Intuitive Surgical (NASDAQ: ISRG) delivered strong third-quarter earnings, growing revenue and rising demand for its robotic surgery systems. But investors still sent the stock sharply lower. Unfortunately, a $450 million antitrust settlement and a procedure-growth forecast that offered little upside appeared to overshadow the company’s better-than-expected results.
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The medical device company reported adjusted earnings of $3 per share on revenue of $3.05 billion. Earnings beat expectations by 36 cents, while revenue topped forecasts by approximately $140 million.
Revenue increased roughly 22% from a year earlier. Adjusted earnings also improved from $2.40 per share, representing growth of 25%.
However, adjusted earnings exclude certain expenses. Investors also need to understand what happened to profits under standard accounting rules, particularly when a large legal charge creates a meaningful difference between the two measures. In this case, that difference was significant.
Intuitive Surgical’s $450 Million Settlement Weighs on Earnings
Intuitive Surgical recorded a $450 million pretax charge tied to the settlement of previously disclosed antitrust class-action litigation. After taxes, the settlement charge reduced earnings by 99 cents per diluted share. Reported earnings came in at $1.49 per share, compared with $1.95 a year earlier.
The agreement remains subject to court approval, and Intuitive reached it without admitting liability or wrongdoing. That, unfortunately, overshadowed some of its better numbers.
Da Vinci and Ion Systems Drive Strong Procedure and Placement Growth
Beyond the settlement, Intuitive Surgical’s operating results offered several encouraging signs. Worldwide procedures using its da Vinci and Ion systems increased approximately 15%. Da Vinci procedures rose about 14%, while Ion procedures grew about 31%.
System placements also remained strong. Intuitive placed 546 da Vinci systems during the quarter, compared with 427 a year earlier. That represents an increase of approximately 28%. The total included 315 da Vinci 5 systems, up from 240. Its installed da Vinci base reached 12,094 systems, an increase of 12%. Ion also expanded. The company placed 56 systems, compared with 50 a year earlier, bringing its installed base to 1,152 systems, up 21%.
Together, these figures show that customers continued adding equipment and using Intuitive’s technology more frequently. Both trends matter for future growth.
Intuitive Surgical’s 2026 Growth Forecast Offers Little Upside
Intuitive Surgical’s updated procedure forecast helps explain why the positive operating numbers failed to lift the stock. Intuitive now expects worldwide da Vinci procedure growth of 14% to 15% for 2026, with results closer to the midpoint. Previously, management expected growth of 13.5% to 15.5%, also near the midpoint. Both ranges have the same midpoint of 14.5%.
In other words, management narrowed the range without raising its central expectation. Against the supplied Wall Street forecast of 14.6%, the update offered little reason to increase growth assumptions. There was better news on profitability. Intuitive raised its adjusted gross-margin outlook to 68.7% to 69.3%, from 68% to 69%. Its forecast for adjusted operating-expense growth remained unchanged at 11% to 13%.
That combination provides some encouragement: management sees a better gross-profit outlook while maintaining its spending-growth expectations.
For shareholders, the next step is watching whether stronger system placements translate into sustained procedure growth and improving profits.
ISRG Stock Reclaims Its 50-Day Moving Average
Intuitive Surgical’s chart shows a notable recovery after a prolonged decline from its late-2025 and early-2026 highs. ISRG recently rallied from its September low near $350 to $431.94, despite falling 1.38% in the latest session.
Shares are now trading above their 50-day simple moving average of $394.26, a bullish development that suggests the stock’s near-term trend has improved. The moving average is also beginning to turn higher, potentially providing support if the recovery continues.
Momentum indicators reinforce the improving picture. The MACD line stands at 11.77, above its signal line at 10.68, while the positive histogram reading of 1.09 indicates bullish momentum remains in place. However, the stock is approaching potential resistance in the $440–$450 area, where traders may look for evidence of a sustained breakout.
Key ISRG Stock Levels to Watch
- Resistance: $440–$450. A sustained move above this zone could strengthen the recovery.
- Near-term support: Around $400–$410, an area to monitor if shares pull back.
- Moving-average support: Approximately $394, where the 50-day moving average currently sits.
The technical setup is improving, but a single session’s decline does not establish a reversal. Holding above the moving average and breaking through resistance would provide stronger confirmation that the recovery has room to continue.
What Intuitive Surgical Investors Should Watch Next
Intuitive Surgical still has plenty working in its favor. Hospitals are adding systems, procedure volumes are growing, and the company raised its gross-margin outlook. Those are encouraging signs, even if the settlement and growth forecast left investors disappointed.
The challenge now is turning that progress into stronger expectations for the quarters ahead. Investors will want to see continued demand, healthy profits, and evidence that newly installed systems are getting more use. This quarter shows why a beat alone may not lift a stock. Intuitive Surgical is growing, but shareholders are looking for a clearer reason to expect more.
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