Adjusted earnings of $3.00 a share topped forecasts by 14% and revenue rose 22%. The company narrowed its 2026 forecast for da Vinci procedure growth to about 14% to 15%, around the same 14.5% midpoint. A $450 million antitrust settlement charge cut reported earnings.
Intuitive Surgical gave investors a strong quarter and a more precise forecast. It did not give them a higher one.
The maker of da Vinci surgical robots reported third-quarter revenue of $3.05 billion, up 22% from $2.51 billion and above the LSEG consensus of $2.91 billion. Adjusted earnings were $3.00 a share, up 25% and 36 cents above the LSEG consensus of $2.64. On a reported basis, earnings fell to $1.49 a share from $1.95, after a $450 million pre-tax charge, or 99 cents a share after tax, to settle an antitrust class action. The settlement still requires court approval.
The shares closed Tuesday at $438.00 and were indicated about 7.8% lower near $403.90 at about 5:36 a.m. Eastern on Wednesday, in thin extended-hours trading.
The procedure forecast
Intuitive now expects worldwide da Vinci procedures to grow about 14% to 15% in 2026, closer to the midpoint of its prior 13.5% to 15.5% range. The midpoint is still 14.5%. The company removed the upside and downside cases without moving the center.
That matters because procedures drive the recurring revenue from instruments and services. Worldwide procedures, including the Ion lung-biopsy system, grew about 15% in the quarter, with da Vinci up about 14% and Ion about 31%. Reported figures put U.S. da Vinci procedure growth at about 10% and international growth at about 20%.
The U.S. figure is the one investors are watching. A domestic growth rate half the international one, combined with a forecast that does not rise after a beat, leaves the debate where it was in July, when the company maintained its outlook and the shares fell about 14% the next day.
Strength elsewhere
The rest of the report was strong. Intuitive placed 546 da Vinci systems, up 28% from 427 a year earlier, including 315 of its newest da Vinci 5. The installed base reached 12,094 systems. The adjusted gross margin widened to 69.9% from 68.0%, and the company bought back 7.8 million shares for $2.94 billion. Results included a $22 million after-tax benefit from tariff refunds, or 6 cents a share.
Placements are the lead indicator for future procedures, and a 28% rise suggests hospitals are still adding capacity.
Market implications
One reading is that the early-trading decline overreacts to a forecast that was narrowed rather than cut. Earnings beat by 14%, placements accelerated and the margin expanded, and the settlement charge is a one-time cost.
A second reading is that the stock was priced for an upgrade that did not come. With U.S. procedure growth at about 10%, a beat that leaves the full-year midpoint unchanged signals that management sees no acceleration ahead.
What to watch
U.S. procedure growth in the fourth quarter; court approval of the settlement; utilization of da Vinci 5 systems; full-year guidance for 2027 in January; and gross margin against the 68.7% to 69.3% full-year range. A pickup in U.S. procedures would address the main concern behind the early-trading decline.