# Intuitive Surgical (ISRG): sales up 22% to $3.05bn, but a $450m antitrust settlement cuts reported profit 26%

> Intuitive Surgical, the maker of the da Vinci surgical robots, reported third-quarter sales of $3.05bn, up 22% from a year ago, and profit before…

- URL: https://centiview.com/post/intuitive-surgical-isrg-sales-up-22-to-3-05bn-but-a-450m-antitrust-settlement-cuts-reported-profit-26
- Published: 2026-10-21T03:20:00.000Z
- Sectors: Healthcare
- Region: US
- Ticker: ISRG
- Sentiment (opinion, not a recommendation): neutral
- Publisher: Centiview (Persie Ltd, London)
- General information only, not financial advice

Intuitive Surgical, the maker of the da Vinci surgical robots, reported third-quarter sales of $3.05bn, up 22% from a year ago, and profit before one-off items of $3.00 per share, up 25%. Reported profit fell 26% to $523m because of a $450m charge to settle an antitrust class action.

## What happened

On 20 October 2026 Intuitive Surgical published results for the three months to 30 September, in a release filed with the US Securities and Exchange Commission (SEC). Sales were $3,048.7m against $2,505.1m a year earlier. The company makes robotic systems that let surgeons operate through small cuts using instruments they control from a console, and it earns money three ways: selling the systems, selling the instruments and accessories used in each operation, and charging for servicing. Worldwide procedures, the operations carried out with its systems, grew about 15%. Procedures on the main da Vinci system grew about 14%, and procedures on its Ion system, used to take samples from the lungs, grew about 31%.

The same day, Intuitive said it had agreed in October, after mediation, to pay $450m to settle the class action known as "In re: da Vinci Surgical Robot Antitrust Litigation", without admitting liability, and to accept agreed changes to how it operates, called injunctive relief. The charge was booked in the third quarter. The settlement still needs approval from the court and may draw objections from members of the class. After the results, shares fell in after-hours trading. GuruFocus reported a fall of nearly 7%; Investing.com reported 13.2%. The sources disagree on the size and timing, so we treat the move as preliminary.

## The numbers, explained

Sales by type: instruments and accessories, the largest part, rose 18.3% to $1,797.4m from $1,518.8m (about 59% of sales). Systems rose 30.3% to $769.1m from $590.4m. Services rose 21.8% to $482.2m from $395.9m. The three lines add up to the $3,048.7m total. Intuitive placed 546 da Vinci systems, up 27.9% from 427, including 315 of the newest da Vinci 5, up 31.3% from 240. Its installed base, the number of systems in hospitals, reached 12,094, up 12.4% from 10,763. Since each system keeps generating instrument and service sales, a growing base supports future sales.

Profit has two versions. Under GAAP, the standard accounting rules, income from operations was $592.6m against $759.7m, down 22.0%, an operating margin of 19.4% against 30.3% (592.6 / 3,048.7 and 759.7 / 2,505.1, our working). Net income attributable to shareholders was $522.8m against $704.4m, down 25.8%, or $1.49 per diluted share against $1.95, down 23.6%. The company's non-GAAP figures leave out items such as the settlement and share-based pay. On that basis operating income rose 30.1% to $1,269.7m (a 41.6% margin against 39.0%), and profit per share rose 25.0% to $3.00 from $2.40. The company says the settlement cost $347m after tax, or $0.99 per share ($347m / 351.6m shares, our check).

Other measures: GAAP gross margin, the share of sales left after the direct cost of making and servicing the products, was 68.4% against 66.4%; the non-GAAP version was 69.9% against 68.0%. The diluted share count fell 2.8% to 351.6m from 361.8m because the company bought back 7.8m shares for $2.94bn in the quarter, about $377 a share on average. Cash and investments were $6,800.4m, down $1.83bn in the quarter. Analysts had expected about $2.64 to $2.65 per share and about $2.91bn of sales, according to Investing.com, GuruFocus and 24/7 Wall St.; these are estimates, not company figures.

