Intuitive Surgical makes robotic systems that help surgeons operate through tiny cuts instead of large incisions. The flagship product is the da Vinci Surgical System, a robot that a surgeon controls from a seated console while robotic arms move precise instruments inside the patient. Hospitals pay a large upfront price to own a da Vinci system, but that is only the beginning. Every procedure uses instruments and accessories that wear out and must be replaced, and hospitals also pay ongoing service contracts to keep the systems running. This three-layer model, hardware placement followed by consumable instruments followed by service, means that the more procedures hospitals perform, the more Intuitive earns, year after year, without selling another system. The diagram below traces where the money goes.

Five years of financial data tell a clear story of expansion. Revenue has grown every single year, from $5.7 billion in 2021 to $10.1 billion in 2025. That is not a small jump. It means the business roughly doubled in size in four years. The engine behind that growth is procedure volume. Approximately 3,153,000 da Vinci procedures were performed in 2025, up 18% from the year before. More procedures mean more instruments consumed, which means more recurring revenue flowing in automatically.

The instruments and accessories segment is the clearest proof of the recurring revenue engine at work. That segment generated $6.02 billion in 2025 alone, up 19% from $5.08 billion in 2024. Hospitals cannot skip buying these consumables. Every surgery requires them. That makes this revenue far steadier than a business that depends on selling expensive new machines every year.

Cash generation has also improved meaningfully. Operating cash flow rose from $2.1 billion in 2021 to $3.0 billion in 2025. Free cash flow, which is what is left after the company spends on buildings and equipment, jumped from $1.7 billion in 2021 to $2.5 billion in 2025. One dip stands out: free cash flow fell sharply to $0.7 billion in 2023 before recovering. That dip reflects heavier spending on factories and infrastructure to support growth, not a collapse in the underlying business. The company also carries no net debt. It holds more cash than it owes, with net cash of $3.4 billion at the end of 2025.

Gross margin has edged down slightly over the five-year period, from 69.3% in 2021 to 66.0% in 2025. The company said tariffs on goods manufactured in Mexico and imported from Germany added approximately $63 million to its cost of revenues in 2025 alone. That pressure is not enormous relative to a $10.1 billion revenue base, but it is real, and the company expects it to continue growing in 2026.

The installed base of da Vinci systems reached approximately 11,106 machines as of December 31, 2025, up 12% from the prior year. Each new system placed is essentially a future revenue stream, because every procedure that machine performs over its lifetime generates instrument and accessory purchases. The fifth-generation da Vinci 5, which received FDA clearance in March 2024, accounted for 870 of the 1,721 systems placed in 2025. That rapid adoption of the newest platform matters, because da Vinci 5 unlocks new digital subscription offerings like My Intuitive Plus that older systems cannot support.

The risks facing this business are specific and worth naming clearly. Weight loss drugs approved by the FDA have already reduced the number of bariatric surgeries performed using da Vinci systems. The company cannot predict how permanent that shift will be. Manufacturing is concentrated in Mexicali, Mexico, and many key components come from sole suppliers, meaning a single factory problem or a new tariff rule can ripple through production quickly. China is a separate and growing concern. The Chinese government launched an anti-corruption campaign in healthcare that delayed hospital equipment purchases, provincial governments have imposed price limits on robotic surgery procedures, and domestic Chinese competitors are gaining ground. The result was fewer systems placed in China than expected in 2025.

Usage-based leases are becoming a bigger part of how hospitals acquire systems. That model shifts risk onto Intuitive. If a hospital installs a system but performs fewer procedures than planned, whether because of weight loss drugs reducing bariatric demand, staffing shortages, or reimbursement problems, Intuitive may not recover the full cost of that machine. The company has no contractual guarantee of minimum usage under these arrangements.