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Reports Tuesday, October 20, 2026. Prepared Thursday, September 24, 2026. This is the Q3 FY2026 print (quarter ending September 30). It has not been reported. The call is after the cash close, 1:30 p.m. PDT (4:30 p.m. ET). The reaction session is Wednesday, October 21. Last reported quarter is Q2 FY2026, released after the close on Thursday, July 16, 2026. Intuitive is a calendar-year company. The homepage calendar tags this date 2026Q4; that label is the announcement-month quarter. This page is 2026Q3.

ISRG | Earnings Preview

Intuitive reports Q3 on Tuesday, October 20, with the July 16 outlook still the only operating word. On that call the company printed revenue of $2,892.3 million, up 18.5% versus Q2 2025 $2,440.0 million, and non-GAAP diluted EPS of $2.80, up 27.9% versus $2.19. Worldwide da Vinci procedure growth was 15%, 200 bps slower than the 17% rate in Q2 2025. Management held the full-year procedure range at 13.5%–15.5% and told investors to use the midpoint. Gross margin was raised to 68%–69%. Nothing filed after July 16, and nothing said at Wells Fargo on September 9, has replaced that stack. There is no quarterly revenue, EPS, or procedure guide. A beat or a miss on October 20 is versus FMP, not versus a company number.

Growth trajectory. Annual revenue accelerated for four straight years: $5,710.1 million in 2021, $6,222.2 million in 2022 (+9.0%), $7,124.1 million in 2023 (+14.5%), $8,352.1 million in 2024 (+17.2%), and $10,064.7 million in 2025 (+20.5%). The quarterly rate has already turned. Revenue growth went from +23.0% in Q1 2026 to +18.5% in Q2 2026, a 442 bp slowdown on the unrounded year-over-year rates. EPS growth went from +38.1% to +27.9%, 1,027 bp unrounded. Worldwide da Vinci procedure growth has decelerated for three straight quarters off the Q3 2025 peak: 20%, then 18%, then 16%, then 15%. The step-down is getting smaller (−200 bps, then −200 bps, then −100 bps). It has not turned. US growth from 16% in Q3 2025 to 12% in Q2 2026 is −400 bps. FMP's Q3 revenue bar of $2,907.8 million is +16.1% versus Q3 2025 $2,505.1 million, another 240 bp slower than Q2. FMP's EPS bar of $2.64 is only +10.0% versus $2.40, 1,790 bp slower than the growth rate just printed.

Why the P&L can still look fine while procedures slow. Q2 instruments and accessories of $1,734.9 million grew 17.7%, systems of $685.0 million grew 19.2%, and services of $472.4 million grew 20.8%. Recurring revenue was $2,469.1 million, 85% of the quarter. Ion procedures grew 36%. A 16% revenue consensus can sit a couple of points above a mid-teens da Vinci procedure rate without anyone being wrong. The number that would surprise is a procedure print that forces the full-year range down, not a revenue print a point either side of $2.91 billion.

Margins were raised. The 70% headline is not the run-rate. Q2 non-GAAP gross profit of $2,023.9 million on $2,892.3 million is a calculated 70.0% margin, +206 bps versus Q2 2025. Management put $36 million pretax of that in an IEEPA tariff refund. Daloopa splits the refund into $27.5 million of product cost and $8.4 million of service, and the EPS effect is $0.08. Ex the refund, management's 68.7% is about +80 bps versus Q2 2025 and already inside the new 68–69% year. The street's +10% EPS bar does not require another refund or another 70% print. A clean quarter near 68% is inside the range, not a miss.

What consensus is underwriting. FMP, pulled 2026-09-24, actuals still null: Q3 EPS $2.64 and revenue $2,907.8 million (unrounded $2,907,761,000). FY2026 is $11,762.0 million and $10.80, which is +16.9% revenue versus FY2025 $10,064.7 million and +20.9% EPS versus non-GAAP $8.93. That is the first annual revenue-growth deceleration after four years of acceleration, about 360 bp slower than 2025's +20.5%. FY2027 is not guided. FMP's $13,273.8 million and $12.08 are +12.9% and +11.9% versus those FY2026 averages. The street already models another slowdown next year. Internal models, Visible Alpha, and Bloomberg were not available.

