Intuitive Surgical Inc

Intuitive Surgical, Inc. (NASDAQ: ISRG) develops, manufactures, and markets da Vinci surgical systems and the Ion endoluminal system. The Company specializes in invasive care and robotic-assisted surgery. Its technologies include the da Vinci surgical systems and the Ion endoluminal system. The da Vinci surgical system is designed to enable surgeons to perform a range of surgical procedures within its targeted general surgery, urologic, gynaecologic, cardiothoracic, and head and neck specialties and consists of a surgeon's console or consoles, a patient-side cart, and a high-performance vision system.

Recent Business and Financial Updates

• Fourth Quarter 2024 Highlights: Intuitive Surgical, Inc. reported significant growth in its fourth quarter of 2024, with worldwide da Vinci procedures increasing by approximately 18% compared to the same period in 2023. The company placed 493 da Vinci surgical systems during this quarter, up from 415 in the fourth quarter of 2023, including 174 da Vinci 5 systems. As of December 31, 2024, the installed base of da Vinci surgical systems grew to 9,902, marking a 15% increase from 8,606 systems at the end of 2023. Revenue for the fourth quarter of 2024 reached USD2.41 billion, a 25% rise from USD1.93 billion in the fourth quarter of 2023. GAAP net income attributable to Intuitive was USD686 million, or USD1.88 per diluted share, compared to USD606 million, or USD1.69 per diluted share, in the prior year. Non-GAAP net income attributable to Intuitive was USD805 million, or USD2.21 per diluted share, up from USD574 million, or USD1.60 per diluted share, in the fourth quarter of 2023. Additionally, fourth quarter 2024 expenses included a USD45 million contribution to the Intuitive Foundation, compared to USD40 million in the same period of 2023.
• Financial Summary for the Fourth Quarter 2024: The financial results for the fourth quarter of 2024 are presented on both GAAP and non-GAAP bases, with non-GAAP measures detailed and reconciled at the end of this release. Revenue for the period was USD2.41 billion, reflecting a 25% increase from USD1.93 billion in the fourth quarter of 2023, driven by higher da Vinci procedure volumes and an expanded installed base of systems. Instruments and accessories revenue grew by 23% to USD1.41 billion from USD1.14 billion, primarily due to an 18% increase in da Vinci procedures, a 70% rise in Ion procedures, and shifts in customer purchasing patterns. Systems revenue also increased to USD655 million from USD480 million, attributed to a lower proportion of leased systems and higher average selling prices for da Vinci systems.
• Operational and Placement Details: In the fourth quarter of 2024, Intuitive Surgical placed 493 da Vinci surgical systems, including 174 da Vinci 5 systems, compared to 415 systems in the same quarter of the previous year. Of these, 222 systems were placed under operating lease arrangements, with 140 under usage-based leases, up from 201 systems (109 usage-based) in 2023. GAAP income from operations for the quarter rose to USD735 million from USD450 million in 2023, with share-based compensation expense increasing to USD180 million from USD152 million. Non-GAAP income from operations also improved to USD928 million from USD621 million. These figures highlight the company’s operational efficiency and strategic focus on expanding its advanced surgical technology offerings.
• Net Income and Tax Considerations: GAAP net income attributable to Intuitive Surgical, Inc. for the fourth quarter of 2024 was USD686 million, or USD1.88 per diluted share, compared to USD606 million, or USD1.69 per diluted share, in 2023. This included excess tax benefits of USD34 million (USD0.09 per diluted share) in 2024, up from USD22 million (USD0.06 per diluted share) in 2023. The 2023 results also included significant tax benefits from the re-measurement of Swiss deferred tax assets (USD67 million) and the receipt of certain tax assets by the Swiss entity (USD92 million), both excluded from non-GAAP calculations. In 2024, a discrete tax benefit of USD19 million (USD0.05 per diluted share) arose from the release of unrecognized tax benefits due to statute expirations, compared to USD23 million (USD0.06 per diluted share) in 2023. Non-GAAP net income for the quarter was USD805 million, or USD2.21 per diluted share, compared to USD574 million, or USD1.60 per diluted share, in 2023, with a discrete tax benefit of USD8 million (USD0.02 per diluted share) in 2024.
• Cash Position and Investment: At the end of the fourth quarter of 2024, Intuitive Surgical held USD8.83 billion in cash, cash equivalents, and investments, an increase of USD521 million during the quarter. This growth was primarily driven by cash generated from operations, partially offset by capital expenditures. The company’s strong liquidity position supports its ongoing investments in innovation and expansion of its surgical system offerings.
• Financial Outlook for 2025: Looking ahead to 2025, Intuitive Surgical anticipates worldwide da Vinci procedures to grow by approximately 13% to 16%, following a 17% increase in 2024 compared to 2023. The company expects its non-GAAP gross profit margin to range between 67% and 68% of net revenue, down slightly from 69.1% in 2024, excluding any potential impact from new tariffs. Non-GAAP operating expense growth is projected to be between 10% and 15%, compared to 10% in 2024. These forward-looking non-GAAP measures are used by management to assess performance, but reconciliations to GAAP measures are not provided due to the uncertainty and variability of certain items, such as legal proceedings, which could materially affect GAAP results. Further details on historical GAAP to non-GAAP reconciliations are available in the accompanying release.

