Intuitive Surgical (ISRG) 10-Q 21 Jul 23 2023 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares	6 Months Ended
	Jun. 30, 2023	Jul. 18, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2023
Document Transition Report	false
Entity File Number	000-30713
Entity Registrant Name	Intuitive Surgical, Inc.
State or Other Jurisdiction of Incorporation or Organization	DE
I.R.S. Employer Identification No.	77-0416458
Entity Address, Address Line One	1020 Kifer Road
Entity Address, City or Town	Sunnyvale
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94086
City Area Code	408
Local Phone Number	523-2100
Title of each class	Common Stock, par value $0.001 per share
Trading Symbol(s)	ISRG
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		351,354,675
Entity Central Index Key	0001035267
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 3,435.4	$ 1,581.2
Short-term investments	2,363.8	2,536.7
Accounts receivable, net	904.2	942.1
Inventory	1,005.2	893.2
Prepaids and other current assets	323.2	299.8
Total current assets	8,031.8	6,253
Property, plant, and equipment, net	2,830.8	2,374.2
Long-term investments	1,332.5	2,623.6
Deferred tax assets	666.5	664.6
Intangible and other assets, net	693.1	710.1
Goodwill	348.6	348.5
Total assets	13,903.3	12,974
Current liabilities:
Accounts payable	199.7	147
Accrued compensation and employee benefits	346.6	401.6
Deferred revenue	405.2	397.3
Other accrued liabilities	586.9	476.2
Total current liabilities	1,538.4	1,422.1
Other long-term liabilities	405.2	439.3
Total liabilities	1,943.6	1,861.4
Contingencies (Note 8)
Stockholders’ equity:
Preferred stock, 2.5 shares authorized, $0.001 par value, issuable in series; zero shares issued and outstanding as of June 30, 2023, and December 31, 2022	0	0
Common stock, 600.0 shares authorized, $0.001 par value, 351.3 shares and 350.0 shares issued and outstanding as of June 30, 2023, and December 31, 2022, respectively	0.4	0.4
Additional paid-in capital	8,150.8	7,703.9
Retained earnings	3,807.7	3,500.1
Accumulated other comprehensive loss	(79.8)	(162.5)
Total Intuitive Surgical, Inc. stockholders’ equity	11,879.1	11,041.9
Noncontrolling interest in joint venture	80.6	70.7
Total stockholders’ equity	11,959.7	11,112.6
Total liabilities and stockholders’ equity	$ 13,903.3	$ 12,974

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Jun. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Preferred stock, shares authorized (in shares)	2,500,000	2,500,000
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, shares authorized (in shares)	600,000,000	600,000,000
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares issued (in shares)	351,300,000	350,000,000
Common stock, shares outstanding (in shares)	351,300,000	350,000,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) shares in Millions, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Revenue:
Total revenue	$ 1,755.9	$ 1,522.1	$ 3,452.1	$ 3,009.8
Cost of revenue:
Total cost of revenue	584	498.8	1,167.2	976.8
Gross profit	1,171.9	1,023.3	2,284.9	2,033
Operating expenses:
Selling, general and administrative	464.3	418.4	944.8	809.5
Research and development	244.4	207.3	489.3	417.8
Total operating expenses	708.7	625.7	1,434.1	1,227.3
Income from operations	463.2	397.6	850.8	805.7
Interest and other income, net	36	9.3	70.2	3.6
Income before taxes	499.2	406.9	921	809.3
Income tax expense	73.2	93.3	134.2	126.3
Net income	426	313.6	786.8	683
Less: net income attributable to noncontrolling interest in joint venture	5.2	5.8	10.7	9.6
Net income attributable to Intuitive Surgical, Inc.	$ 420.8	$ 307.8	$ 776.1	$ 673.4
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (in dollars per share)	$ 1.20	$ 0.86	$ 2.21	$ 1.88
Diluted (in dollars per share)	$ 1.18	$ 0.85	$ 2.18	$ 1.84
Shares used in computing net income per share attributable to Intuitive Surgical, Inc.:
Basic (in shares)	350.9	358.1	350.6	358.2
Diluted (in shares)	357.3	363.9	356.6	365.3
Other comprehensive income (loss), net of tax:
Unrealized gains on hedge instruments	$ 6	$ 4.4	$ 8.5	$ 5.4
Unrealized gains (losses) on available-for-sale securities	13.1	(33.4)	50.7	(124.1)
Foreign currency translation gains (losses)	8.5	(5.5)	22.7	(2)
Prior service cost for employee benefit plans	0	0	0	0.1
Other comprehensive income (loss)	27.6	(34.5)	81.9	(120.6)
Total comprehensive income	453.6	279.1	868.7	562.4
Less: comprehensive income attributable to noncontrolling interest	4.1	4.8	9.9	9
Total comprehensive income attributable to Intuitive Surgical, Inc.	449.5	274.3	858.8	553.4
Corporate Joint Venture
Operating expenses:
Less: net income attributable to noncontrolling interest in joint venture	5.2	5.8	10.7	9.6
Product
Revenue:
Total revenue	1,468.6	1,270.4	2,881.6	2,508.8
Cost of revenue:
Total cost of revenue	498	421	991	818.3
Service
Revenue:
Total revenue	287.3	251.7	570.5	501
Cost of revenue:
Total cost of revenue	$ 86	$ 77.8	$ 176.2	$ 158.5