What to watch on October 20

• The procedure sentence, not the EPS print. First-half da Vinci growth was about 15.2% on the company's rounded counts. Holding the year at 14.5% means the second half near 14%, and a Q3 rate below Q2's 15% is what that script implies. It is not, by itself, a guide cut. Moving the range down, or walking the language from the midpoint toward the low end, is the negative surprise. Raising the range, which is what they did at this point in 2025, would reverse the July message.
• US growth versus the 12% just printed. The comp is Q3 2025's 16%. Samath would not rule out a second-half US rate below 10% when asked at Wells Fargo on September 9. He also would not give a regional number. A US print that takes another leg down is what pushes the year toward 13.5%.
• Clean gross margin inside 68–69%. The July 24 tariff sunset was replaced the same day, not removed. Do not model a Q3 margin tailwind from it. Another IEEPA refund would be upside versus the language of the guide, not something they told investors to underwrite.
• Extended-use math for 2027. A subset of EndoWrist instruments gets more uses starting in the first half of 2027. Force feedback, stapling, and energy are excluded. Samath deferred the numbers to this call. It does not change the 2026 margin range unless they say it does. It is the item the FY2027 EPS estimate of $12.08 does not have a bridge for.
• Competition is a Q&A item, not a Q3 unit number. J&J's Ottava received FDA de novo authorization on July 22 for selected US accounts. Medtronic's Hugo is still a urology label in the US, with a September 16 LigaSure clearance and a Sentire distribution deal outside the US. Management has not blamed the US slowdown on share loss.
• J&J on October 13 is the only confirmed device print in front of this one. UnitedHealth the same morning is the utilization and ACA read-through, not a robotics comp. Stryker, the Mako comp, is on FMP for October 29 and is not company-confirmed here. It reports after Intuitive.

The July 17 reaction session fell 14.1% after a beat, because the procedure range was not raised. That price is Daloopa adjusted OHLCV and has no fundamental id. It is the setup, not a valuation. No options implied move was sourced.

Intuitive does not guide quarterly revenue, EPS, gross margin, operating margin, or EBITDA. It did not on the Q4 2025, Q1 2026, or Q2 2026 calls. The stock trades the full-year procedure range and where inside that range management points, plus the non-GAAP gross-margin and opex-growth ranges.

Posture: conservative on history, no longer sandbagged on the procedure point estimate. FY2025 procedures were walked up from an initial 13%–16% to a final 17%–17.5%, and the counted year finished at about +17.5%. FY2026 opened at 13%–15%, was raised once in April to 13.5%–15.5%, and was not raised in July. At the same point in 2025 they raised the range. This year they held the range and aimed at the middle. The range was not cut. The point inside it was. It is also the first time the procedure guide might be a forecast rather than a floor. Margin guidance went the other way: raised 50 bps at both ends in April and again in July. The opex ceiling was cut from 15% to 14% to 13%. Cost guidance got tighter. Volume guidance got more honest.

The midpoint is arithmetic, not a new company datapoint. FY2025 procedures were 2,012,000 in the US plus 1,141,000 outside the US, or 3,153,000. First-half 2026 was 528,000 + 319,000 + 552,000 + 337,000 = 1,736,000, versus first-half 2025 465,000 + 267,000 + 495,000 + 280,000 = 1,507,000, or +15.2%, which is Samath's "closer to 15%." A 14.5% year is about 3.610 million procedures and second-half growth near 13.9% versus 1,646,000 in the second half of 2025, the cited full year minus that first half. The low end of the range is about 11.9% in the second half. The high end is about 15.8%, which would mean almost no slowdown from the first half. Q3 can print below that second-half average without a guide cut, because the Q3 2025 worldwide rate was 20% and last year's international calendar moved some holiday volume from Q4 into Q3.

Stock compensation of $880–$900 million, other income of $315–$335 million, and a non-GAAP tax rate of 22–23% are the July 16 call. Daloopa has no guidance series for those three lines. No Intuitive Foundation contribution is expected in 2026. A $70 million contribution was made in Q4 2025. Capex guidance was dropped in January.

