ISRG vs ALC vs PEN Stock Comparison

Intuitive Surgical, Alcon and Penumbra Prices as of Oct 26, 2026 Peers: Industry group
ISRG Intuitive Surgical Inc
$451.63 +11.5% 1M -17.4% 1Y
Market cap
$157.49B
P/E
53.3x
Revenue (TTM)
$11.58B
Div. yield
–
Medical Devices Healthcare
6 wins
ALC Alcon Inc
$70.00 +8.6% 1M -8.0% 1Y
Market cap
$34.30B
P/E
53.3x
Revenue (TTM)
$10.80B
Div. yield
–
Medical Devices Healthcare
1 win
PEN Penumbra Inc
$325.19 +2.0% 1M +28.5% 1Y
Market cap
$12.81B
P/E
79.7x
Revenue (TTM)
$1.50B
Div. yield
–
Medical Devices Healthcare
2 wins

Head to Head

9 decided of 12

Intuitive Surgical leads on 6 of the 12 questions below (Intuitive Surgical 6, Penumbra 2, Alcon 1). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionISRGALCPENLeader
Larger companyMarket capitalisation $157.49B $34.30B $12.81B ISRG
Cheaper on earningsLower P/E, profitable companies only 53.3x 53.3x 79.7x ISRG
Cheaper on forward earningsLower price / next fiscal year consensus EPS 39.5x 21.7x 72.6x ALC
Faster revenue growthRevenue growth, trailing twelve months +20.5% +8.5% +17.6% ISRG
More profitableNet margin, trailing twelve months 25.5% 6.0% 10.7% ISRG
Better return on capitalReturn on invested capital — 3.6% — –
Less leveragedLower net debt / EBITDA — — — –
Higher dividend yieldTrailing dividend yield 0.00% 0.00% — –
Better 1-year returnPrice return, last 12 months -17.4% -8.0% +28.5% PEN
Better 5-year returnAnnualised price return, 5 years +5.3%/yr -3.0%/yr +3.7%/yr ISRG
Less volatileAnnualised volatility, 1 year 34.6% 28.7% 26.4% PEN
Higher overall scoreMean of the five percentile scores vs peers 80/100 68/100 74/100 ISRG

Percentile Scorecard

ISRGALCPEN

Each axis is the mean percentile of its metrics against the company's industry group. 100 is the best in the group, 50 the middle.

Scores by Axis

AxisISRGALCPEN
Valuation 53 #108 of 228 79 #48 of 228 55 #104 of 228
Growth 80 #45 of 221 47 #118 of 221 94 #15 of 221
Profitability 98 #6 of 208 76 #50 of 208 87 #29 of 208
Financial Health 78 #53 of 239 61 #95 of 239 85 #37 of 239
Shareholder Returns 92 #12 of 137 75 #35 of 137 49 #70 of 137
Overall 80 68 74
  • ISRG ranked among 248 companies in Medical Devices and Diagnostics
  • ALC ranked among 248 companies in Medical Devices and Diagnostics
  • PEN ranked among 248 companies in Medical Devices and Diagnostics

Price Performance

Price return, split-adjusted, before dividends. Click a name to hide or show it.

Returns

PeriodISRGALCPENSPY
1 month +11.5%+8.6%+2.0% -0.8%
3 months +26.6%+4.1%+1.8% +3.5%
6 months -4.1%-7.9%-0.9% +7.0%
Year to date -20.3%-11.2%+4.6% +12.2%
1 year -17.4%-8.0%+28.5% +13.0%
3 years +74.4%0.0%+68.7% +86.3%
3 years, per year +20.4%0.0%+19.0% +23.1%
5 years +29.4%-14.3%+19.8% +68.6%
5 years, per year +5.3%-3.0%+3.7% +11.0%
10 years +510.6%—+386.4% +258.0%
10 years, per year +19.8%—+17.1% +13.6%

Risk

MeasureISRGALCPENSPY
Volatility, 1Y 34.6%28.7%26.4% 12.7%
Downside volatility, 1Y 37.5%28.9%17.8% 12.7%
Beta vs S&P 500, 1Y 0.900.380.06 1.00
Return / volatility, 1Y -0.50-0.281.08 1.02
Max drawdown, 5Y -49.9%-38.4%-59.7% -25.4%
From 52-week high -23.8%-19.7%-9.5% -1.8%
52-week high $592.85$87.18$359.40 $779.14
52-week low $332.02$62.02$225.54 $631.97

Valuation History

Weekly multiples on trailing twelve-month fundamentals. Negative or extreme readings (a loss year, a collapsed denominator) are left out so the chart stays readable.