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Operating activities:
Net income	$ 786.8	$ 683
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and loss on disposal of property, plant, and equipment	180	157.5
Amortization of intangible assets	10	12.3
Gain on sale of business	0	(3.8)
Loss on investments, accretion of discounts, and amortization of premiums on investments, net	14.4	33.8
Deferred income taxes	(17.7)	(40.1)
Share-based compensation expense	286.3	247.5
Amortization of contract acquisition assets	14.9	13.6
Changes in operating assets and liabilities, net of effects of acquisitions:
Accounts receivable	39.3	(56)
Inventory	(288.6)	(245.5)
Prepaids and other assets	(13.8)	(90.1)
Accounts payable	36.5	12.4
Accrued compensation and employee benefits	(55)	(71.5)
Deferred revenue	12.2	(3.1)
Other liabilities	31.8	19.7
Net cash provided by operating activities	1,037.1	669.7
Investing activities:
Purchase of investments	(14)	(1,376.2)
Proceeds from sales of investments	37.5	0
Proceeds from maturities of investments	1,486.9	1,865.1
Purchase of property, plant, and equipment	(372.4)	(224.1)
Acquisition of businesses, net of cash, and intellectual property and other investing activities	(7.3)	(13.3)
Net cash provided by investing activities	1,130.7	251.5
Financing activities:
Proceeds from issuance of common stock relating to employee stock plans	174.8	106.6
Taxes paid related to net share settlement of equity awards	(140.6)	(179)
Repurchase of common stock	(350)	(606.6)
Payment of deferred purchase consideration	(2.1)	(3)
Net cash used in financing activities	(317.9)	(682)
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	7	6
Net increase in cash, cash equivalents, and restricted cash	1,856.9	245.2
Cash, cash equivalents, and restricted cash, beginning of period	1,600.7	1,306
Cash, cash equivalents, and restricted cash, end of period	$ 3,457.6	$ 1,551.2

DESCRIPTION OF THE BUSINESS

DESCRIPTION OF THE BUSINESS	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
DESCRIPTION OF THE BUSINESS	DESCRIPTION OF THE BUSINESS Intuitive Surgical, Inc. (“Intuitive” or the “Company”) develops, manufactures, and markets da Vinci ® surgical systems and the Ion ®

