Intuitive Surgical [ISRG]
investment-memo v1.6.0 · analysis dated 27–28 July 2026, migrated onto the Criteria framework 2026-07-29 Price $361.96 (scan) / $361.80 (Alpaca close in the body) · Archetype COMPOUNDER Implied path: 26.0% required vs 17.4% demonstrated → margin −8.6pp · 12-month target $427 base (+17.9%)
This document no longer states a position verdict. Under v1.6.0 the memo scores every Criteria, blocks on none, and emits an analysis. Whether that analysis justifies a position is a question about a particular book.
Inputs are taken from reports/scan/ISRG_analysis.json (as_of 2026-07-28) rather than recomputed, per the
update spec. ISRG's EDGAR data is the freshest of the four names in this batch — 28 days stale, against
89–119 for the others.
| Solved for | revenue CAGR, 5 years |
| Held fixed | terminal EBIT margin 20.0%; exit multiple 29.9x EV/EBIT; WACC 10.0%; horizon 5 years |
| EV implied by spot $361.96 | $124,905m — 353.28m shares, net cash $2,968m |
| TTM revenue (TTM, not last-FY) | $10,608.2m, as of 2026-06-30 (28 days stale) |
| EV / TTM sales | 11.77x — by far the richest of the four names migrated in this batch |
| THE PRICE REQUIRES | 26.0% revenue CAGR for five years |
| Demonstrated | 17.4% |
| MARGIN — demonstrated − required | −8.6pp |
| Exit multiple | 29.9x EV/EBIT |
| Exit multiple basis | GROWTH_MATCHED, n = 32 |
| Comparator growth span | 9.4% – 25.8%, which brackets ISRG's 17.4% |
| Trading multiple today | 40.2x EV/EBIT |
| IMPLIED COMPRESSION | 29.9 ÷ 40.2 − 1 = −25.6% |
| RESULT | FAIL on the scan's inputs — but see the terminal-margin correction below, which reverses it |
Sensitivity — over the exit multiple, never over scenario probabilities:
| Exit multiple (EV/EBIT) | 20.9x | 25.4x | 29.9x (base) | 34.4x | 38.9x | 42.5x |
|---|---|---|---|---|---|---|
| Required revenue CAGR | 35.3% | 30.1% | 26.0% | 22.5% | 19.5% | 17.4% |
| Margin vs 17.4% demonstrated | −17.9pp | −12.7pp | −8.6pp | −5.1pp | −2.1pp | 0.0pp |
At a flat 20.0% terminal margin, breakeven requires a 42.5x exit multiple against 40.2x today — i.e. slight multiple expansion five years out.
DISCLOSED DEFECT IN THE PRE-COMPUTED INPUT, AND ON THIS NAME IT REVERSES THE RESULT (2026-07-29). The update spec describes a "derived terminal margin" in the scan file. There is none —
ISRG_analysis.jsonhas noterminal_marginkey. The publishedrequired_cagr_pctinverts exactly to a flat 20.0% terminal EBIT margin applied to every name in the universe, the hardcoded0.20thatcoverage_scan.py's own comments record as a defect fixed after these scan files were written.ISRG's actual operating margin is 29.3% — nearly half again the assumed 20.0%, and the largest gap of the four names in this batch. Substituting it: required CAGR 16.7%, margin +0.7pp, breakeven exit multiple 29.0x against 40.2x today. The Criteria flips from FAIL to PASS.
Terminal EBIT margin Source Required CAGR Margin Result 20.0% scan's universe-wide constant (undisclosed in the file) 26.0% −8.6pp FAIL 29.3% ISRG's own current operating margin 16.7% +0.7pp PASS This is the most consequential single correction in this batch. The scan figure is the headline because the spec instructs use of the pre-computed inputs, but the reader should not treat −8.6pp as the settled answer. Applying a 20% terminal margin to a business already earning 29.3% is not conservatism — it is an unargued parameter driving the result, which is exactly the failure class the growth-matched exit multiple was introduced to close. The two corrections belong to the same family and only one of them was applied.
Step 1 — near-term revenue. Alpha Vantage EARNINGS_ESTIMATES, cached 2026-07-28 (byte-identical to the
27 July pull; the vendor snapshot had not moved, which is reported as a data limitation, not a finding):
| Value | Source | |
|---|---|---|
| TTM revenue now | $10,608.2m | ISRG_analysis.json (EDGAR XBRL) |
| FY2026E revenue | $11,774m | Alpha Vantage consensus, 30 analysts — sourced |
| FY2027E revenue | $13,240m | Alpha Vantage consensus, 31 analysts — sourced |
| TTM revenue at Jul-2027 | $12,507m | 0.5 × FY2026E + 0.5 × FY2027E |
| Implied revenue growth | +17.9% |
Step 2 — named product-cycle events inside the window, each dated in the Catalyst Criteria calendar: Q3-2026 results (~20 Oct 2026, est. from the company's own cadence and flagged as such); the dV5 placement mix (246 of 468 placements in Q2-2026); the Ion ramp; the XiR average selling price, which management has explicitly withheld. No date is asserted here that the calendar does not carry with its (est.) flag.
