ISRG · Health care(orthopedic, prosthetic & surgical appliances & supplies) · 10 years of annual accounts filed with the SEC · latest fiscal year ended 2025-12-31
Intuitive Surgical Inc reported revenue of $10.1 billion in fiscal 2025, after growing 15.7% a year over the previous 9 years. Its operating margin narrowed from 35.1% in 2016 to 29.3%. Of the $17.3 billion its operations generated over 10 years, 46.4% went to buybacks and 27.6% back into the business; the share count rose 2.5%. On the accounting screens, it passes 6 of 8 Piotroski tests, its Altman Z'' of 12.01 is in the safe zone and its Beneish M-score is below the -1.78 line; none of the six cross-checks between its statements fires.
Revenue, fiscal 202510.1B+15.7% a year over 9 years
Operating margin29.3%gross margin 66.0%
Return on invested capital—
Free cash flow after stock pay1.7B16.9% of revenue
Net debt ÷ EBITDA—net debt —
Piotroski F-score6/8tests of improvement passed
Share counts are in today's shares. The SEC's filings restate only recent years after a split, so these jumps were read as splits and the older years scaled to match — otherwise per-share figures would compare different units:
3-for-1 before fiscal 2019.
Is it growing?
Revenue and the operating income it turns into. Growth that does not reach operating income is growth bought with margin.
RevenueOperating income
05.0B10.0B15.0B
2016Revenue 2.7BOperating income 949.7M
2017Revenue 3.1BOperating income 1.1B
2018Revenue 3.7BOperating income 1.2B
2019Revenue 4.5BOperating income 1.4B
2020Revenue 4.4BOperating income 1.0B
2021Revenue 5.7BOperating income 1.8B
2022Revenue 6.2BOperating income 1.6B
2023Revenue 7.1BOperating income 1.8B
2024Revenue 8.4BOperating income 2.3B
2025Revenue 10.1BOperating income 2.9B
2016201720182019202020212022202320242025
Compound growth a year
3 yrs
5 yrs
9 yrs
Revenue
+17.4%
+18.2%
+15.7%
Operating income
+23.1%
+22.9%
+13.4%
Net income
+29.3%
+21.9%
+16.2%
Earnings per share
+29.2%
+21.8%
+15.9%
Free cash flow per share
+37.4%
+16.7%
+10.0%
Shares
+0.1%
+0.1%
+0.3%
Falling shares are buybacks: each remaining share owns more of the company.
Does it earn more than its capital costs?
Margins say how much of each sale is kept; return on invested capital says how much the business earns on the money it needs to operate. Growth only creates value when that return is above the cost of the capital.
Return on invested capitalCost of capital today · 10.2%
0.0%5.0%10.0%15.0%
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2016201720182019202020212022202320242025
Economic profit
Needs a cost of capital, which comes from the valuation below.
Return on equity
16.0%
Return on assets
14.0%
Asset turnover
0.49×
Research & development
13.0% of revenue
Overheads (SG&A)
23.7% of revenue
Is the profit cash, and where does the cash go?
Net income is an accounting opinion; free cash flow is what was left in the bank after investing. Stock-based pay does not leave the bank — shareholders pay it through dilution — so it is shown taken off as well.
Net incomeFree cash flowAfter stock-based pay
01.0B2.0B3.0B
2016Net income 738.3MFree cash flow 1.0BAfter stock-based pay 855.5M
2017Net income 670.9MFree cash flow 953.2MAfter stock-based pay 744.1M
2018Net income 1.1BFree cash flow 982.2MAfter stock-based pay 721.0M
2019Net income 1.4BFree cash flow 1.2BAfter stock-based pay 836.8M
2020Net income 1.1BFree cash flow 1.1BAfter stock-based pay 747.9M
2021Net income 1.7BFree cash flow 1.7BAfter stock-based pay 1.3B
2022Net income 1.3BFree cash flow 958.4MAfter stock-based pay 445.2M
2023Net income 1.8BFree cash flow 749.6MAfter stock-based pay 156.8M
2024Net income 2.3BFree cash flow 1.3BAfter stock-based pay 627.0M
2025Net income 2.9BFree cash flow 2.5BAfter stock-based pay 1.7B
2016201720182019202020212022202320242025
Where 10 years of operating cash went, 2016–2025
17.3B generated by the business. Each band is its share of that total.