FY2026 FMP revenue of $11,762 million is consistent with a 14.5% procedure year plus the historical wedge of revenue growth over procedure growth. FY2025 revenue growth of +20.5% ran about 300 bp ahead of procedure growth of about +17.5%. It is not consistent with a year that finishes at the 13.5% low end. FY EPS of $10.80 is operating leverage on the higher margin guide and opex growing slower than revenue. Street Q3 EPS growth lagging street revenue growth by about 610 bp is the same shape, and it is the easier of the two hurdles.

Q3 2026 has not printed. Columns below are the July 16 full-year framework where a quarterly line does not exist. Consensus exists only at consolidated revenue and EPS. Procedure growth, placements, margins, and segments are not on the FMP earnings feed. Those cells are "not published," not zero. Internal is n/a on every row. There is no company quarterly number to difference against the street, so % gap versus a guide midpoint is n/a.

Current quarter — Q3 2026

Q3 2025 lines foot: $1,518.8 + $590.4 + $395.9 = $2,505.1 million. Ion is not in the da Vinci guide. Q3 2025 Ion procedures were 37,900. Q2 2026 was 47,900, growth 36%, down from 39% in Q1. Still fast, still decelerating, and too small to carry a $2.91 billion quarter.

Eight reported quarters — trajectory, not the unreported print

Periods are calendar quarters. Growth rates that are already year-over-year are compared with the same quarter a year earlier. Margins are non-GAAP gross profit divided by revenue and are labeled calculated.

Q2 2026 revenue growth of +18.5% is slower than Q1 2026 and slower than Q3 2025's +22.9%. The red cells are decelerations in the year-over-year rate, not declines in dollars. The 70.0% gross margin includes the refund. The clean compare is management's 68.7%, about +80 bps versus Q2 2025's 67.9%. Gross profit used in the margin row: Q3 2024 $1,407.8 million, Q4 2024 $1,678.4 million, Q1 2025 $1,496.6 million, Q2 2025 $1,657.1 million, Q3 2025 $1,703.8 million, Q4 2025 $1,942.1 million, Q1 2026 $1,879.1 million, Q2 2026 $2,023.9 million. A dash means the series was not in the pull, not a zero.

Five-year revenue — the acceleration that the quarterly rate has now broken

FY2026E is FMP, 24 revenue analysts, not a company guide and not a Daloopa figure. +16.9% would be the first break in a four-year acceleration. FY2025 non-GAAP EPS of $8.93 is the base for FMP's $10.80, or +20.9%. Earlier annual non-GAAP EPS is not restated here without a fresh series id.

FQ+1 guide (expected) — Q4 2026

Do not expect a quarterly guide on October 20. Intuitive did not issue one at Q4, Q1, or Q2. The forward number that can move is a revision to the FY2026 procedure range, or another point at the midpoint, not a Q4 revenue or EPS range.

FMP's quarterly file did not include 2026Q4. An arithmetic leftover of the FY consensus is not a street number and is not in the table. Samath's holiday comment cuts the other way for Q4: some international volume that landed in Q3 2025 had previously sat in Q4, so the Q4 comparison is slightly easier. A soft Q3 on the 20% comp can still be consistent with a full-year midpoint if Q4 reaccelerates. Watch the commentary.

FY guide outstanding — what gets revised or reiterated on October 20

This is the FY2026 framework already on the books. It is not a FY2027 guide. FY2027 is not guided on any line.

Tone into October is split, and it has been since July 16. Profitability language got more confident through the first half. Volume language went the other way. Procedure growth was raised in April and then frozen in July, with management now pointing at the midpoint and describing a second half below the first half. The new narrative is US deferral of procedures that can wait, tied to ACA premium and coverage changes after enhanced subsidies expired, on top of a tougher Q3 comparison. Capital, da Vinci 5, and Ion are still described as healthy. No pre-announcement has walked the ranges back. Daloopa's 2026Q3 document index is empty. The July 21 10-Q restates Q2. It does not update the outlook.