Step 3 — the multiple, on ISRG's own history. Price-to-sales on a constant current share count (353.28m) against an internally-consistent EDGAR-derived TTM revenue series, daily, 2020-01-02 → 2026-07-27 (n = 1,649).
| Window | ISRG's current P/S percentile | Range |
|---|---|---|
| 6.5-year (full available) | 0.3rd | 10.63x – 35.25x, median 21.88x |
| 3-year | 0.7th | 10.63x – 35.25x, median 24.15x |
| 1-year | 2nd | 10.63x – 30.57x, median 22.46x |
| 6-month | 4th | 10.63x – 26.92x, median 19.06x |
| 3-month | 8th | 10.63x – 18.92x, median 16.89x |
ISRG's current P/S is effectively the lowest observation in six and a half years of its own history (11.43x against a 10.63x minimum). Two consequences follow, and both are stated rather than smoothed over:
(a) An own-history anchor cannot generate a downside case here. There is no lower multiple in the record to revert to. The band below therefore has almost no downside leg, and that is a limitation of the instrument, not a claim that ISRG cannot fall. The genuine downside case lives in the Downside Criteria — a named permanent-impairment cause — not in the multiple.
(b) The up-case anchor is UNIDENTIFIED. The multiple traversed 10.63x to 18.92x within ninety days (price $466.64 on 2026-04-28 → $357.16 on 2026-07-27, a −23% move, on top of −32% over six months). There is no stable recent regime to mean-revert to. Reverting to the 3-year median of 24.15x would imply $902, +149% — a number this document will not present as a target. Declared UNIDENTIFIED rather than defaulted to a percentile of a distribution that straddles a regime break.
| Case | Multiple | Basis | Target | vs spot $361.96 |
|---|---|---|---|---|
| Multiple at its 6.5-year floor | 10.63x | own all-time-low observation | $397 | +9.6% |
| Base — multiple held flat | 11.43x | today's own level; no multiple opinion | $427 | +17.9% |
| Any re-rating case | — | UNIDENTIFIED | — | — |
For reference only, not as a target: the nearest observed multiple above today is the 3-month 25th percentile of 16.31x, which would imply $609 (+68%). It is recorded as an observation about the data.
Sanity band vs the external reference. The stale aggregator average is ~$490; the post-Q2 revised cluster is $375 – $483 (Evercore $375, Leerink $454, Raymond James $483). The base of $427 sits inside that revised cluster, near its midpoint. That is a check on the output, never a calibration target — and the distinction matters here, because the same test on this exact name is where indexing to an external target was shown to fail (best achievable correlation +0.08).
CORRECTION — the old output was a probability-weighted value of $356 (−0.3% to spot). The new 12-month base is $427 (+17.9%). The instruments differ: the old figure was a probability-weighted blend of multi-year DCF value ranges labelled as a valuation, then compared to spot to produce a net E[R] of −0.41% (later −1.69% on the price move). The new figure is a 12-month target built on consensus revenue and ISRG's own multiple. This is the single largest correction in the batch, and its direction is the one the framework predicted: item B16 recorded 16 of 16 house outputs below spot; ISRG's was one of them.
| Item | Old figure | Corrected | Note |
|---|---|---|---|
| Revenue basis | FY2025A $10,065m | TTM $10,608.2m to 2026-06-30 | TTM, never last-FY |
| Revenue recency | not stated | 28 days — the freshest in the batch | stated |
| Long-horizon output | probability-weighted value $356, −0.3%; net E[R] −0.41% / −1.69% | retired | replaced by the implied path; the cash hurdle is retired with it |
| 12-month target | (none built separately) | $427 (+17.9%) | §0.2 — the memo previously reported only a long-horizon output, which is itself the defect valuation.md exists to prevent |
| Sensitivity axis | scenario probabilities / bear weight | exit multiple | §0.1 |
| Terminal margin | 20.0% (undisclosed constant) | 29.3% is ISRG's own — flips the result to PASS | §0.1 |
| Momentum | reported as a FAIL that helped force the classification | MEASURED, entry timing only | see 05_Trade_Construction.md |
Nothing below this line has been deleted. The body is the original v1.4.0/v1.4.2 analysis. Where it states a conclusion this framework no longer draws, a superseding note marks it.
