Intuitive Surgical (ISRG) Q3 2026 Earnings Call: Q&A Summary

Q: Larry Biegelsen with Wells Fargo asked whether the recent U.S. procedure growth of 10% represents a temporary lull and if innovations and pricing actions will help accelerate growth next year.

A: Dave Rosa, CEO, and Jamie Samath, CFO, stated that the U.S. opportunity relies on expanding addressable markets, increasing capacity through strong system placements, growing ambulatory surgery center (ASC) adoption, and investing in new indications like cardiac and breast surgery.

Q: Robert Marcus with JPMorgan asked about the timeline of the extended use program (EUP) and China pricing, potential stocking impacts, and how elasticity will influence volumes.

A: Jamie Samath, CFO, explained that the blended headwind will be 3% to 5% once fully implemented across 2027 and that management has confidence in demand elasticity based on previous pricing initiatives.

Q: Travis Steed with Bank of America asked for an update on pipeline opportunities that can add revenue per procedure, specifically regarding AI use cases, imaging, GI robotics, and lung cancer.

A: Dave Rosa, CEO, highlighted active developments including Rose systems and endobronchial ultrasound for Ion, advanced visualization technologies like hyperspectral imaging, and upcoming AI features.

Q: Rick Wise with Stifel asked about progress in ambulatory surgery centers (ASCs), the impact of extended use approaches, and how competitive dynamics involving modular systems play in.

A: Dave Rosa, CEO, and Jamie Samath, CFO, noted that cart-based architectures remain the best balance of capability and usability, while noting that under 10% of U.S. soft tissue surgery is currently in ASCs.

Q: Adam Maeder with Piper Sandler asked about current adoption levels for force sensing instruments and whether any offsets are assumed in the 3% to 5% headwind.

A: Jamie Samath, CFO, stated that about 8% of da Vinci 5 cases involved force feedback in the quarter and pointed to SP procedure growth and integrated insufflation tube sets as revenue offsets.

Q: Jayson Bedford with Raymond James asked how long it will take to fully implement the EUP program and when to expect the gross impact on revenue per procedure.

A: Jamie Samath, CFO, stated that implementation will roll out country by country starting in the U.S. in late Q1 and Europe in the second half of 2027, reaching full impact by the end of the year.

Q: Matt Taylor with Jefferies asked what the customer settlement practically means for customers and if remanufacturing represents a real headwind.

A: Dave Rosa, CEO, and Jamie Samath, CFO, explained that the no-fault settlement provides a clear framework for working with third-party instrument manufacturers and service providers, strengthening customer relationships.

Q: Chris Pasquale with Barclays asked about considerations for profitability and the ability to continue expanding operating margins next year.

A: Jamie Samath, CFO, reiterated an operating margin target range of 35% to 40% and emphasized a priority to reinvest in innovative capabilities and growth drivers.