How the words changed across the last four outlooks:

• October 21, 2025. Rosa called the quarter excellent. Procedure guidance for 2025 was raised to 17.0%–17.5%. He described US growth of 16% and flagged anecdotal elective acceleration in July and August around Medicare and ACA noise that third-party data did not clearly confirm. That unproven pull-forward is the tough US comparison Samath is now pointing at.
• January 22, 2026. Tone on 2025 was strong. The first 2026 procedure range of 13–15% was a clear step down from a year that grew about 18%. The 200 bp width was the uncertainty budget for ACA subsidies, Medicaid, Europe, China, Japan, and obesity drugs. Gross margin was guided roughly flat with 2025, with tariffs at 1.2% of revenue. Capex guidance was dropped.
• April 21, 2026. Tone stepped up. Procedure growth and gross margin were each raised 50 bps. The tariff allowance was cut to 1.0%. Freight and semiconductor memory were named as new costs and described as small versus cost reductions and volume leverage. Samath said he had not seen a significant ACA effect in Q1 and was still cautious. Japan was "remain cautious" short term even after the June reimbursement change was in view.
• July 16, 2026. Financial tone stayed positive. Volume tone cooled. They did not raise the procedure range that had been raised 90 days earlier, and they told investors to use the midpoint. Rosa's adjective was solid, with an explicit moderation versus the start-of-year US expectation. US growth of 12% versus 14% in Q1 was concentrated in procedures that can be deferred. Asked whether delayed cases come back inside the guide, he split the cause between ACA and the law of large numbers and stopped there. He did not put a second-half snapback into the number. That is a step down from excellent, and from the April raise.

The pattern that matters: through 2025, procedure guidance was a rising floor. In 2026 it was raised once and then held. Margin guidance is still a rising floor. Management trusts cost and mix more than it trusts US procedure timing. They have earned a beat record. They have not earned the right, this quarter, to have the midpoint sentence ignored as another sandbag. If the year finishes near 15.5% again, the midpoint language was the old costume. If it finishes near 14.5%, the sentence was the information.

Capital is the offset, and they were specific. US placements were 267, up from 216. OUS placements were 201, up from 179. Trade-ins were 144 versus 83. About half of US placements were trades into da Vinci 5, so installed-base growth is slower than placements. The US installed base ended at 6,615 versus 6,087, only +8.7%, while procedures are the binding constraint. Utilization growth was 3%. Samath called the US capital environment stable and said the pipeline had not been hit by ACA caution, at least through the July call. He also said they will watch US procedures over the coming quarters. That is confidence in the capital cycle with an explicit tripwire.

Geography, July versus April. China is still the weak book: two systems in the quarter, including the first da Vinci 5 in Hong Kong, and no mainland clearance. Japan shifted from "remain cautious" to a "cautious tone of optimism" after the June 1 reimbursement change, with placements 25 versus 15. Europe depends on the market. India was called out as another strong quarter, with da Vinci 5 clearance the week of the call. None of that was used to raise the procedure guide.

What would confirm the script: worldwide da Vinci growth below the first-half pace but still consistent with a full-year outcome near 14.5%; US growth that does not take another leg down from 12%; gross margin inside 68–69% with a clear statement of whether any further IEEPA refund is in the number; no cut to the procedure range. What would break it: a procedure-range cut, a midpoint that moves to the bottom, US growth that management stops attributing to timing, or a gross-margin range give-back after two raises.

The one place management is saying something the 2027 model does not yet contain is extended use. They will not assume Force Feedback or SP fully offsets a lower price per use. Instruments and accessories grew faster than procedures in Q2 because da Vinci 5, SP, and Force Feedback were accretive to revenue per procedure. Extended use is the give-back, sized on this call, hitting the P&L in 2027. The street's step from +16.9% revenue growth in 2026 to +12.9% in 2027 already assumes deceleration. It does not isolate this program. That is the contradiction worth listening for. It is not a reason to raise the 2026 procedure forecast they just pinned.

The setup is a deceleration print, not a new guide. Nothing in the published consensus says the street has cut the procedure algorithm further since July. What changed after the call is the competitive and regulatory calendar. None of those items should move Q3 procedure volume. They will move the Q&A.