MultipleISRGALCPEN
P/E now vs peer median 53.3xmedian 30.6x 53.7xmedian 30.6x 79.7xmedian 30.6x
P/S now vs peer median 13.5xmedian 3.0x 3.2xmedian 3.0x 8.5xmedian 3.0x
EV/EBITDA now vs peer median 37.3xmedian 17.5x —median 17.5x 59.4xmedian 17.5x
P/FCF now vs peer median 43.5xmedian 23.3x 19.6xmedian 23.3x 59.3xmedian 23.3x
P/B now vs peer median 9.7xmedian 2.4x 1.6xmedian 2.4x 8.4xmedian 2.4x
PEG now vs peer median 2.07median 0.87 2.56median 0.87 1.05median 0.87

Financial History

Reported figures by fiscal period, placed on the calendar year (or quarter) each period ended in, so companies with different fiscal years line up.

Trailing twelve monthsISRGALCPEN
Revenue $11.58B $10.80B $1.50B
Gross profit $7.78B $6.17B $1.02B
Operating income $3.28B $948.00M $187.34M
Net income $2.97B $643.00M $160.59M
Free cash flow $3.60B $1.74B $215.91M
R&D $1.49B $1.43B $92.25M
EPS (diluted) $8.41 $1.30 $4.06
Cash & equivalents $2.98B $1.36B $205.27M
Total debt – $4.72B –
Shares (diluted) 351.60M 496.20M 39.57M
Enterprise value $137.78B $25.27B $10.52B

All Metrics

58 metrics · best in bold

Bold marks the best reading: the lowest positive value for multiples, leverage and payout, the highest for everything else. The bar under each value is its percentile against that company's own peers. Hover a value for its rank and the peer median.

Valuation

12 metrics
MetricISRGALCPEN
P/E 53.3x 53.7x 79.7x
P/FCF 43.5x 19.6x 59.3x
P/Operating cash flow 38.3x 14.8x 46.1x
P/S 13.5x 3.2x 8.5x
P/B 9.7x 1.6x 8.4x
P/Tangible book 10.5x 2.6x 8.4x
EV/EBITDA 37.3x – 59.4x
EV/EBIT 46.4x 38.7x 64.9x
EV/Revenue 13.2x 3.4x 8.1x
EV/FCF 42.4x 21.1x 56.3x
EV/Operating cash flow 37.3x 15.9x 43.7x
PEG (3Y EPS CAGR) 2.07 2.56 1.05

Growth

14 metrics
MetricISRGALCPEN
Revenue growth (1Y) 20.5% 8.5% 17.6%
Revenue CAGR (3Y) 19.1% 5.9% 17.1%
Gross profit growth (1Y) 21.9% 11.7% 20.0%
Gross profit CAGR (3Y) 19.5% 7.3% 19.9%
Operating income growth (1Y) 16.6% -34.3% 17.6%
Operating income CAGR (3Y) 24.8% 7.5% 73.0%
Net income growth (1Y) 7.5% -40.1% 8.7%
Net income CAGR (3Y) 24.4% 21.1% 76.7%
EPS growth (1Y) 10.8% -40.7% 7.8%
EPS CAGR (3Y) 25.7% 21.0% 76.1%
Operating cash flow growth (1Y) 38.1% 10.3% 37.9%
Operating cash flow CAGR (3Y) 26.4% 25.9% 146.0%
Free cash flow growth (1Y) 58.4% 7.5% 33.6%
Free cash flow CAGR (3Y) 42.0% 48.0% 650.9%

Profitability

14 metrics
MetricISRGALCPEN
Gross margin 67.2% 57.2% 67.8%
EBITDA margin 35.3% – 13.6%
Operating margin 28.4% 8.8% 12.4%
Pretax margin 31.3% 6.9% 13.5%
Net margin 25.5% 6.0% 10.7%
FCF margin 31.1% 16.1% 14.3%
Operating cash flow margin 35.3% 21.4% 18.5%
Return on equity 17.3% 2.9% 10.7%
Return on assets 14.8% 2.1% 8.3%
Return on invested capital – 3.6% –
Return on capital employed 18.7% 3.4% 11.0%
Asset turnover 0.6x 0.3x 0.8x
Cash conversion (OCF / net income) 1.4x 3.6x 1.7x
Stock comp / revenue 7.2% 1.6% 4.0%

Financial Health

11 metrics
MetricISRGALCPEN
Debt / assets – 15.2% –
Debt / equity – 0.2x –
Net debt / EBITDA – – –
Debt / FCF – 2.7x –
Liabilities / assets 16.7% 30.6% 22.5%
Equity / assets 83.3% 69.4% 77.5%
Interest coverage – 9.2x –
Current ratio 3.3x 2.1x 5.7x
Quick ratio 2.3x 1.3x 3.6x
Cash ratio 1.6x 0.7x 2.8x
Altman Z-score 30.92 – 19.28