| Input | 27 Jul (initiation) | 28 Jul (refresh) | Change |
|---|---|---|---|
| Price (Alpaca SIP close) | $357.16 | $361.80 | +1.30% |
| Consensus FY2027 revenue | $13,239.6m | $13,239.6m | none — snapshot byte-identical |
| Consensus FY2027 EPS | $12.0195 | $12.0195 | none |
| Consensus FY2026 revenue / EPS | $11,774.0m / $10.7927 | unchanged | none |
| House FY2027 revenue | $13,268.5m | unchanged | — |
| the dissolved variant-vs-consensus test (old Gate 2A) gap | +0.22% | +0.22% | none |
| Probability-weighted E[P] | $356.05 | $356.05 | none |
| Net E[R] | −0.41% | −1.69% | −1.28pp (price only) |
| 12-1 momentum | −18.4% | −17.8% | +0.6pp |
| % of 52-week high | 60.2% | 59.9% | −0.3pp |
| vs 200-day MA | −26.1% | −25.1% | +1.0pp |
| Realised vol, 252d | 35.9% | 36.1% | +0.2pp |
| Realised vol, 63d | — | 48.3% (ex 17-Jul gap: 38.0%) | see note |
| Beta vs SPY, 1yr | 0.88 | 0.90 | +0.02 |
| ATM IV, 20-Nov / 15-Jan | 41.3% / 42.1% | 41.1% / 40.5% | −0.2 / −1.6pp |
One Alpha Vantage call was used (EARNINGS_ESTIMATES, ISRG, 28 Jul 2026) against the shared 25/day cap and
cached immediately to data/av_earnings_estimates_20260728.json. It returned a response byte-identical to the
27 July cache. Consensus therefore did not move; the vendor has not refreshed its snapshot. the dissolved variant-vs-consensus test (old Gate 2A) is
unchanged at +0.22%. Reported as a limitation of the data, not as a finding about the Street.
The volatility note matters and is carried here so it is not lost in Task 5. 21-day realised volatility reads 71.1% and 63-day 48.3% — which would move the name from the Moderate to the High volatility tier. Excluding the single 17 July earnings gap those become 48.1% and 38.0%, and 126-day falls from 39.7% to 33.6%. The 252-day figure is 36.1%. The apparent vol regime change is one day of data. The tier stays Moderate; the sizing stays 1.0%. This is structurally the same artifact as the falsified "Ion ramp," caught by the same rule (normalise, and check whether one observation is carrying the series).
Post-earnings revision detail (feeds the PEAD check in Task 5 §R.1): FY2026 EPS $10.4192 → $10.7927 (+3.58%), FY2027 $11.7858 → $12.0195 (+1.98%), Q3 2026 $2.5883 → $2.6350 (+1.80%), all measured against the 30-days-prior (pre-print) field. Estimate-revision momentum is positive.
Mention-frequency: no new quarter exists (2026Q2 is the latest call; next is ~20 Oct). The 14-quarter series was re-derived from the pinned Alpha Vantage corpus and reproduces exactly — see Task 5 §R.6 for the restated per-10k tables and the re-verification that the three previously-falsified claims stay falsified.
| Price (Alpaca SIP close, 27-Jul-2026) | $357.16 |
| Diluted shares (Q2 2026 10-Q) | 357.3m |
| Market capitalisation | $127.6bn |
| Cash and investments | $8.63bn |
| Total debt | $0 |
| Enterprise value | $119.0bn |
| Multiple | Value |
|---|---|
| EV / LTM revenue ($11.03bn) | 10.8x |
| EV / FY2026E consensus revenue | 10.1x |
| EV / FY2027E consensus revenue | 9.0x |
| P / LTM GAAP EPS ($8.79) | 40.6x |
| P / FY2026E consensus non-GAAP EPS ($10.79) | 33.1x |
| P / FY2027E consensus non-GAAP EPS ($12.02) | 29.7x |
ISRG's forward P/E averaged 55.1x over 2020–2024 (year-end price ÷ next-year actual non-GAAP EPS; the FY2024 $7.34 and FY2025 $8.93 non-GAAP EPS figures are taken from the Q4 2025 8-K reconciliation, so the recent end of that series is filing-sourced). Today it is 33.1x — a 40% de-rating (Chart 12).
The decomposition is stark and worth stating precisely (Chart 22):
| 2026 year-to-date | |
|---|---|
| Share price | −36.4% ($561.98 → $357.16) |
| Consensus FY2026 EPS revision (90 days) | +3.6% ($10.41 → $10.79) |
| Implied multiple change | −38.6% |
100% of the 2026 decline is multiple compression. None of it is numbers. Estimates have gone up — FY2026E non-GAAP EPS from $10.42 to $10.79 over 30 days, FY2027E from $11.79 to $12.02 — while the stock fell 37% (Chart 21). This is not a company missing; it is a market repricing the duration and certainty of a growth stream. Which is exactly why a valuation-based argument, in either direction, is the wrong tool here. The question is whether the repricing is correct, and that is a question about procedure growth, not about a multiple.
Consensus estimates (Alpha Vantage EARNINGS_ESTIMATES, pulled 27 July 2026, cached to
data/av_earnings_estimates.json):
| FY2026E | FY2027E | |
|---|---|---|
| Revenue (mean) | $11,774m (30 analysts) | $13,240m (31 analysts) |
| Non-GAAP EPS (mean) | $10.79 (24 analysts) | $12.02 (26 analysts) |
| EPS range | $10.66 – $11.08 | $11.28 – $12.72 |
| EPS 30 days ago | $10.42 | $11.79 |
| Revisions, trailing 30d | 2 up, 0 down | 0 up, 2 down |
| Implied revenue growth | +17.0% | +12.4% |
| Implied EPS growth | +20.8% | +11.4% |
Consensus rating and targets (public aggregators, 27 July 2026 — flagged as aggregator-sourced, not a paid feed): approximately 79% Buy, average target ~$490 across 32–40 analysts. Post-Q2 target cuts cluster much lower and are the more relevant data:
| Firm | Action, 17 July 2026 | New target | Old |
|---|---|---|---|
| Evercore ISI | Maintain In-Line | $375 | $430 |
| Leerink | Maintain Outperform | $454 | $573 |
| Raymond James | Maintain Outperform | $483 | $577 |
| Bernstein | Cut on US growth concerns | (cut) | — |
The house view sits below the Street's stale $490 average and inside the post-Q2 revised cluster of $375–483. Decomposing the gap:
Honest framing of who is contrarian: a bullish view on ISRG is with the Street's rating (79% Buy) and against the market's price. It means the bull case requires other people to change their minds about a multiple, with no informational advantage.
