Intuitive Surgical ISRG is focusing on Ambulatory surgery centers (ASCs) as an important channel for its robotic-surgery expansion. The company is targeting the low-cost ASC segment with refurbished XiR platforms priced below its flagship model. This strategy resulted in significant growth in ASC placements during the second quarter.
ISRG placed 27 da Vinci systems at ASCs in the United States, with 20 of those being refurbished XiR platforms. Management also stated that the increase reflected its recent focus on the ASC segment, while describing the placements as part of broader greenfield expansion.
The growing ASC opportunity aligns with the broader shift toward outpatient surgery, where economics and procedure mix can differ substantially from those of traditional hospitals. Intuitive Surgical is addressing this market through a segmented portfolio rather than relying exclusively on its newest and most expensive platforms.
XiR provides a lower-cost entry point while retaining access to the broader fourth-generation da Vinci ecosystem, making robotic surgery more accessible to cost-conscious customers. Management said XiR has been particularly attractive to ASCs and smaller hospitals, while gaining traction internationally.
This strategy could expand Intuitive Surgical’s addressable customer base. Management noted that XiR can introduce robotics to new customers, helping them establish robotic programs and potentially adopt more advanced systems over time. About 130 XiR systems were installed globally over the past year, with approximately 50 in the United States.
Procedure economics could provide another catalyst. Intuitive Surgical plans to introduce extended-use EndoWrist instruments in 2027, targeting lower cost per procedure in high-volume benign procedures. Management specifically linked the initiative to opportunities in benign outpatient procedures and cost-constrained markets.
Thus, ASCs represent more than another sales channel. They provide Intuitive Surgical with an avenue to expand robotic adoption through lower-cost systems, new facilities and potentially broader procedure utilization, while leveraging its established ecosystem.
Peer Updates
Stryker SYK is positioning its broad orthopedic and MedSurg portfolio to capitalize on the continued migration of procedures toward ASCs. Management said the shift in orthopedic site of care should continue and views ASCs as an opportunity to win across its portfolio, including hips and knees.
The company is also using Mako RPS to address a specific ASC customer segment — surgeons who are not ready to adopt the full Mako platform but want robotic assistance for total-knee procedures. Following a limited second-quarter launch and early conversions, Stryker plans to ramp up Mako RPS commercialization. Its broader ASC strategy also benefits from products across surgical technologies, communications and other portfolio categories.
Zimmer Biomet ZBH is approaching the ASC market through a combination of technology, surgical products and a broader customer-centric portfolio. Management explicitly identified stronger surgical performance in the second quarter as part of its ASC strategy. Technology remains a major growth driver, supported by a strong robotics pipeline and products spanning large-footprint robotics, handheld technologies, CT and non-CT solutions and mixed reality.
The company is also emphasizing efficiency rather than simply implant pricing in the ASC setting. Management noted that implants account for only about 14-15% of ASC costs, highlighting the importance of reducing surgical time, avoiding inpatient transfers and lowering readmission rates. ZBH is also evaluating adjacent acquisitions in areas where procedures are primarily performed in ASCs.
ISRG’s Price Performance, Valuation and Estimates
Shares of ISRG have lost 30.6% so far this year compared with a 6.9% decline of the industry.
Image Source: Zacks Investment Research
From a valuation standpoint, Intuitive Surgical trades at a forward price-to-earnings ratio of 33.81X, above the industry average. But it is significantly lower than its five-year median of 67.76X. ISRG carries a Value Score of F.
Image Source: Zacks Investment Research
The Zacks Consensus Estimate for Intuitive Surgical’s 2026 earnings implies a 20.3% rise from the year-ago period’s level.
Image Source: Zacks Investment Research
The stock currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Beyond Nvidia: AI's Second Wave Is Here
The AI revolution has already minted millionaires. But the stocks everyone knows about aren't likely to keep delivering the biggest profits. AI’s second wave is moving from infrastructure to implementation and these companies are at the forefront of this transition, positioned to become what Amazon and Google were to the internet era.
See Stocks Now >>Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report
Intuitive Surgical, Inc. (ISRG): Free Stock Analysis Report
Stryker Corporation (SYK): Free Stock Analysis Report
Zimmer Biomet Holdings, Inc. (ZBH): Free Stock Analysis Report
This article originally published on Zacks Investment Research (zacks.com).