Reinvested in the business 28%4.8B
Acquisitions 1%244.6M
Dividends 0%0
Share buybacks 46%8.0B
Kept, or used to pay down debt 25%4.3B
Over the same years it paid 4.4B in stock. The share count rose 2.5%. 3.6B of the buybacks went beyond offsetting that dilution.
Per share
Earnings per shareFree cash flow per shareDividend per share
$0.00$2.00$4.00$6.00$8.00
2016Earnings per share $2.09Free cash flow per share $2.92
2017Earnings per share $1.92Free cash flow per share $2.73
2018Earnings per share $3.16Free cash flow per share $2.76
2019Earnings per share $3.85Free cash flow per share $3.27
2020Earnings per share $2.94Free cash flow per share $3.17
2021Earnings per share $4.66Free cash flow per share $4.78
2022Earnings per share $3.65Free cash flow per share $2.65
2023Earnings per share $5.03Free cash flow per share $2.10
2024Earnings per share $6.42Free cash flow per share $3.60
2025Earnings per share $7.87Free cash flow per share $6.87
2016201720182019202020212022202320242025
Shares outstanding
Diluted shares
345.0M350.0M355.0M360.0M365.0M370.0M
2016Diluted shares 353.7M
2017Diluted shares 348.9M
2018Diluted shares 356.4M
2019Diluted shares 358.4M
2020Diluted shares 361.0M
2021Diluted shares 365.8M
2022Diluted shares 362.0M
2023Diluted shares 357.4M
2024Diluted shares 362.0M
2025Diluted shares 362.7M
2016201720182019202020212022202320242025
How strong is the balance sheet?
Debt is not bad in itself; debt the business cannot service in a bad year is. Net debt is debt minus cash, and below zero the company holds more cash than it owes.
Net debt ÷ EBITDA
—
Interest coverage
— operating income ÷ interest
Current ratio
4.87 current assets ÷ current liabilities
Cash conversion cycle
224 days collects in 55d, stock 196d, pays in 27d
Three classic screens of the accounts
Each asks a different question of the same statements — is it improving, does it look like a company heading for distress, do the accounts resemble ones that were manipulated. None is a verdict; each shows what moves it.
Piotroski F-score
Is the business improving? Nine yes-or-no tests, this year against last.
6of 8 tests passed
✓ProfitableReturn on assets above zeropassed
✓Cash from operationsOperating cash flow above zeropassed
✓Profitability improvedReturn on assets higher than a year beforepassed
✓Profit backed by cashOperating cash flow above net income (low accruals)passed
–Less long-term debtLong-term debt as a share of assets fell — not reportedno data
✓More liquidCurrent ratio higher than a year beforepassed
✕No new sharesShare count did not growfailed
✕Better gross marginGross margin higher than a year beforefailed
✓Sells more per assetAsset turnover higher than a year beforepassed
Where it misleads: it measures change, not level. An excellent business that stood still for a year scores low; a poor one recovering from a disaster scores high.
Altman Z''-score
Does the balance sheet look like those of companies that went bankrupt?
12.01safe zone
1.12.6
Working capital ÷ assets 0.38 × 6.56+2.49
Retained earnings ÷ assets 0.34 × 3.26+1.12
Operating income ÷ assets 0.14 × 6.72+0.97
Equity ÷ liabilities 7.08 × 1.05+7.44
Where it misleads: buybacks. A company that returns so much cash that its equity turns small or negative sinks the last two ratios without being anywhere near bankruptcy. Banks and insurers do not fit the model at all.
Beneish M-score
Do the accounts resemble those of companies that manipulated their earnings?
-2.44below the -1.78 line
-1.78
Receivables vs sales 1.03+0.95
Gross margin slipping 1.02+0.54
Soft assets 0.70+0.28
Sales growth 1.21+1.07
Slower depreciation 0.85+0.10
Overheads vs sales 0.92-0.16
Profit not in cash -0.01-0.04
Leverage rising 1.05-0.34
Where it misleads: fast growth and acquisitions. Sales growth carries a heavy weight, so a company growing 50% a year scores like a suspect without having done anything. It is a screen from a 1999 study, not an accusation.
Where the statements disagree
Cross-checks between the income statement, the balance sheet and the cash flow for the latest year, each with the benign reading and the worrying one.
None of the six cross-checks fires for the latest year: receivables and inventory move with revenue, profit turns into cash, investment keeps up with depreciation, the tax rate is ordinary and debt is moderate.
What is it worth, under which assumptions?
A company is worth the cash it will generate, brought back to today. This model projects revenue with growth that fades over the years, applies a free cash flow margin, and discounts the result at the cost of capital. Every assumption says where it came from, and all of them can be changed.