SUPERSEDED (2026-07-29). The original concluded that this is "precisely the setup this framework is built to decline." That reasoning is retired. v1.6.0 requires no variant versus consensus — the requirement was the contrarian-only trap, and Path B is dissolved rather than renamed. Agreeing with the Street is recorded under the Consensus Criteria (MEASURED) and declines nothing.
The model (ISRG_Underwriting_Model_2026-07-27.xlsx, DCF tab) is a ten-year unlevered FCF DCF with mid-year
convention, verified in Excel and tied to an independent Python recalculation to the cent.
| Input | Value | Source / status |
|---|---|---|
| Risk-free rate | 4.20% | ASSUMPTION — no live rates feed this session |
| Equity risk premium | 4.50% | ASSUMPTION — standard long-run US ERP |
| Beta | 1.00 | Blend of 1-yr regressed 0.88 and 2-yr 1.13 vs SPY, from Alpaca daily returns |
| WACC | 8.70% | Computed; no debt |
| Normalised tax rate | 18.0% | GAAP effective has run 13–15% on SBC excess benefits; 18% is deliberately conservative |
| Terminal growth | 3.5% | ASSUMPTION |
| Capex / revenue | 6.0% | vs 5.4% actual FY2025; conservative |
| D&A / revenue | 5.2% | vs FY2025 depreciation $600m on $10,065m = 6.0% |
Base case output: $326.53 per share, −8.6% versus spot. Terminal value is 67% of enterprise value.
RESOLVED IN v1.4.0 — and stated carefully, because the prior build did not hide this. The prior published base was $334.38, built on
Assumptions!C26 = 14.5%FY2027 revenue growth while the dissolved variant-vs-consensus test (old Gate 2) used the revised house build of +11.5%. The prior02_Financial_Model_Notes.mdflagged that openly as "a deliberate, disclosed inconsistency," arguing the higher number kept the DCF from looking tuned to fit the decision. That argument has real merit. But it left the memo's headline DCF value describing a forecast the memo did not hold, and leftIncome Statement!H19computing +2.9% versus consensus while every narrative section said +0.2%. The better discipline is to run the DCF on the house forecast and then say plainly that it moves against you. Done: FY2027E revenue now computes to $13,268m, +0.22% vs consensus — exactly what the dissolved variant-vs-consensus test (old Gate 2) always claimed — and the base falls to $326.53. Note the prior build's own estimate of this effect ("roughly $310–315") was too low by $13–16; the real number was only available by running it. Re-verified by reading back calculated cells in Excel. Bear and Bull runs used their own FY2027 growth rates and are unaffected.
| Scenario | DCF value/share |
|---|---|
| Bear | $173 |
| Base | $327 (was $334 — see the correction above) |
| Bull | $461 |
Sensitivity (Chart 14) spans $256 to $497 across WACC 7.75–9.75% and terminal growth 2.5–4.5%.
A $241 spread — 71% of the base value — driven entirely by two unobservable inputs, on a model where 68% of the value sits beyond year ten, is not a valuation. It is an arithmetic restatement of the assumptions. Moving the terminal growth rate by 50bp moves the answer by ~$20; moving WACC by 50bp moves it by ~$30. Nothing in this memo should turn on it, and nothing does.
The DCF earns its place in exactly one way: it says that at $357, the market is already paying roughly fair value for — and, after the correction, slightly above — a reasonable base case. It is a sanity check that there is no obvious mispricing, not a price target. A price target quoted to the cent off this model would be false precision, and this memo does not quote one — it quotes ranges (Section 3.6).
Per Section 1.2, procedure growth ≈ installed-base growth + ~3% utilisation, and procedures drive 76% of revenue.
So the model that decides the investment is a fleet model, not a cash-flow model. It lives on the
Placement Share tab.