SUMMARY OF SIGNIFICANT ACCOUNTI

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation In the opinion of management, the accompanying unaudited Condensed Consolidated Financial Statements (“Financial Statements”) of Intuitive Surgical, Inc. and its wholly and majority-owned subsidiaries have been prepared on a consistent basis with the audited Consolidated Financial Statements for the fiscal year ended December 31, 2022, and include all adjustments, consisting of only normal, recurring adjustments, necessary to fairly state the information set forth herein. The Financial Statements have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (“SEC”) and, therefore, omit certain information and footnote disclosure necessary to present the Financial Statements in accordance with United States (“U.S.”) generally accepted accounting principles (“GAAP”). These Financial Statements should be read in conjunction with the audited Consolidated Financial Statements and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, which was filed with the SEC on February 10, 2023. The results of operations for the first six months of 2023 are not necessarily indicative of the results to be expected for the entire fiscal year or any future periods. The Financial Statements include the results and balances of the Company’s majority-owned joint ventures, Intuitive Surgical-Fosun Medical Technology (Shanghai) Co., Ltd. and Intuitive Surgical-Fosun (HongKong) Co., Ltd. (collectively, the “Joint Venture”) with Shanghai Fosun Pharmaceutical (Group) Co., Ltd. (“Fosun Pharma”). The Company holds a controlling financial interest in the Joint Venture, and the noncontrolling interest is reflected as a separate component of the consolidated stockholders’ equity. The noncontrolling interest’s share of the earnings in the Joint Venture is presented separately in the Condensed Consolidated Statements of Comprehensive Income. Risks and Uncertainties The Company’s future results of operations and liquidity could be materially adversely affected by macroeconomic and geopolitical factors in the U.S. and globally, including the supply chain environment, inflationary pressure, higher interest rates, instability in the global financial markets, labor shortages, significant disruptions in the commodities’ markets as a result of the Russia and Ukraine conflict, the introduction of or changes in tariffs, trade barriers, or regulatory requirements, and uncertain or reduced demand, as well as the impact of any initiatives or programs that the Company may undertake to address financial and operational challenges faced by its customers. The Company continues to experience difficulties in obtaining a sufficient supply of a number of component materials used in its products, such as semiconductor components as well as a range of other materials including, but not limited to, metals and polymers, as the global supply has become constrained due to increased demand for certain materials. Additionally, prices of such materials remain elevated due to the increased demand and supply shortages. With higher interest rates, access to credit may become more difficult, and any insolvency of the Company’s key suppliers, including sole-sourced and single-sourced suppliers, may exacerbate current supply chain challenges. Also, liquidity concerns in the broader financial services industry could result in delayed access or loss of access to the Company’s key suppliers’ uninsured deposits or loss of their ability to draw on existing credit facilities involving a troubled or failed financial institution. While supply chain disruptions have been, and may continue to be, challenging, the situation has shown signs of improvement during the first half of 2023, relative to 2022. The Company is actively engaged in activities to seek to mitigate the impact of any supply chain disruptions on our operations. Such global shortages in important components have resulted in, and will continue to cause, inflationary cost pressure in the Company’s supply chain. To date, these supply chain challenges have not materially impacted the Company’s results of operations or ability to deliver products and services to its customers. However, if shortages in important supply chain materials in the semiconductor or other markets continue, the Company could fail to meet product demand, which could result in deferred or canceled procedures. Additionally, if inflationary pressures in component costs persist, the Company may not be able to quickly or easily adjust pricing, reduce costs, or implement countermeasures. Additionally, there is continued uncertainty surrounding the impact of any monetary policy changes taken by the U.S. Federal Reserve and other central banks to address the structural risks associated with inflation. Fluctuations in labor availability globally, including labor shortages and staff burnout and attrition, could also impact the Company’s ability to hire and retain personnel critical to its manufacturing, logistics, and commercial operations. The Company is also highly dependent on the principal members of its management and scientific staff. The loss of critical members of the Company’s team, or its inability to attract and retain qualified personnel, could significantly harm its operations, business, and ability to compete. Hospitals are also experiencing challenges with staffing and cost pressures that could affect their ability to provide patient care. Additionally, hospitals are facing significant financial pressure as supply chain constraints and inflation drive up operating costs, higher interest rates make access to credit more expensive, unrealized losses decrease available cash reserves, and fiscal stimulus programs enacted during the COVID-19 pandemic wind down. Hospitals may also be adversely affected by the liquidity concerns in the broader financial services industry that could result in delayed access or loss of access to uninsured deposits or loss of their ability to draw on existing credit facilities involving a troubled or failed financial institution. To the extent macroeconomic conditions remain challenging, it is likely that hospitals’ spend on capital equipment will be adversely impacted. In addition, as competition progresses in various markets, longer selling cycles and pricing pressures are likely to result. As of the date of issuance of these Financial Statements, the extent to which these macroeconomic factors may materially adversely affect the Company’s financial condition, liquidity, or results of operations is uncertain. The Company maintains the majority of its cash and cash equivalents in accounts with major U.S. and multi-national financial institutions, and our deposits exceed insured limits. Market conditions could impact the viability of these institutions. To date, these market conditions and liquidity concerns have not impacted our results of operations. However, in the event of failure of any of the financial institutions where we maintain our cash and cash equivalents, there can be no assurance that we would be able to access uninsured funds in a timely manner or at all. Any inability to access or delay in accessing these funds could adversely affect our business and financial position. The Company is also subject to additional risks and uncertainties due to the ongoing COVID-19 pandemic. The extent of the impact on the Company’s business is highly uncertain and difficult to predict. The Company’s customers may divert resources to treat COVID-19 patients and defer some elective surgical procedures, both of which may impact the Company’s customers’ ability to meet their obligations, including to the Company. The severity of the impact of the COVID-19 pandemic on the Company’s business will depend on a number of factors, including, but not limited to, the duration and severity of the pandemic and the extent and severity of the impact on the Company’s customers, all of which are uncertain and cannot be predicted. Recently Adopted Accounting Pronouncements Troubled Debt Restructurings and Vintage Disclosures In March 2022, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2022-02, Financial Instruments-Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures (“ASU 2022-02”), which eliminates the accounting guidance for troubled debt restructurings by creditors while enhancing disclosure requirements for certain loan refinancings and restructurings by creditors when a borrower is experiencing financial difficulty. Additionally, the standard requires disclosure of current-period gross write-offs by year of origination for financing receivables and net investments in leases within the scope of Subtopic ASC 326-20, Financial Instruments-Credit Losses-Measured at Amortized Cost . The Company adopted ASU 2022-02 on January 1, 2023, on a prospective basis. There was no impact of the adoption of ASU 2022-02 on the Company’s Financial Statements in the three and six months ended June 30, 2023. Recently Issued Accounting Pronouncements The Company continues to monitor new accounting pronouncements issued by the FASB and does not believe any accounting pronouncements issued through the date of this report will have a material impact on the Company’s Financial Statements. Significant Accounting Policies There have been no new or material changes to the significant accounting policies discussed in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, that are of significance, or potential significance, to the Company.

