Oct 20, 2026 earnings call — Pricing actions and product adoption drive procedure growth
Management said pricing actions will reduce da Vinci I&A revenue per procedure by approximately 3% to 5% once fully implemented.
Revenue $3.0B (est $2.9B) · EPS $3.00 (est $2.65)
Key quotes
"Today, we are also quantifying the instrument pricing actions we discussed in July, which we expect to reduce da Vinci I&A revenue per procedure by approximately 3% to 5% on a mix-constant basis once fully implemented."
"In Q3, total procedures increased 15%, driven by 14% growth in da Vinci procedures and 31% growth in Ion procedures."
"Compared with laparoscopy, da Vinci procedures were associated with 54% lower odds of conversion with significant reductions observed in benign hysterectomy, ventral and inguinal hernia repair, myomectomy, cholecystectomy and benign colon surgery."
Analyst Q&A 8
U.S. procedure growth outlook
Q (Larry Biegelsen · Wells Fargo): He asked if the recent slow U.S. da Vinci growth is temporary and whether innovations and pricing actions will accelerate U.S. procedures as soon as next year.
A: Management said the U.S. opportunity has two parts: the near-term addressable procedures and longer-term new indications. Customers are now building routine dashboards showing robotics compares favorably, and Intuitive pointed to data, portfolio, commercial capacity, pricing and ecosystem as the foundation for durable U.S. procedure growth. They highlighted four focus areas: adding capacity (U.S. net placements rose 41%), ASC focus, advancing cardiac and breast, and R&D for new indications over longer horizons.
"First is adding capacity, particularly to support the benign general surgery growth." — Jamie Samath (CFO)
Extended use impact and elasticity
Q (Robert Marcus · JPMorgan): He asked about timelines and possible stocking around extended use, the gross and operating margin impact, and how volumes might respond to the pricing actions.
A: They said there may be some minor stocking-related ordering volatility but they don't expect it to be significant and will call it out. Management expects a modest gross margin impact across '27 to be offset by cost reduction programs, so any effect on operating margin should be small and ultimately offset during the year; they also said they believe the pricing actions will drive elasticity, especially where cost is a barrier to adoption for high-volume benign procedures.
"In terms of the impact on gross margin, I would say that it would be a modest impact on gross margin that we'll look across '27 to offset with the cost reduction programs that we have in play." — Jamie Samath (CFO)
Pipeline items that add revenue per case
Q (Travis Steed · BofA): He asked which pipeline items could add revenue per procedure, including AI, imaging, GI robot work, and lung cancer programs.
A: They named two Ion development programs: a ROSE on-site cytology system and endobronchial ultrasound integrated into Ion to enable staging. Management said both should speed detection-to-diagnosis and be accretive to revenue per case on Ion, and they also have vision programs for da Vinci (hyperspectral imaging, fluorescent molecules, AI features) that they expect will add revenue per procedure.
"Both of those should be and bring value to the Ion program, speed up the time, we think, from detection to diagnosis and ultimately treatment, but will be accretive to the revenue per case on the Ion platform." — David Rosa (CEO)
ASC opportunity and competition
Q (Frederick Wise · Stifel): He asked about progress in ASCs, how EUP might affect the opportunity, and whether Intuitive needs a modular system given competitors offering modular platforms.
A: Management said ASC customers want repeatable, easy-to-learn, reliable solutions and that choices hinge on architecture, pricing that fits ASC economics, a broader ecosystem, and supporting infrastructure. They believe a cart-based da Vinci architecture is the best balance of capability and usability and that a modular architecture is not required; Jamie added that slightly under 10% of U.S. soft tissue surgery is in ASCs today, about 70% of that is affiliated with IDNs, and overall ASC penetration is low in the first quartile, so XiR supply makes ASCs a focus.
"we believe that it is not required to have a modular type of architecture to serve the needs of the customer in these segments where they are doing benign procedures and maybe increasingly complex procedures over time." — David Rosa (CEO)
Force sensing instrument adoption
Q (Adam Maeder · Piper Sandler): He asked whether force sensing instruments offset the EUP headwind, current adoption rates, how adoption could evolve, and the main use cases.
A: David gave an anecdote where a leading prostate surgeon attributed about a 10-point improvement in potency recovery to Force Feedback, suggesting it can improve outcomes. Jamie said about 8% of da Vinci 5 cases involved Force Feedback this quarter (supply was fully available later in the quarter), they aim for much higher penetration pending evidence, and noted other offsets: SP I&A per procedure is higher than multi-port and integrated insufflation (used about 85% of the time) adds about $100 per procedure, which can offset the 3% to 5% headwind.
"In terms of adoption, this quarter, about 8% of da Vinci 5 cases involve Force Feedback." — Jamie Samath (CFO)
EUP rollout timing
Q (Jayson Bedford · Raymond James & Associates): He asked how long full implementation of the EUP will take, when the 3% to 5% gross impact per procedure will appear, and the expected impact in 2027.
A: Jamie said the rollout will be country-by-country, starting with the U.S.; the U.S. submission is in process and they expect to start rolling out later in Q1 pending clearance. Europe would come next in the second half of '27 and other markets around that timing, and they don't expect to reach the full impact until the end of the year.
"So I don't think we get to the full impact until the end of the year, frankly." — Jamie Samath (CFO)
Settlement and remanufacturing impact
Q (Matthew Taylor · Jefferies): He asked what the one-time, no-fault settlement means practically for customers and whether remanufacturing has been a headwind.
A: They said the settlement is an agreement with customers about third-party instrument remanufacturers and third-party service providers and it provides a clear framework for continued cooperation in those areas. Management said this lets them focus on advancing safety, quality and security, and Gary added the resolution strengthens customer relationships and defines how they work together on instruments and servicing.
"So this settlement really is an agreement with our customers, specifically regarding third-party instrument remanufacturers and third-party service providers." — David Rosa (CEO)
Margins and future profitability
Q (Chris Pasquale · Barclays): He asked what factors to consider for profitability beyond offsetting EUP, and how management views the ability to keep expanding margins.
A: Jamie said their expected operating margin range is between 35% and 40% and they plan to invest in innovation and capability where it drives differentiated value and growth. He noted current margins (41%, 42%) give them capacity to invest, they will finish planning and decide on operating expenses, and will give guidance in January; David closed with broader company comments.
"I think what we've said for some time now is kind of the range of where we'd expect to be on operating margin is between 35% and 40%." — Jamie Samath (CFO)