What is the real money-making machine of Intuitive Surgical?

On the surface, Intuitive Surgical ( sells Da Vinci surgical robots to make money. In Q3 2025, they sold 427 units, a year-on-year rise of 13%. But this is just the beginning of the story.

The real cash cow is here:

The robot system only accounts for 25% of the revenue. The remaining 75% is the main course—consumables and services account for 60% of the total revenue! Every time a surgery is performed using a robot, consumables must be purchased. So even though the installation volume of robots has risen by 13%, the number of surgeries has increased by 20%. This figure is crucial.

Reverse view of the 10-year trend:

Ten years ago, Bots sales accounted for 30% of revenue. At this rate, they may only account for 20% in ten years, while the annuity-style revenue from consumables and services could reach 80%. This is the story of shifting from “selling hardware” to “selling subscriptions + services.”

How to view valuation:

P/E 72x, indeed expensive. But this is the standard pricing for growth stocks. The key is how fast this consumable flywheel can turn—if the growth rate of surgeries outpaces the installation speed, it indicates that this model is still accelerating.

In the next decade, the value anchor of this company will shift from “how many Bots are sold” to “how high the repurchase rate can be.” This is the story worth paying attention to.