Earnings Preview: Intuitive Surgical (ISRG) looks poised for a strong Q4

Intuitive Surgical, Inc. (NASDAQ: ISRG) is a pioneer in robotic-assisted surgical technology, developing advanced systems that enable healthcare professionals to perform minimally invasive procedures with greater precision and efficiency. Having successfully commercialized and scaled its robotic platform, the company has more than 10,000 da Vinci systems—its flagship product—installed worldwide. Building on this established footprint, Intuitive Surgical plans to transition to direct sales in parts of the European market in the first half of 2026, a move aimed at strengthening market presence and improving margins.

Estimates

The Sunnyvale, California-based medical device maker will publish its Q4 numbers on Thursday, January 22, at 4:05 pm ET. On average, Wall Street analysts expect adjusted earnings of $2.26 per share for the quarter, vs. $2.21 per share in Q4 2024. The positive forecast reflects an estimated 13.8% growth in December-quarter revenues to $2.75 billion. Intuitive Surgical has a strong track record of outperforming estimates – quarterly revenues and profits have consistently beaten estimates for nearly three years.

In a preliminary report published this week, the company projected an 18% annual growth in worldwide procedures and a 17% rise in Da Vinci procedures during the fourth quarter. Preliminary fourth-quarter revenue is around $2.87 billion, up 19% from the year-ago quarter.

Intuitive Surgical’s shares started 2026 on a high note, though momentum faded later, with the pullback extending into this week. Even so, the stock’s most recent close was above the 52-week average price of $522.66. At one point, the stock traded close to the all-time high reached about a year ago, and ISRG has gained nearly 6% over the past six months.

Double-Digit Gain

In the September quarter, adjusted earnings rose to $2.40 per share from $1.84 per share in Q3 2024, exceeding expectations. On a reported basis, net income was $704 million or $1.95 per share in the third quarter, compared to $565 million or $1.56 per share in the prior year. The bottom line benefited from a 23% jump in third-quarter revenues to $2.51 billion, which exceeded analysts’ consensus estimates. Worldwide da Vinci procedures grew approximately 19% year-over-year.

“Demand for da Vinci V upgrades drove strong domestic placements. We believe upgrades are an effective way for customers to expand throughput and capabilities. These capabilities include force sensing, surgeon autonomy, telepresence, and various other digital tools that may lead to enhanced understanding of what great surgery looks like and further adoption of robotic-assisted surgery over time. Additionally, it is our intent to offer refurbished Xi systems as part of our broader portfolio, which will help expand access in certain geographies and sites of care,” said the company’s president, David Rosa, in the Q3 FY25 earnings call.

The Market

For a long time, Intuitive Surgical has benefited from a first-mover advantage, as its da Vinci system was the first robotic-assisted surgical platform to receive FDA clearance for general laparoscopic surgery. Over the years, the company has maintained its market share through a differentiated business model and continued product innovation. However, the medical device market is witnessing increased competition — recently, Medtronic launched its Hugo robotic-assisted surgery system in the US after receiving FDA clearance for urologic procedures.

The stock experienced volatility in early trading on Thursday, after a modest opening. Meanwhile, analysts’ positive outlook indicates the stock might regain momentum ahead of the upcoming earnings.