Shareholder Returns

7 metrics
MetricISRGALCPEN
Dividend yield – 0.4% –
Net buyback yield 2.7% 2.7% -0.2%
Shareholder yield 2.7% 3.1% -0.2%
Payout ratio (earnings) – – –
Payout ratio (FCF) – – –
Dividend growth (1Y) – – –
Dividend CAGR (3Y) – – –

Analyst Estimates

Solid lines are reported fiscal-year results; dashed lines are the consensus for the years ahead. Hover a year for the analysts' high and low, and how each result compared with its estimate.

ConsensusISRGALCPEN
Forward P/E 39.5xFY2026 21.7xFY2026 72.6xFY2026
EPS, next fiscal year $11.42FY2026 $3.23FY2026 $4.48FY2026
EPS growth, next FY +27.9%FY2026 +8.0%FY2026 +16.7%FY2026
EPS growth, the year after +4.4% +15.8% +42.6%
Revenue, next fiscal year $11.57BFY2026 $10.54BFY2026 $1.63BFY2026
Revenue growth, next FY +15.0%FY2026 +4.7%FY2026 +16.3%FY2026
Revenue growth, the year after +11.5% +8.1% +7.5%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersISRGALCPEN
Held by institutions 86.2% 48.8% 86.6%
Institutions holding 2,235 629 451
Change in shares held, QoQ +4.6% +5.3% +0.9%
Institutions buying 1,070 225 195
Institutions selling 877 274 182
Buyers to sellers 1.22 0.82 1.07

Return Correlation

Daily returns, last 12 months

1.00 means two stocks move in lockstep, 0 that they move independently. Pairs below about 0.5 diversify each other.

ISRGALCPEN
ISRG 1.00 0.39 0.12
ALC 0.39 1.00 0.16
PEN 0.12 0.16 1.00

Add a Peer

Largest companies in the same industry

Related Comparisons

Frequently Asked Questions

Which is bigger, ISRG, ALC and PEN?

Intuitive Surgical (ISRG) is the largest by market capitalisation: Intuitive Surgical (ISRG) $157.49B, Alcon (ALC) $34.30B, Penumbra (PEN) $12.81B.

Which stock is cheaper, ISRG, ALC and PEN?

Intuitive Surgical (ISRG) trades on the lowest price-to-earnings ratio (Intuitive Surgical (ISRG) 53.3x, Alcon (ALC) 53.3x, Penumbra (PEN) 79.7x). On next year's consensus earnings, Alcon (ALC) is cheapest (Intuitive Surgical (ISRG) 39.5x, Alcon (ALC) 21.7x, Penumbra (PEN) 72.6x). A lower multiple can reflect slower expected growth, so read it next to the growth figures.

Which company is growing faster?

Intuitive Surgical (ISRG) grew revenue fastest over the trailing twelve months: Intuitive Surgical (ISRG) +20.5%, Alcon (ALC) +8.5%, Penumbra (PEN) +17.6%.

Which company is more profitable?

Intuitive Surgical (ISRG) has the highest net margin (Intuitive Surgical (ISRG) 25.5%, Alcon (ALC) 6.0%, Penumbra (PEN) 10.7%).

Which stock has performed better?

Over the past year Penumbra (PEN) returned the most: Intuitive Surgical (ISRG) -17.4%, Alcon (ALC) -8.0%, Penumbra (PEN) +28.5%. Over five years, Intuitive Surgical (ISRG) compounded fastest (Intuitive Surgical (ISRG) +5.3%/yr, Alcon (ALC) -3.0%/yr, Penumbra (PEN) +3.7%/yr). Returns are price only, before dividends.

Which stock is riskier?

By one-year price volatility, Penumbra (PEN) has been the steadiest (Intuitive Surgical (ISRG) 34.6%, Alcon (ALC) 28.7%, Penumbra (PEN) 26.4%). Volatility measures how widely the price swings, not the risk of the business.

Which is the better stock, ISRG, ALC and PEN?

There is no single answer; it depends on what you are buying for. On the 12 head-to-head measures on this page, Intuitive Surgical (ISRG) leads on 6. Business Quant does not give investment advice; use the comparison as a starting point for your own research.

Data from SEC filings, exchange prices and consensus estimates, via Business Quant. Percentile scores compare each company with its own peer group, so two companies' scores are each relative to different peers unless you rank against the whole market. Price returns exclude dividends. Nothing on this page is investment advice.