Inputs, with honest labelling:
| Input | Value | Status |
|---|---|---|
| ISRG FY2025 placements | 1,721 | DISCLOSED (10-K p.67) |
| Installed base 31-Dec-2025 | 11,106 | DISCLOSED |
| Utilisation growth | +3% | DISCLOSED (10-K p.67; Q2 2026 US) |
| Retirement rate | 5.2% of opening base | CALIBRATED — from the disclosed roll-forward; cross-checks to 5.31% annualised on H1 2026 |
| ISRG share of global new placements, 2025 | ~87% | ESTIMATE — NOT DISCLOSED BY ANYONE |
| Total-market new-placement growth | 12% p.a. | ASSUMPTION |
The 87% share estimate is triangulated from competitors' cumulative-procedure disclosures: CMR ~45,000 patients treated globally (March 2026); Distalmotion ~3,000 patients; Medtronic Hugo "tens of thousands" of procedures across 30+ countries; J&J Ottava pre-commercial. Those cumulative figures imply competitor fleets in the low hundreds against ISRG's 11,710. No vendor publishes comparable unit placements and no paid feed provides this either — 87% could reasonably be 82% or 92%. The conclusions below are deliberately insensitive to that level and sensitive only to the direction and pace of change, which is the point of running it as a grid.
| Scenario | ISRG share of new placements by 2030 | Installed-base CAGR 2025–30 | 2030E procedure growth |
|---|---|---|---|
| Bull | holds at 85% | 11.9% | 14.8% |
| Base | erodes to 78% | 11.3% | 13.7% |
| Bear | collapses to 65% | 10.0% | 11.5% |
The model calibrates: Base case 2026 installed-base growth computes to 12.0%, matching the disclosed actual +12% exactly.
The counter-intuitive result: even if Intuitive loses a quarter of its share of new placements by 2030, da Vinci procedure growth only falls to ~11.5% — because the underlying market is assumed to compound at 12%. Share loss, at any plausible pace, does not break this business inside five years.
Chart 32 / Placement Share tab, 2030E procedure growth:
| Market growth ↓ / 2030 share → | 60% | 65% | 70% | 78% | 85% | 90% |
|---|---|---|---|---|---|---|
| 3% | 7.1% | 7.8% | 8.4% | 9.4% | 10.2% | 10.7% |
| 5% | 7.9% | 8.6% | 9.2% | 10.3% | 11.1% | 11.7% |
| 7% | 8.7% | 9.4% | 10.1% | 11.2% | 12.1% | 12.7% |
| 9% | 9.5% | 10.3% | 11.0% | 12.2% | 13.2% | 13.8% |
| 12% | 10.8% | 11.6% | 12.5% | 13.7% | 14.8% | 15.5% |
| 15% | 12.2% | 13.1% | 14.0% | 15.4% | 16.5% | 17.3% |
Reading across a row versus down a column: share spans 3.6 points of procedure growth; market growth spans 5.1–6.6 points. Market growth matters roughly 1.7x more than competitive share.
This reframes the entire debate. The market has spent 2026 repricing ISRG on competitive entry — Hugo, Ottava, the July 22 De Novo. That is the second-order variable. The first-order variable is the growth of the addressable procedure pool, and it is being attacked by things that have nothing to do with robotics vendors:
If the reviewer takes one methodological point from this memo, it should be this: the consensus narrative and the actual sensitivity were pointing at different variables, and the model was what revealed it.
FY2025 actuals from EDGAR XBRL; prices from Alpaca, 27 July 2026. Medtronic is FY ending 24 April 2026.
| Company | Mkt cap ($bn) | FY25 revenue ($m) | Rev growth | Op margin | Gross margin | P/E (trailing GAAP) |
|---|---|---|---|---|---|---|
| ISRG | 126.2 | 10,065 | +20.5% | 29.3% | 66.0% | 44.2x |
| SYK | 129.1 | 25,116 | +11.2% | 19.5% | 64.0% | 39.8x |
| BSX | 68.8 | 20,074 | +19.9% | 18.0% | 69.0% | n/a¹ |
| EW | 48.0 | 6,068 | +11.5% | 20.8% | 78.0% | 44.7x |
| ABT | 183.3 | 44,328 | +5.7% | 18.2% | n/a¹ | 28.1x |
| MDT | 108.2 | 36,364 | +8.4% | 17.8% | n/a¹ | 22.5x |
| PEN | 12.6 | 1,404 | +17.5% | 13.5% | 67.1% | 70.9x |
| GMED | 10.6 | 2,939 | +16.7% | 16.3% | n/a¹ | 19.8x |
| Median ex-ISRG | +11.5% | 18.0% | 33.9x |
¹ Not tagged under the standard XBRL concept for that issuer; flagged rather than substituted.
Reading it honestly: ISRG trades at a 30% premium to the peer median P/E — it is not cheap versus peers. But it grows 1.78x the median rate and carries the highest operating margin in the set by ~9 points (Charts 23, 24). On growth-adjusted terms the premium is modest. On the forward numbers that matter, ISRG is at 29.7x consensus FY2027E EPS — versus SYK and EW at high-20s to ~30x forward on roughly half the growth rate.
The comps do not settle anything. They say ISRG is no longer priced as a category of one, which is a change, and they place fair value in a wide band. Applied to FY2027E EPS:
| Multiple | On consensus $12.02 | On house $12.89 |
|---|---|---|
| 22x | $264 | $284 |
| 26x | $313 | $335 |
| 30x | $361 | $387 |
| 33x | $397 | $425 |
| 36x | $433 | $464 |
| Scenario | Weight | Value range | Midpoint | vs spot |
|---|---|---|---|---|
| Bear | 25% | $200 – 245 | $220 | −38.4% |
| Base | 48% | $330 – 390 | $360 | +0.8% |
| Bull | 27% | $450 – 500 | $475 | +33.0% |
| Probability-weighted | $356 | −0.3% |
Two v1.4.0 changes, each with a single stated cause. (1) The Base range and midpoint fall, forced mechanically
by the DCF correction ($334.38 → $326.53) — a consequence of fixing the model, not a change of view. (2) The bear
weight falls 30% → 25% because the XiR/ASC evidence (01b, Part 4, Vector D) materially de-risks one named bear
driver — the migration of benign general surgery to a channel the prior memo said ISRG could not serve. The
release is split to Base and Bull. No other input changed, and the Task 5 decision is unchanged either way.
