Can ISRG's Strong Q2 Procedure Volume Translate Into Durable EPS Upside?

Intuitive Surgical ISRG delivered a solid second-quarter 2025 performance, with procedure volumes up 17% year over year, maintaining double-digit growth across key U.S. and international markets. The performance was led by continued strength in general surgery and gynecology, with particular momentum in hernia repair, bariatrics and colorectal procedures. China also rebounded after a soft first quarter, contributing to international growth.

However, while procedure growth was robust, translating this volume into durable EPS upside presents a nuanced picture. Gross margin during the second quarter declined 200 bps year over year to 67.9%. This was due to higher component and logistics costs, foreign exchange pressure, and a higher mix of new platforms like da Vinci 5, which, while early in adoption, comes with lower margins.

The company placed 395 da Vinci systems in the second quarter (up year over year), with a rising mix of operating leases that depresses near-term revenue recognition but offers long-term recurring benefits. Instruments & Accessories (I&A) revenues grew 18.5%, benefiting from strong procedure growth, and Systems revenue climbed 28.2%, indicating expanding support from an installed base that now exceeds 10,000 systems globally.

Importantly, ISRG reiterated its 2025 margin guidance (66-67%) and highlighted levers to improve operating efficiency, including automation, scale, and a growing contribution from digital tools and services like My Intuitive and SmartFire. With da Vinci 5 expanding into more procedures and Ion gaining traction, particularly in the United States, margin headwinds may moderate.

While strong procedure volume in the second quarter bodes well for I&A sales and long-term system utilization, near-term EPS expansion will depend on controlling margin pressures from FX, inflation and platform mix. If ISRG can drive operational efficiencies while scaling adoption of its newer platforms, durable EPS upside could follow its procedure strength.

Peer Performance

Globus Medical GMED delivered a strong first-quarter 2025 performance with net sales of $598.1 million and adjusted EPS of 68 cents. The integration with NuVasive continues to yield benefits, with synergy capture and operational scale supporting margin expansion. The company saw volume-driven growth across its musculoskeletal solutions, particularly in Enabling Technologies and Imaging, with demand for robotic-assisted surgeries sustaining momentum. GMED also reaffirmed its 2025 guidance, indicating confidence in execution. Overall, robust procedural growth and operational leverage position GMED favorably as they continue to scale its combined platform.

Zimmer Biomet ZBH reported first-quarter 2025 sales of $1.91 billion, up 2.3% at cc, while adjusted EPS was $1.81, down from $1.94 a year ago. U.S. Hips led growth with a 3.7% increase, driven by new launches like the Z1 stem and OrthoGrid. While U.S. Knees remained flat, it is expected to gain traction through expanded adoption of cementless and partial options. The company reaffirmed its 3-5% constant currency organic growth guidance, supported by ongoing product rollouts and channel optimization. Despite modest EPS pressure from tariffs and acquisition costs, ZBH’s procedural volume and innovation cycle remain key tailwinds.

ISRG’s Price Performance, Valuation and Estimates

Shares of ISRG have lost 6.4% in the year-to-date period compared with the industry’s decline of 7.7%.

From a valuation standpoint, Intuitive Surgical trades at a forward price-to-sales ratio of 16.7, above the industry average. But, it is still lower than its five-year median of 17.1. ISRG carries a Value Score of D.

The Zacks Consensus Estimate for Intuitive Surgical’s 2025 earnings implies a 6.8% rise from the year-ago period’s level.

The stock currently carries a Zacks Rank #2 (Buy). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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This article originally published on Zacks Investment Research (zacks.com).

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