Value per share, with these assumptions$39.55discounted at 10.2% a year · 54% of it from after year 10
Type a share price on the left to ask the reverse questions: what growth, what margin or what discount rate that price implies.
What the value implies, in the usual multiples
At this model's value
Price ÷ earnings
5.0×
Enterprise value ÷ EBITDA
4.0×
Enterprise value ÷ revenue
1.4×
Free cash flow yield
11.9%
From cash flows to a value per share
10 years of cash flow, today6.6B
Everything after, today7.7B
The whole business14.3B
Minus net debt-0
What belongs to shareholders14.3B
Divided among 362.7M shares: <strong>$39.55</strong> each.
The projection next to its history
Reported free cash flow after stock pay, then the model's. A projection that looks nothing like the past needs a reason.
ReportedProjected
0500.0M1.0B1.5B2.0B
2016Reported 855.5M
2017Reported 744.1M
2018Reported 721.0M
2019Reported 836.8M
2020Reported 747.9M
2021Reported 1.3B
2022Reported 445.2M
2023Reported 156.8M
2024Reported 627.0M
2025Reported 1.7B
2026Projected 686.0M
2027Projected 797.7M
2028Projected 913.8M
2029Projected 1.0B
2030Projected 1.1B
2031Projected 1.3B
2032Projected 1.3B
2033Projected 1.4B
2034Projected 1.5B
2035Projected 1.5B
2016201820202022202420262028203020322034
Year by year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Revenue
11.9B
13.8B
15.8B
17.8B
19.8B
21.7B
23.4B
24.7B
25.8B
26.4B
Growth
18.0%
16.3%
14.6%
12.8%
11.1%
9.4%
7.7%
5.9%
4.2%
2.5%
Cash margin
5.8%
5.8%
5.8%
5.8%
5.8%
5.8%
5.8%
5.8%
5.8%
5.8%
Free cash flow
686.0M
797.7M
913.8M
1.0B
1.1B
1.3B
1.3B
1.4B
1.5B
1.5B
Worth today
622.7M
657.1M
683.2M
699.7M
705.6M
700.5M
684.5M
658.2M
622.6M
579.2M
If the least-known inputs move
Value per share as two inputs change at a time. Neighbouring cells that differ a lot are the conclusion: the value depends on numbers nobody knows to a point.
The discount rate and growth forever
discount ↓ · forever →
1.5%
2.0%
2.5%
3.0%
3.5%
9.2%
41
43
46
49
53
9.7%
38
40
43
45
48
10.2%
36
38
40
42
44
10.7%
34
35
37
39
41
11.2%
32
33
35
36
38
Year-one growth and the final margin
margin ↓ · growth →
14.0%
16.0%
18.0%
20.0%
22.0%
4.6%
29
31
33
36
39
5.2%
31
34
36
39
42
5.8%
34
37
40
43
46
6.3%
36
39
43
46
50
6.9%
39
42
46
49
53
All the inputs moving at once
5,000 valuations, each with growth, final margin, discount rate and growth forever drawn at random around the values on the left (spreads of 3.0%, 2.0%, 1.0% and 0.5%). Not a probability — the spreads are assumptions too — but an honest picture of how wide the answer is.
10th percentile$24.68
Median$39.50
90th percentile$59.05
$20.00$40.00$60.00$80.00
Half of the simulations land between <b>$31.43</b> and <b>$48.91</b>; one in ten below $24.68, one in ten above $59.05.
Does the long run make sense?
2.2×The terminal value prices the business in year 10 at 2.2 times that year's EBITDA.
3%To grow 2.5% forever while reinvesting 77% of its after-tax operating profit, the business must earn 3% on the new capital.
54%of the value comes from after year 10. The more of it, the more the answer depends on the part nobody can see.
What lenders charge, after the tax saving on interest: 6.68% × (1 − 13.1%) = <strong>5.80%</strong>.
Weighted by how much of each the company uses (book value (no price given)): <strong>10.18%</strong>, the rate every future cash flow is discounted at.
What it has filed lately
The last twelve months at the SEC, most important first: annual and quarterly reports, events, large holders and insiders.
Accounts from the company's own SEC filings; lines some companies do not report are shown as a dash rather than estimated. The risk-free rate is the 10-year US Treasury yield. A DCF is a way of making assumptions explicit, not a forecast: it states what the company would be worth if the assumptions held. The scores are screens that point where to look, not verdicts. Nothing here is a recommendation to buy or sell.