Ion procedures of 47,900 grew 36%. Placements were only 55 versus 54. The deceleration in the growth rate is the base case, not a thesis-breaker, unless utilization also stalls. Japan placements of 25 are the OUS capital offset off a small base. OUS revenue of $959.1 million grew 18.3%, in line with OUS procedure growth rather than ahead of it. The street's 16% revenue growth needs that OUS offset to continue while the US is at 12%.

Window is July 17 through September 24, after the Q2 report and before the Q3 call. The earnings release, the July 16 call, and the July 21 Form 10-Q are excluded. No new Intuitive recall was posted on the FDA enforcement list in the window. Nothing in the window changed the procedure or margin framework.

The Deion Sanders partnership on July 27 is brand marketing. It is not a procedure, placement, or pricing catalyst and is left out of the operating read. Enhanced ACA subsidies had not been restored as of this preview. The July guide assumes they are not back. A late extension would not reopen an enrollment window that already closed, so it would be a weak 2026 volume fix. The guide's ACA assumption is intact, and it is still unquantified by the company.

Consistent beater. Over the last 12 reported quarters, Q3 2023 through Q2 2026, Intuitive beat on non-GAAP diluted EPS in 12 of 12 quarters and on revenue in 11 of 12. The last four quarters are 4 of 4 on both lines. The only miss in the window is Q3 2023 revenue, −1.3%, and that quarter still beat on EPS. EPS-beat magnitude widened across the three four-quarter blocks: +8.4%, then +14.0%, then +16.3%. The latest print did not extend that widening. Q2 2026 was +12.9% on EPS and +2.4% on revenue. Eight cents of the $0.32 EPS beat was the tariff refund. Ex that $0.08, the EPS surprise is about +9.7%, the smallest since Q1 2025's +4.0%. Q3 2026 has not printed.

Actuals are Daloopa. Consensus is FMP /stable/earnings pulled 2026-09-24, except Q1 2026 EPS. FMP shows that quarter as $2.80 actual versus a $2.51 estimate. Daloopa non-GAAP is $2.50. The print-time street figure of $2.08 is the one used. Every other EPS estimate, and every revenue estimate, is the live FMP figure. A beat is any positive surprise. Surprise is (actual − estimate) / estimate.

Surprise heatmap

Quarters run left to right, oldest to newest. Color is the surprise versus the consensus defined above. Red is the only miss. Yellow is a small beat. Green is a solid beat. Blue is a large beat (revenue above 5%, EPS above 16%). Q3 2026 is not on the grid.

Read left to right. Revenue is one red cell, then a year of small beats, one large cell in Q4 2024, a steadier green run, and a fade back to yellow in Q2 2026. EPS is a beat in every cell. It spikes in Q4 2024, resets in Q1 2025, then alternates wide and merely solid: +20.6%, +11.5%, +20.2%, +12.9%. The last cell is a median beat, not the widest one.

Revenue surprise magnitude improved early and has not improved since. The first four quarters averaged +1.0%. The middle four and the last four both averaged +4.0%. Q2's +2.4% is the smallest revenue beat since Q3 2024, and it sits on decelerating growth. The history says Intuitive clears a street EPS number. It does not say the next surprise will look like the +20% EPS beats of Q3 2025 and Q1 2026. Copying the last-four average onto $2.64 is the wrong bar. Q2 included a refund, Q3 faces the 20% procedure comp and the holiday shift, and the tax guide of 22–23% sits above the rate they were running when Q3 2025 was a low tax quarter. An in-line $2.64 would be the first EPS miss versus the street in this window, and it would still be consistent with every qualitative sentence in the July outlook.

The beats the street has been paying for are mostly da Vinci 5 mix, purchase-versus-lease mix, and fixed-cost leverage on procedure growth that was in the mid-to-high teens. The thinner recent beat is a slower procedure rate, plus items below the procedure line. Going into Q3, management has already said growth is closer to the middle of 13.5–15.5% than to the top. That is a volume conversation. The historical +16% average EPS surprise should not be the base case.