12,094 systems at September 30, 2026, up 12% year over year. |
| 2026 adjusted gross margin guidance | 68.7%–69.3%, including an estimated tariff impact of 0.9% of revenue and excluding recognized tariff refunds. |
| 2026 adjusted operating expense guidance | Growth of 11%–13%. |
Procedure growth supports recurring revenue
Procedure volumes matter because use of the surgical platforms generates demand for instruments and accessories. That business produced $1.80 billion of third-quarter revenue, up from $1.52 billion a year earlier, and accounted for more than half of total company sales.
Intuitive attributed the increase primarily to approximately 14% growth in da Vinci procedures and 31% growth in Ion procedures. Total revenue also benefited from higher operating lease revenue and a larger installed system base.
Systems revenue reached $769 million, compared with $590 million a year earlier. The company placed 546 da Vinci systems during the quarter, including 315 da Vinci 5 systems, versus 427 total placements and 240 da Vinci 5 placements in the third quarter of 2025.
Settlement charge separates reported and adjusted profit
GAAP net income fell to $523 million, or $1.49 per diluted share, from $704 million, or $1.95 per share, a year earlier. The quarter included a $450 million pre-tax charge for a proposed settlement of previously disclosed antitrust class action litigation.
The company reached a written settlement agreement in October without admitting liability or wrongdoing. The agreement includes a one-time payment and mutually agreed injunctive relief, but remains subject to preliminary and final court approval.
On a non-GAAP basis, net income increased to $1.05 billion, or $3.00 per diluted share, from $867 million, or $2.40 per share. Both GAAP and non-GAAP earnings included a $22 million after-tax benefit from refunds of tariffs paid in prior periods.
Conclusion
The remaining quarter will determine where full-year procedure growth lands within the narrowed range. Court approval of the proposed antitrust settlement also remains pending.
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