Intuitive Surgical Inc (NASDAQ: ISRG)

Sector: Healthcare Industry: Medical Instruments & Supplies CIK: 0001035267
Market Cap 174.27 Bn
P/B 9.78
P/E 61.02
P/S 17.31
ROIC (Qtr) 14.17
Div Yield % 0.00
Rev 1y % (Qtr) 18.76
Total Debt (Qtr) 0.00
Debt/Equity (Qtr) 0.00

About

Intuitive Surgical, Inc., known by its ticker symbol ISRG, is a prominent player in the medical technology industry, specializing in the design, development, and commercialization of robotic-assisted surgical systems. The company's primary business activities are centered around its da Vinci surgical system, an advanced technology that enables surgeons to perform complex procedures with enhanced precision, dexterity, and control. The da Vinci surgical system is a sophisticated piece of equipment, composed of several components including the surgeon...

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Price action

Investment thesis

Bull case

  • Operating cash flow of 3.03B provides exceptional 147.11x coverage of minority interest expenses 20.60M, showing strong core operations.
  • Tangible assets of 19.24B provide exceptional 37.97x coverage of deferred revenue 506.70M, showing strong service capability backing.
  • Robust free cash flow of 2.49B exceeds capital expenditure of 539.80M by 4.61x, indicating strong organic growth funding capability.
  • Operating cash flow of 3.03B provides strong 5.98x coverage of deferred revenue 506.70M, indicating service delivery capability.
  • Cash position of 3.37B provides exceptional 163.50x coverage of minority interest expenses 20.60M, indicating strong liquidity.

Bear case

  • Investment activities of 665.80M provide weak support for R&D spending of 1.31B, which is 0.51x, suggesting potentially insufficient investment in innovation relative to other capital deployment.
  • Cash reserves of 3.37B provide limited coverage of acquisition spending of (13.90M), which is -242.30x, suggesting aggressive expansion might strain liquidity if market conditions deteriorate.
  • The company's operating cash flow of 3.03B shows concerning coverage of stock compensation expenses of 788.20M, with a 3.84 ratio indicating potential earnings quality issues.
  • Operating cash flow of 3.03B is outpaced by equity issuance of (1.95B) (-1.56 ratio), indicating concerning reliance on equity markets for funding operations.
  • Short-term investments of 2.57B exceed receivables of 1.53B by 1.68x, indicating potentially inefficient capital allocation given collection cycle needs.

Geographic Distribution Breakdown of Revenue (2025)

Geographic Distribution Breakdown of Revenue (2025)

Peer comparison

Companies in the Medical Instruments & Supplies
S.No. Ticker Company Market Cap P/E P/S Total Debt (Qtr)
1 ISRG Intuitive Surgical Inc 174.27 Bn 61.02 17.31 0.00 Bn
2 BDX Becton Dickinson & Co 59.72 Bn 37.77 3.14 19.18 Bn
3 RMD Resmed Inc 39.76 Bn 26.76 7.37 0.85 Bn
4 ALC Alcon Inc 38.93 Bn 37.18 3.82 5.24 Bn
5 WST West Pharmaceutical Services Inc 17.69 Bn 133.13 12.54 0.30 Bn
6 HOLX Hologic Inc 16.81 Bn 30.91 4.07 2.52 Bn
7 COO Cooper Companies, Inc. 16.37 Bn 43.67 4.00 2.51 Bn
8 ALGN Align Technology Inc 13.73 Bn 36.29 3.45 0.09 Bn

Industry comparisons

Current Valuation Value Ind Avg Percentile
EV to Assets EV to Assets 8.38 2.75
EV to Cash from Ops. EV/CFO 56.58 39.87
EV to Debt EV to Debt 0.00 27.09
EV to EBIT EV/EBIT 52.10 32.86
EV to EBITDA EV/EBITDA 47.33 19.31
EV to Free Cash Flow [EV/FCF] EV/FCF 68.84 0.88
EV to Market Cap EV to Market Cap 0.98 -4.26
EV to Revenue EV/Rev 17.04 252.61
Price to Book Value [P/B] P/B 9.78 6.13
Price to Earnings [P/E] P/E 61.02 184.03
Dividend Metrics Value Ind Avg Percentile
Dividend Coverage Ratio Dividend Coverage Ratio 0.00 -1.09
Dividend Payout Ratio % Div Payout % (Qtr) 0.00 1.36
Dividend per Basic Share Div per Share (Qtr) 0.00 0.25
FCF Dividend Payout Ratio % FCF Div Payout % (Qtr) 0.00 8.74
Interest Coverage Interest Coverage 0.00 -117.83
Growth Metrics Value Ind Avg Percentile
Capex Growth (1y) % Capex 1y % (Qtr) 51.42 -53.47
Cash and Equivalents Growth (1y) % Cash & Equiv 1y % (Qtr) 66.12 414.02
Dividend Growth (1y) % Dividend Growth (1y) % 0.00 -1.48
EBIAT Growth (1y) % EBIAT 1y % (Qtr) 22.97 -57.42
EBITDA Growth (1y) % EBITDA 1y % (Qtr) 27.17 -106.89
EBIT Growth (1y) % EBIT 1y % (Qtr) 23.77 -37.00
EBT Growth (1y) % EBT 1y % (Qtr) 23.77 -42.63
EPS Growth (1y) % EPS 1y % (Qtr) 22.32 -15.05
FCF Growth (1y) % FCF 1y % (Qtr) 91.03 56.29
Gross Profit Growth (1y) % Gross Profit 1y % (Qtr) 17.89 67.95
Liquidity Ratios Value Ind Avg Percentile
Asset Utilization Ratio Asset Util Ratio (Qtr) 0.49 0.54
Cash Payout Ratio Cash Payout (Qtr) 0.00 0.03
Cash Ratio Cash Ratio (Qtr) 1.68 2.51
Current Ratio Curr Ratio (Qtr) 4.88 7.80
Debt to Equity Ratio Debt/Equity (Qtr) 0.00 0.55
Interest Cover Ratio Interest Cover Ratio 0.00 -117.83
Times Interest Earned Times Interest Earned 0.00 -117.83
Profitability Value Ind Avg Percentile
EBITDA Margin % EBITDA Margin % (Qtr) 39.40 -2,368.59
EBIT Margin % EBIT Margin % (Qtr) 32.70 -2,472.59
EBT Margin % EBT Margin % (Qtr) 32.70 -2,442.52
Gross Margin % Gross Margin % (Qtr) 66.00 30.06
Net Profit Margin % Net Margin % (Qtr) 28.40 -2,438.49