Spot ($357) sits inside the base-case range. There is no valuation edge at this price in either direction on this instrument.
SUPERSEDED (2026-07-29). The original continued: "that is … why the decision in Task 5 is not a valuation call." Task 5 no longer contains a decision. The v1.6.0 valuation output is §0 above: implied path requires 26.0% vs 17.4% demonstrated (−8.6pp) on the scan's constant terminal margin, or +0.7pp and a PASS on ISRG's own 29.3% margin; 12-month target $427 (+17.9%).
Chan, Karceski & Lakonishok (2003) find growth persistence beyond chance is nearly nonexistent, and that sustained 20%+ growth for 5+ years at multi-billion revenue scale is a top-decile outcome. Explicitly, against that prior:
The 30% bear weight is the single most consequential judgment in this memo, and it is a judgment, not an output. A reader who thinks 15% is right gets a materially different answer. Under v1.6.0 the bear weight is no longer a valuation input at all — the sensitivity runs over the exit multiple (§0.1), not over probabilities, precisely because a judgement input that determines the answer should not be the axis the analysis is run on.
History window: 2023Q1 – 2026Q2, fourteen consecutive quarters. Eight were pulled this session; the sweep
stopped at 2022Q4 on the Alpha Vantage 25/day cap, so 2022 and earlier is not covered and no claim below
extends past 2023Q1. Counts are per 10,000 words because two transcripts (2023Q4, 2025Q1) are materially
truncated — raw counts in those quarters understate, and the prior build's headline Ion finding was an artifact
of exactly that. Charts: Exhibits 36 (heatmap), 37 (prepared-vs-total series), 38 (PubMed corroboration).
Full method, the generative open-question list, and the independent-corpus investigation are in
01b_Unpublished_Scoping_and_TAM.md.
| Term | 23Q1 | 23Q3 | 24Q1 | 24Q3 | 25Q1* | 25Q3 | 25Q4 | 26Q1 | 26Q2 | First material qtr | Prepared-remarks share | Read |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| XiR | 0 | 0 | 0 | 0 | 0 | 1 | 10 | 3 | 14 | 2025Q4 | 43% and rising; CEO prepared remarks 2 qtrs running | EMERGING — strongest in the dataset |
| ASCs | 0 | 0 | 0 | 0 | 0 | 7 | 11 | 0 | 7 | 2025Q3 | 26% | EMERGING — new channel |
| cardiac | 0 | 0 | 0 | 0 | 1 | 6 | 16 | 4 | 2 | 2025Q3 | 16% — Q&A-driven | EMERGING but analyst-led |
| GI | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 5 | 2026Q2 | 0% — entirely Q&A | NEW, single quarter, unprompted only by an analyst |
| endoluminal | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 0 | 1 | 2024Q3 (re: Ion) | 67% | NOT a first-ever mention — see correction below |
| Ion | 20 | 16 | 21 | 21 | 4* | 25 | 18 | 17 | 18 | pre-window | 89% | STABLE — flat at ~24/10k, no trend |
| SP | 11 | 12 | 10 | 14 | 2* | 16 | 13 | 20 | 14 | pre-window | 82% | STABLE / high |
| force feedback | 0 | 0 | 7 | 8 | 9 | 21 | 11 | 4 | 8 | 2024Q1 | 71% | Emerged, now decaying from peak |
| extended use | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 5 | 2026Q2 | 40% | EMERGING |
| cost | 3 | 10 | 1 | 2 | 2 | 9 | 11 | 8 | 16 | 2025Q3 | 63% | EMERGING — highest in 14 qtrs |
| access | 4 | 3 | 1 | 3 | 1 | 4 | 8 | 10 | 7 | 2025Q4 | 57% | EMERGING |
| reimbursement | 3 | 3 | 2 | 1 | 0 | 2 | 4 | 8 | 5 | 2026Q1 | 40% | EMERGING |
| affordability | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 2026Q2 | 100% | FIRST APPEARANCE in 14 qtrs |
| China | 19 | 19 | 17 | 13 | 8 | 9 | 8 | 7 | 8 | pre-window | 63% | DECAYING — halved per 10k |
| bariatric | 1 | 19 | 4 | 2 | 0 | 3 | 1 | 1 | 2 | 2023Q2 | 100% | DECAYING from the 2023 GLP-1 peak |
| backlog / capacity | 6 / 7 | 0 / 6 | 6 / 2 | 1 / 2 | 0 / 1 | 0 / 3 | 0 / 0 | 0 / 2 | 0 / 2 | pre-window | — | DECAYED to zero |
* truncated transcript — 2025Q1 has 2,400 words versus a ~7,900 norm
Emerging: XiR, ASCs, extended use, cost, access, reimbursement, affordability — and read as one
cluster rather than seven terms, this is a company publicly repositioning to a segmented value strategy.
cardiac and GI are also emerging but are Q&A-weighted and Q&A-only respectively.
