Instruments and accessoriesWide moat

Intuitive Surgical (ISRG) — moat facet

Sixty percent of revenue, paid per operation, and about to be asked to earn the same on fewer instruments.

Instruments and accessories are the business. The line had revenue of $6,018.9 million in 2025, from $5,079.0 million in 2024 and $4,276.6 million in 2023 1, 60% of the company 2. It covers the instruments and accessories used in each da Vinci or Ion operation.

Instruments and accessories revenue ($m)$4,276.6m2023$5,079.0m2024$6,018.9m2025$2,841.8mH1 2025$3,421.3mH1 2026Intuitive Surgical Form 10-K FY2025 and 10-Q Q2 2026
About 18-20% a year, the pace of the operations it is sold into.

It is paid per operation. A chip inside each instrument limits it to a set number of uses, so revenue follows procedures rather than placements. In 2025 da Vinci procedures rose 18% to about 3,153,000 and Ion procedures 51% to about 144,100 3, and instrument revenue rose 19% 4.

The line compounded at about 18.6% a year from 2023 to 2025 5, close to the pace of procedures.

Intuitive does not disclose the margin on instruments alone. Product gross margin, for instruments and systems together, was 65.7% in 2023, 67.2% in 2024 and 66.3% in 2025 6.

The latest quarter grew more slowly. Instrument and accessory revenue was $1,734.9 million in the June 2026 quarter against $1,474.1 million, up 18% 7, driven by about 15% growth in da Vinci procedures and about 36% in Ion procedures 8. U.S. instruments were $1,180.4 million and the rest of the world $554.5 million 9.

The outlook has two known headwinds. Procedure growth is guided to 13.5% to 15.5% for 2026 against 18% in 2025 10, and the Extended Use Program will allow more uses per instrument on selected EndoWrist products from the first half of 2027 11, lowering the number of instruments each operation needs. The number to watch is instrument revenue growth against worldwide procedure growth: in the June quarter it was 18% against about 15%, and falling below procedure growth after 2027 would show the cost of the program.

Moat trajectory: Holding steady

Instrument revenue grew 18% in the June 2026 quarter, against 19% for 2025, as procedure growth slowed.

The number that tests this moat
Reported
Instruments and accessories revenue, first half
$3,421.3M in H1 2026, +20% on $2,841.8M

The line tracks procedures; a first half growing more slowly than procedures would mean less revenue per operation.

Source: Intuitive Surgical Form 10-Q, Q2 2026 ↗
References
  1. ReportedThe line had revenue of $6,018.9 million in 2025, from $5,079.0 million in 2024 and $4,276.6 million in 2023 , 60% of the company .
    Intuitive Surgical Form 10-K FY2025 - revenue by line 2023-2025 (instruments and accessories, systems, service), recurring revenue and operating lease revenue, product and service gross margins, placements and leases, procedures and installed base, and the drivers of each — FY2023-FY2025 · publ. February 2026 · source ↗
  2. Moat Explorer calcThe line had revenue of $6,018.9 million in 2025, from $5,079.0 million in 2024 and $4,276.6 million in 2023 , 60% of the company .
    Moat Explorer calculation from Intuitive Surgical's Form 10-K FY2025 and Q2 2026 Form 10-Q: shares of revenue and growth rates — FY2023 to Q2 2026 · publ. 2026-09-23 · source ↗
  3. ReportedIn 2025 da Vinci procedures rose 18% to about 3,153,000 and Ion procedures 51% to about 144,100 , and instrument revenue rose 19% .
    Intuitive Surgical Form 10-K FY2025 - revenue by line 2023-2025 (instruments and accessories, systems, service), recurring revenue and operating lease revenue, product and service gross margins, placements and leases, procedures and installed base, and the drivers of each — FY2023-FY2025 · publ. February 2026 · source ↗
  4. ReportedIn 2025 da Vinci procedures rose 18% to about 3,153,000 and Ion procedures 51% to about 144,100 , and instrument revenue rose 19% .
    Intuitive Surgical Form 10-K FY2025 - revenue by line 2023-2025 (instruments and accessories, systems, service), recurring revenue and operating lease revenue, product and service gross margins, placements and leases, procedures and installed base, and the drivers of each — FY2023-FY2025 · publ. February 2026 · source ↗
  5. Moat Explorer calcThe line compounded at about 18.6% a year from 2023 to 2025 , close to the pace of procedures.
    Moat Explorer calculation from Intuitive Surgical's Form 10-K FY2025 and Q2 2026 Form 10-Q: shares of revenue and growth rates — FY2023 to Q2 2026 · publ. 2026-09-23 · source ↗
  6. ReportedProduct gross margin, for instruments and systems together, was 65.7% in 2023, 67.2% in 2024 and 66.3% in 2025 .
    Intuitive Surgical Form 10-K FY2025 - revenue by line 2023-2025 (instruments and accessories, systems, service), recurring revenue and operating lease revenue, product and service gross margins, placements and leases, procedures and installed base, and the drivers of each — FY2023-FY2025 · publ. February 2026 · source ↗
  7. ReportedInstrument and accessory revenue was $1,734.9 million in the June 2026 quarter against $1,474.1 million, up 18% , driven by about 15% growth in da Vinci procedures and about 36% in Ion procedures .
    Intuitive Surgical Form 10-Q, quarter ended 30 June 2026 - revenue by line and region for Q2 and H1 2026, product and service gross margins, installed base — Q2 2026 · publ. July 2026 · source ↗
  8. ReportedInstrument and accessory revenue was $1,734.9 million in the June 2026 quarter against $1,474.1 million, up 18% , driven by about 15% growth in da Vinci procedures and about 36% in Ion procedures .
    Intuitive Surgical Q2 2026 results release (8-K exhibit 99.1) - procedure growth, drivers of instrument and systems revenue, placements, 2026 procedure growth guidance, cash and investments of $8.63 billion — Q2 2026 · publ. 21 July 2026 · source ↗
  9. ReportedU.S. instruments were $1,180.4 million and the rest of the world $554.5 million .
    Intuitive Surgical Form 10-Q, quarter ended 30 June 2026 - revenue by line and region for Q2 and H1 2026, product and service gross margins, installed base — Q2 2026 · publ. July 2026 · source ↗
  10. ReportedProcedure growth is guided to 13.5% to 15.5% for 2026 against 18% in 2025 , and the Extended Use Program will allow more uses per instrument on selected EndoWrist products from the first half of 2027 , lowering the number of instruments each operation needs.
    Intuitive Surgical Q2 2026 results release (8-K exhibit 99.1) - procedure growth, drivers of instrument and systems revenue, placements, 2026 procedure growth guidance, cash and investments of $8.63 billion — Q2 2026 · publ. 21 July 2026 · source ↗
  11. ReportedProcedure growth is guided to 13.5% to 15.5% for 2026 against 18% in 2025 , and the Extended Use Program will allow more uses per instrument on selected EndoWrist products from the first half of 2027 , lowering the number of instruments each operation needs.
    Intuitive Surgical Q2 2026 earnings call, as reported by BigGo Finance - the Extended Use Program raising permitted uses on selected EndoWrist instruments from the first half of 2027 — Q2 2026 · publ. July 2026 · source ↗
Sources
Generated September 23, 2026