Intuitive Surgical ISRG is set to report first-quarter 2026 earnings on April 21. The Zacks Consensus Estimate for sales and earnings is pegged at $2.61 billion and $2.08 per share, respectively. Earnings per share (EPS) estimates for ISRG have declined 1 cent to $9.96 for 2026 and 3 cents to $11.32 for 2027 over the past 30 days.
The company heads into first-quarter earnings season following a strong finish to 2025, marked by robust procedure growth, expanding system placements and accelerating adoption of its next-generation robotic platforms. While fourth-quarter momentum was broad-based across geographies and product lines, the key question for investors is whether this strength was sustained into the first quarter amid macro pressures, pricing headwinds and rising competition.
Intuitive Surgical’s close peers, Thermo Fisher Scientific TMO and Boston Scientific BSX, are slated to announce their quarterly numbers in the upcoming weeks. (Stay up to date with all quarterly releases: See Zacks Earnings Calendar.)
Earnings Surprise History
In the last reported quarter, ISRG delivered an earnings surprise of 12.44%. Its earnings beat estimates in each of the trailing four quarters, delivering an average surprise of 13.24%.
In the last reported quarter, Thermo Fisher Scientific and Boston Scientific delivered an earnings surprise of 2.18% and 2.56%, respectively.
Intuitive Surgical, Inc. Price and EPS Surprise
Intuitive Surgical, Inc. price-eps-surprise | Intuitive Surgical, Inc. Quote
What the Zacks Model Unveils
Our proven model does not conclusively predict an earnings beat for Intuitive Surgical this time around. The combination of a positive Earnings ESP and a Zacks Rank #1 (Strong Buy), 2 (Buy) or 3 (Hold) increases the chances of an earnings beat. This is not the case here, as you will see below.
ISRG has an Earnings ESP of 0.00% and a Zacks Rank #3 at present. You can see the complete list of today’s Zacks #1 Rank stocks here.
Key Factors Likely Driving Q1 Performance
Intuitive Surgical’s core growth engine — procedures — likely remained resilient in the first quarter, supported by continued strength in U.S. general surgery and acute care procedures. Fourth-quarter trends showed strong after-hours procedure growth and sustained utilization gains, particularly driven by the adoption of the da Vinci 5 platform, a trend that’s likely to have continued in the first quarter.
International markets, including India, Korea and distributor-led regions, also delivered strong growth exiting 2025, suggesting continued momentum into the soon-to-be-reported quarter. However, capital constraints in Europe and slower recovery in Japan might have moderated growth rates.
Segmental Performance Outlook
Instruments & Accessories (I&A): This segment is expected to have remained the primary revenue driver in the first quarter, benefiting from higher procedure volumes and increased adoption of da Vinci 5 and SP instruments. Pricing pressure — particularly in China and within U.S. ambulatory surgery centers (ASCs) — might have weighed on revenue per procedure despite volume growth.
Systems: System placements likely remained strong, supported by ongoing da Vinci 5 upgrades and trade-in cycles. Hospitals evaluating efficiency gains and workflow improvements have continued to favor da Vinci 5, which demonstrated higher utilization than prior-generation systems. Softer capital spending in certain international markets and competitive intensity in China must have limited upside.
Services: Recurring revenue streams, including service contracts and digital ecosystem offerings such as telepresence and case insights, likely saw steady growth. Increasing integration of data analytics and AI-driven tools is enhancing customer stickiness and long-term monetization potential, which might have led to higher revenues in the first quarter.
Ion Platform: The Ion bronchoscopy platform remains an emerging growth lever. Continued expansion in lung biopsy procedures and ongoing investments in adjunct technologies such as ROSE and endobronchial ultrasound likely supported modest sequential growth in the quarter.
Price Performance & Valuation
Intuitive Surgical’s shares have lost 17.3% so far this year compared with the industry’s 11.5% decline. The company’s shares have underperformed the S&P 500 Index’s gain of 1.9% as well as the Zacks Medical sector’s decrease of 5%.
ISRG has underperformed Thermo Fisher Scientific’s 8.2% decline but outperformed Boston Scientific’s 32.2% decline year to date.
YTD Price Performance
Image Source: Zacks Investment Research
Now, let us take a look at the value Intuitive Surgical offers to its investors at current levels.
ISRG is trading at a premium compared to its industry, with a forward 12-month P/E of 45.23X compared with the industry’s 26.25X. The current valuation came down from a five-year high of 96.05X but is higher than the five-year low of 41.90X. ISRG has traded at a premium to the industry valuation over the past five years, reflecting its higher growth prospects. The current Value score of D reflects a high valuation.
ISRG's P/E F12M Graph
Image Source: Zacks Investment Research
Investment Thesis
Intuitive Surgical entered first-quarter 2026 with strong underlying momentum, driven by sustained procedure growth, expanding installed base and increasing adoption of advanced platforms like da Vinci 5, SP and Ion. The company’s long-term growth trajectory remains intact, supported by a large untapped market for minimally invasive surgery and continuous innovation across robotics, imaging and digital ecosystems.
However, near-term challenges persist. Pricing pressure in key markets, lower-margin mix from newer platforms, tariff impacts and macro-driven capital constraints could weigh on profitability. Moreover, elevated valuation levels continue to limit upside potential in the absence of meaningful earnings acceleration.
Conclusion
Intuitive Surgical has strong fundamental factors supporting its uptrend, along with a favorable Zacks Rank. The Style Score of C reflects moderate strength in the stock. However, an earnings beat for the fourth quarter remains inconclusive. So, we will advise investors to wait for the earnings release before making an entry into the stock.
Although the company’s valuation has declined, it still trades above the industry average. The premium likely reflects strong fundamentals, including growth in procedures and its installed base.
While current shareholders may hold their position, new investors should wait for the first-quarter results and analyze the new updates before making an entry. However, the valuation may remain elevated as ISRG expands system placements outside the United States, increases utilization within existing U.S. accounts and broadens into additional indications.
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This article originally published on Zacks Investment Research (zacks.com).