Decaying: growth (155 → 102 per 10k, the largest single decay in the corpus), China (halved while the
disclosed situation deteriorated), bariatric (the problem persists; the discussion does not), backlog and
capacity (to zero — the supply-constraint era is over), and prostatectomy / hysterectomy / colon
resection (the mature US core has left the vocabulary while cholecystectomy, hernia and appendectomy
persist).
Stable: Ion, SP, Japan, Europe.
endoluminal is not a first-ever 2026Q2 mention. It appears in 2024Q3 prepared remarks — Gary
Guthart: "Turning to our endoluminal system, we launched Ion in Q3 of 2019." It is ISRG's standing
descriptor for Ion. What is genuinely new in 2026Q2 is endoluminal applied to the GI tract, which is a
narrower and more defensible claim.Honesty note the counts cannot capture. cardiac falls to 2 mentions in 2026Q2 — yet those two mentions are
in prepared remarks and carry a hard number: "cardiac procedures accelerated to 39% growth in Q2." Mention
counts measure attention, not economics, and a falling count can carry rising information. Always read the
surrounding text.
Full build in 01b, Part 5; arithmetic on the model's TAM & Vectors tab; all values read back from Excel.
FY2025: 3,244,100 total procedures (3.10m da Vinci + 0.144m Ion) on $10,065m of revenue = $3,103 of all-in revenue per procedure. Enterprise value at $357.16 = $118,970m.
| Terminal EV/revenue | Implied sustainable revenue | Implied annual procedures | % of management's own 9m "direct line of sight" |
|---|---|---|---|
| 4.0x | $29,743m | 9.59m | 107% |
| 5.0x | $23,794m | 7.67m | 85% |
| 6.0x | $19,828m | 6.39m | 71% |
| 7.0x | $16,996m | 5.48m | 61% |
At $357.16, ISRG's enterprise value requires roughly 7.7 million annual procedures — 2.4x FY2025's 3.24 million, and 85% of the entire 9-million-procedure pool management itself described as being "in direct line of sight" at JPMorgan in January 2026. Even after a 41% drawdown, the price requires near-complete capture of the company's own stated opportunity.
This is conservative in two ways: revenue per procedure is held flat when the disclosed trend is down ($1,860 → $1,830 of da Vinci I&A per procedure, with EUP and XiR both pushing it lower); and 5.0x sits mid-range against SYK ~5x, BSX ~3.5x, EW ~8x for a business with 70% gross and 40% operating margins.
Cross-check against the pipeline (the answer to the reviewer's thesis): the four vectors — Ion/lung, cardiac, endoluminal GI, XiR/ASC — are worth ~1.56m incremental annual procedures sized generously. The price requires ~4.4m. The pipeline carries about one third of the growth embedded in today's valuation; the other two thirds must come from deeper penetration of the core. The pipeline is the option, not the thesis.
EV/TAM, secondary only, with its denominator's elasticity stated as required. 9m procedures × $3,103 = $27,923m revenue TAM → EV/TAM = 4.26x. But management moved that denominator from 6m procedures (2023 investor deck) to 7m to 9m (JPMorgan, January 2026) — a +50% redefinition in three years, at its own discretion, with no external audit — while simultaneously citing a 20m total soft-tissue pool in 2023, at which EV/TAM would be 1.9x. The ratio moves by more than 2x on a management slide. That is exactly why it is a secondary sanity check here and never the headline.
ISRG did not appear anywhere in the 2026-07-27 screen (reports/screens/Screen_2026-07-27.md and .json) —
not among the 47 scored longs, not among the 27 scored shorts, not among the 76 dropped names. Verified: zero
occurrences of the string "ISRG" in the screen output.
This is a user-directed name, not a screen pick. It was in the liquid universe — it is a $126bn mega-cap — but it failed to clear the Stage B momentum/trend shortlists in either direction. The long cut in this cycle was roughly +310% trailing 12-1 momentum; ISRG's is −18.4%.
What that means, stated as base-rate information rather than a footnote: this name arrives with no momentum tailwind and, in fact, an active momentum headwind. The screening funnel exists because momentum is the most robust anomaly in the empirical record (Jegadeesh & Titman 1993, persistent out-of-sample across markets and decades), and because Grinold's IR ≈ IC × √breadth says the edge comes from underwriting names with base-rate support. A name that fails the screen is being underwritten on the analyst's judgment alone, with the empirical prior running against it. That should raise the evidentiary bar, and in this memo it does — it is the direct input to Momentum Criteria, which fails.
