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Call sheet · Q2'26

Intuitive Surgical (ISRG)

Q2'26 earnings call · held July 16, 2026 · compared with the Q1'26 call · management-credibility review
4/12
Disclosure score
2 high, 3 medium, 1 low flags
Financial quality
Bottom line
The Extended Use Program is a margin time bomb that management refuses to quantify, launching H1 2027 to defend against competition and ASC economics. The Street sees 'solid execution' with 19% revenue growth, but underneath, every growth metric decelerated: US procedures, SP growth, Ion growth, and utilization all slowed. The binding constraint is market saturation in the US (law of large numbers, not ACA) while China is effectively dead with just 2 system placements. 'We are still finalizing pricing for this initiative, and will provide additional quantification on our next earnings call' is Jamie dodging the key question. My view changes if they quantify EUP impact at less than 3% margin hit or China placements exceed 10 systems in Q3.

The 30-second version

  • Extended Use Program (EUP) is the real story: ISRG launching lower-cost instruments in H1 2027 targeting benign procedures
  • US procedure growth decelerated to 12% (from 14% in Q1) with ACA subsidies taking the blame
  • China is bleeding out while management pretends it's stable

What changed this quarter

MetricQ1'26Q2'26Change
Total Revenue$2.77B (23% YoY)$2.89B (19% YoY)400 bps deceleration
EPS (Non-GAAP)$2.50 (38% YoY)$2.80 (28% YoY)1000 bps deceleration
da Vinci Procedures847K (16% YoY)15% YoY100 bps deceleration
US da Vinci Procedures14% YoY12% YoY200 bps deceleration
OUS da Vinci Procedures19% YoY20% YoY+100 bps acceleration
da Vinci System Placements431 systems468 systems+8.6% sequential
da Vinci 5 Placements232 systems246 systems+6% sequential growth
China System Placements4 systems2 systems50% sequential decline
SP Procedures68% YoY growth61% YoY growth700 bps deceleration
Ion Procedures43K (39% YoY)48K (36% YoY)300 bps deceleration

Accountability tracked

6 new promises made5 narrative shifts flagged6 prior promises scored
Inside the full report
The complete write-up covers the full promise ledger with kept/missed calls, disclosure-quality scoring, the metrics-vanished check, verification items, and the questions to ask next quarter.
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Scores, kept-promise rates, and flags on this site reflect the author's opinion, applying a stated methodology to statements management made on public earnings calls. Informational and educational purposes only - not investment advice, a recommendation, or an offer to buy or sell any security. Sources believed reliable but not guaranteed; the author may hold positions in the securities discussed.

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