Technical Observation (on the daily chart):

The Relative Strength Index (RSI) over a 14-day period stands at a value of 63.29, currently upward trending and moving towards overbought levels, with expectations of a consolidation or upward momentum in case of USD 620 resistance level is broken. The price in between the range of USD 550- USD 620, with expectations of momentum in either side the price breaks this range. Additionally, the stock's current positioning is above both the 50-period SMA and 200-period SMA, which may serve as dynamic short to medium-term support levels.

As per the above-mentioned price action, recent key business and financial updates, momentum in the stock over the last month, and technical indicators analysis, a ‘WATCH`’ rating has been given for Intuitive Surgical, Inc. (NASDAQ: ISRG) at the closing price of USD 600.89, as of February 18, 2025. 

Individuals can evaluate the stock based on the support and resistance levels provided in the report in case of keen interest taking into consideration the risk-reward scenario. 

Markets are trading in a highly volatile zone currently due to certain macro-economic issues and prevailing geopolitical tensions. Therefore, it is prudent to follow a cautious approach while investing.

Related Risk: This report may be looked at from a high-risk perspective and a recommendation is provided for a short duration. This report is solely based on technical parameters, and the fundamental performance of the stocks has not been considered in the decision-making process. Other factors which could impact the stock prices include market risks, regulatory risks, interest rates risks, currency risks, social and political instability risks etc. 

Note 1: Past performance is not a reliable indicator of future performance.

Note 2: The reference date for all price data, currency, technical indicators, support, and resistance level is February 18, 2025. The reference data in this report has been partly sourced from REFINITIV.

Note 3: Investment decisions should be made depending on an individual's appetite for upside potential, risks, holding duration, and any previous holdings. An 'Exit' from the stock can be considered if the Target Price mentioned as per the Valuation and or the technical levels provided has been achieved and is subject to the factors discussed above.

Note 4: Target Price refers to a price level that the stock is expected to reach as per the relative valuation method and or technical analysis taking into consideration both short-term and long-term scenarios.

Note 5: ‘Kalkine reports are prepared based on the stock prices captured either from the New York Stock Exchange (NYSE), NASDAQ Capital Markets (NASDAQ), and or REFINITIV. Typically, all sources (NYSE, NASDAQ, or REFINITIV) may reflect stock prices with a delay which could be a lag of 15-20 minutes. There can be no assurance that future results or events will be consistent with the information provided in the report. The information is subject to change without any prior notice.