All readings are for a contemplated LONG position. Chart 17.
| Signal | Computed value | Read | What this factor says |
|---|---|---|---|
| Price momentum (12-1) | −18.4% (vs SPY +15.7%) | STRONG HEADWIND | Bottom-decile large-cap momentum. Jegadeesh & Titman 1993; Asness/Moskowitz/Pedersen 2013. Buying this is buying a falling knife |
| 52-week-high proximity | 60.2% of the $592.85 high | STRONG HEADWIND | George & Hwang 2004 — stocks far from the 52wk high underperform. 52-week low of $332.02 was set 23 July, four sessions ago |
| Trend filter (200dma) | −26.1% below ($483.56); also −12% below the 50dma ($405.59) | STRONG HEADWIND | Downtrend fully intact. No lower-high sequence has been broken |
| Earnings surprise (SUE) | Q2 2026 non-GAAP EPS $2.80 vs $2.50 consensus = +11.9%. Q1 2026 $2.50 vs $2.11 = +18.7% | TAILWIND | Bernard & Thomas 1989 (PEAD). Two consecutive large beats predict positive drift. Note the $0.08 IEEPA tariff refund: ex-that, Q2 was +8.8% — still a clean beat |
| Estimate revisions | FY2026E $10.42 → $10.79 (+3.5% in 30d); FY2027E $11.79 → $12.02 (+2.0%); 2 up / 0 down on FY26 | TAILWIND | Chan/Jegadeesh/Lakonishok 1996. Revisions positive while price fell 37% — a genuine divergence |
| Gross profitability | GP/Assets = 0.352 (LTM); 0.325 FY2025 | STRONG TAILWIND | Novy-Marx 2013. High and rising. Top-quartile for a mega-cap |
| Accruals (Sloan) | (NI − CFO)/Assets = −0.9% (FY2025); negative every year 2021–25 | STRONG TAILWIND | Sloan 1996. CFO exceeds net income consistently. Earnings quality is clean — no red flag anywhere |
| Asset growth | +3.5% YoY (LTM), down from +21.4% (FY2024) | STRONG TAILWIND | Cooper/Gulen/Schill 2008 — low asset growth predicts outperformance. The 2023–24 capacity build has rolled off |
| Piotroski F-score | 8 / 9 | STRONG TAILWIND | Piotroski 2000. Only failed criterion: FY2025 GAAP gross margin fell (66.0% vs 67.5%) on tariffs and dV5 mix — and it has already recovered (H1 2026: 66.9% vs 65.5%) |
| Short interest | ~1% of float; no meaningful change reported (Nasdaq/aggregator, lagged) | NEUTRAL / mild tailwind | Asquith/Pathak/Ritter 2005. Nobody is short this. No squeeze fuel, and no informed-short signal either |
| Insider buying | ZERO open-market purchases in 12 months, through a 41% drawdown | NEUTRAL, notably absent | Cohen/Malloy/Pomorski 2012 — buys are the signal, sales are noise. The signal that would have mattered did not appear |
Every quality and fundamental factor is a tailwind. Every price-based factor is a strong headwind. There is no ambiguity in either block:
These do not net out — they are a description of a specific, recognisable situation: a high-quality business in a violent multiple de-rating, where the fundamentals have not yet broken and the market is pricing that they will. The quality factors are measuring the past; the price factors are the market's forecast.
The empirically honest reading is that momentum and PEAD are in direct conflict here, and momentum is both the more robust anomaly and the one operating at the longer horizon. Trying to buy quality into bottom-decile momentum has historically been expensive, and Daniel & Moskowitz (2016) is only a partial defence — momentum crashes occur off market bottoms, not off single-name de-ratings.
The scorecard therefore reads: Quality Criteria is corroborated — the quality block strongly supports a durable-fundamentals mechanism.
SUPERSEDED (2026-07-29). The original continued: "Gate 6 fails (the price block is unambiguous). It does not resolve Gate 2 … and that is where this idea actually dies." Both clauses are retired. Momentum Criteria is MEASURED — it cannot fail a name, only time an entry; the price block is real and is reported as an unfavourable entry window (12-1 −17.8%, 18.7th cross-sectional percentile). And the variant-vs-consensus test is dissolved, so nothing "dies" on it — the Consensus Criteria records the gap and blocks nothing.
Alpaca options snapshots, 27 July 2026 (Chart 27):
| ATM implied vol, 20-Nov-2026 | 41.3% |
| ATM implied vol, 15-Jan-2027 | 42.1% |
| Realised vol, trailing 1 year | 35.9% |
| Realised vol, trailing 2 years | 34.5% |
| Variance risk premium | ~5–6 vol points |
| Beta vs SPY (1yr regressed) | 0.88 (correlation only 0.31) |
Skew is inverted versus the usual equity pattern: Nov-20 calls are bid over puts (C420 at 42.0% IV vs P360 at 39.5%, P340 at 39.9%). That is demand for a rebound, not for downside protection — the market is not pricing crash risk, it is pricing an already-happened crash and someone is paying up for the bounce.
Implication for Task 5: buying premium here is expensive. The Nov-20 ATM straddle (C360 mid $33.81 + P360 mid $30.86 = $64.67) implies an 18.1% move by 20 November — which already brackets most of the base-case range. With IV 5–6 points over realised and calls skewed rich, a naked long call is a structurally poor way to express a bullish view, and a defined-risk call spread is the only defensible options structure. This is worked through in Task 5.