## Why it matters

Intuitive earns most of its money from repeat purchases. A hospital buys or leases a system once, then pays for instruments each time it operates. This quarter, 53.3% of placements were operating leases (291 of 546, our working) against 54.1% a year earlier, and 29.3% were usage-based leases against 26.9%, where the hospital pays as it uses the system. For hospitals, the results show surgeons still choosing robotic surgery in growing numbers. For rivals building competing robots, an installed base above 12,000 systems and a tool-by-tool revenue stream are the benchmark they face.

The settlement is separate from how the business is running. A one-off $450m payment is about 14.8% of the quarter's sales (450 / 3,048.7). It cut reported profit but did not change the operating figures that exclude it, which improved. What it means for competition depends on the injunctive terms, which the sources we read did not describe, and on court approval. The company's own forecast for 2026 is da Vinci procedure growth of about 14% to 15%, expected closer to the midpoint, non-GAAP gross margin of 68.7% to 69.3% including an estimated tariff cost of 0.9% of sales, and growth in non-GAAP operating spending of 11% to 13%. It assumes current tariffs stay in place to the end of the year.

## What to watch next

The settlement is subject to preliminary and final approval by the court, and no dates were given in the sources we read. The date of fourth-quarter results was also not stated in the documents we read, so we do not give one. Readers can compare that report with the forecast ranges above, and with this quarter's procedure growth of about 14% for da Vinci, about 31% for Ion and a 12,094-system installed base. The company says tariff costs could be material if new tariffs are imposed.

- GAAP: the standard accounting rules companies must report under
- Non-GAAP: the company's own version of profit, excluding items such as one-off charges
- Installed base: the number of systems already in hospitals
- Injunctive relief: changes to business practices agreed as part of a legal settlement

> **Why it matters** Intuitive Surgical makes the leading robotic surgery systems. Sales and operations grew strongly, but a $450m legal settlement cut reported profit.

> **What we verified** Sales $3,048.7m vs $2,505.1m, GAAP EPS $1.49 vs $1.95, non-GAAP EPS $3.00 vs $2.40, procedure growth (about 14% da Vinci, 31% Ion), placements 546 vs 427, installed base 12,094, buyback 7.8m shares for $2.94bn, guidance ranges: Intuitive Q3 2026 earnings release, Form 8-K (SEC). Sales, EPS, the $450m charge ($0.99 a share), placements and guidance: Investing.com, GuruFocus and 24/7 Wall St. Settlement details and court approval: GuruFocus and the release. EPS and sales estimates and the after-hours move (about 7% to 13%, sources disagree): Investing.com and GuruFocus, preliminary. All percentages, margins and ratios are our own working.

### Sources
- [Intuitive Q3 2026 earnings release, Form 8-K (SEC), 20 October 2026](https://www.sec.gov/Archives/edgar/data/0001035267/000103526726000067/q326ex-991earningsrelease.htm)
- [Intuitive Surgical slides 13% as earnings hit by pre-tax charge (Investing.com)](https://www.investing.com/news/earnings/intuitive-surgical-slides-13-as-earnings-hit-by-pretax-charge-93CH-4961000)
- [Intuitive Surgical settles da Vinci robot antitrust case with $450M charge (GuruFocus)](https://www.gurufocus.com/news/9132728/intuitive-surgical-isrg-settles-da-vinci-robot-antitrust-case-with-450m-charge)
- [Intuitive Surgical shares fall nearly 7% after Q3 earnings beat (GuruFocus)](https://www.gurufocus.com/news/9132783/intuitive-surgical-isrg-shares-fall-nearly-7-after-q3-earnings-beat)
- [Intuitive Surgical Q3 2026 earnings (24/7 Wall St.)](https://247wallst.com/cards/intuitive-surgical-q3-2026-earnings-isrg-01m5df1chhjrb37g5rqp6kqhkx)