ISRG
Intuitive Surgical, Inc.$496.70
Sell
Target $360.88
Report: Mar 13, 2026Healthcare • Medical - Instruments & Supplies • Mature CompounderSnapshot
Decision-first overview with recommendation, valuation anchor, and current setup.
Company Overview
Research Snapshot
Price History
Pelican View
Current$496.70-27.3%
Rec: SellConviction: High
Entry Target
N/A
N/A
Fair Value
$360.88
(27% below current)
Stop Loss
N/A
N/A
Position Size
None
Time Horizon
N/A
Key Metrics
Live Snapshot
Market Data
52 Week High$603.88
52 Week Low$425.00
Avg. 3 Month Volume1.92M
Efficiency
LTM Gross Margin66.0%
LTM EBITDA Margin39.4%
LTM EBIT Margin32.7%
LTM Operating Margin29.3%
LTM ROA14.4%
LTM ROE16.4%
LTM ROIC23.8%
LTM ROCE18.5%
Capital Structure
Market Cap (MM)$163.7B
Enterprise Value (MM)$160.3B
Shares Outstanding355.10M
Total Debt (MM)$0.00M
Cash & Equivalents (MM)$3.37B
LTM Net Debt (MM)$-3.37B
LTM Net Debt/EBITDA-0.8x
Growth
TTM Rev. Growth20.5%
Last 3-Yr Rev. CAGR17.4%
Last 3-Yr EBITDA CAGR26.1%
Last 3-Yr EPS CAGR29.1%
Valuation
Street Target Price$638.75
LTM EV/Revenue15.9x
LTM EV/Gross Profit24.1x
LTM EV/EBIT48.7x
LTM EV/EBITDA40.4x
LTM P/E57.3x
LTM EV/FCF64.4x
LTM P/FCF65.7x
LTM P/TB8.5x
LTM P/B9.2x
Dividend Yield0.0%
Payout Ratio0.0%
Executive SummarySituation: Current price is $496.7 versus fair value $360.88 (-27.3% expected return), and valuation confidence is stable. Debate: Bull case depends on FY 2026 Margin Guidance Revision: As the 120bps tariff impact fully hits the P&L, management may be forced to lower full-year earnings guidance, triggering a multiple de-rating. Bear case centers on Geopolitical Tariff Escalation: A further increase in US-Mexico or US-China tariffs would directly impair the company's cost of revenue, as 80-90% of instruments are made in Mexico. Conclusion: Recommendation is Sell with no position, pending a materially better risk/reward setup.
Bull Case
The da Vinci 5 rollout triggers a multi-year upgrade cycle with higher ASPs and increased procedure efficiency; the Ion platform's 50%+ growth rate captures a massive new TAM in lung biopsies; recurring revenue reaches 90% of the mix, insulating the company from hospital CapEx cycles.
Bear Case
Gross margin compression is structural, driven by a permanent shift to lower-margin products and unavoidable tariff costs; GLP-1 drugs cause a permanent high-single-digit decline in bariatric procedure volumes; the current 60x P/E multiple leaves no margin for error in a slowing growth environment.
Key Catalysts
Near-Term (0-6 months)Impact: High
FY 2026 Margin Guidance Revision: As the 120bps tariff impact fully hits the P&L, management may be forced to lower full-year earnings guida...
Mid-Term (6-18 months)Impact: Moderate
GLP-1 Data Update: Continued surgeon feedback confirming a high-single-digit decline in bariatric procedures would validate bear concerns ab...
Long-Term (18+ months)Impact: Moderate
Intuitive Surgical is at a critical juncture following its July 2025 CEO transition and the recent 150-basis-point drop in gross margins, ma...
Primary Risks
Concern: High
Geopolitical Tariff Escalation: A further increase in US-Mexico or US-China tariffs would directly impair the company's cost of revenue, as...
Concern: Medium
China Market Displacement: Local Chinese competitors gaining provincial preference could permanently reduce ISRG's OUS growth rate.
Concern: Medium
The stewardship verdict is mixed. While the board is highly independent and features deep financial expertise (Audit Chair Lewis Chew is a f...
Recent Activity
2025-10-22SEC Filing (8-K)
+13.89%Intuitive Surgical reports Q3 2025 earnings with 23% revenue growth to $2.51 billion and 20% procedure volume growth
2025-01-15SEC Filing (8-K)
+7.65%Intuitive Surgical announces preliminary Q4 and full year 2024 financial results.
2024-10-18SEC Filing (8-K)
+10.01%Intuitive Surgical reported Q3 2024 financial results with 17% revenue growth to $2.04 billion and 18% da Vinci procedure volume growth.
2024-07-19SEC Filing (8-K)
+9.34%Intuitive Surgical reported Q2 2024 financial results with 14% revenue growth to $2.01 billion and 17% da Vinci procedure volume growth.
2024-01-10SEC Filing (8-K)
+10.25%Intuitive Surgical announces preliminary Q4 and full year 2023 financial results.
Valuation Table
9.8/10Decision Grade
Scenario Range
$237
Bear
$398
Base
$490
Bull
$497