FINANCIAL INSTRUMENTS

FINANCIAL INSTRUMENTS	6 Months Ended
	Jun. 30, 2023
Investments, All Other Investments [Abstract]
FINANCIAL INSTRUMENTS	FINANCIAL INSTRUMENTS Cash, Cash Equivalents, and Investments The following tables summarize the Company’s cash and available-for-sale debt securities’ amortized cost, gross unrealized gains, gross unrealized losses, allowance for credit loss, and fair value by significant investment category reported as cash and cash equivalents, short-term investments, or long-term investments as of June 30, 2023, and December 31, 2022 (in millions): Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- June 30, 2023 Cash $ 520.3 $ — $ — $ — $ 520.3 $ 520.3 $ — $ — Level 1: Money market funds 2,915.1 — — — 2,915.1 2,915.1 — — U.S. treasuries 1,860.8 — (61.0) — 1,799.8 — 1,294.2 505.6 Subtotal 4,775.9 — (61.0) — 4,714.9 2,915.1 1,294.2 505.6 Level 2: Corporate debt securities 1,490.5 — (53.9) (1.1) 1,435.5 — 829.5 606.0 U.S. government agencies 361.2 — (14.3) — 346.9 — 183.8 163.1 Municipal securities 118.2 — (4.1) — 114.1 — 56.3 57.8 Subtotal 1,969.9 — (72.3) (1.1) 1,896.5 — 1,069.6 826.9 Total assets measured at fair value $ 7,266.1 $ — $ (133.3) $ (1.1) $ 7,131.7 $ 3,435.4 $ 2,363.8 $ 1,332.5 Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- December 31, 2022 Cash $ 497.2 $ — $ — $ — $ 497.2 $ 497.2 $ — $ — Level 1: Money market funds 1,084.0 — — — 1,084.0 1,084.0 — — U.S. treasuries 2,715.2 — (96.6) — 2,618.6 — 1,542.4 1,076.2 Subtotal 3,799.2 — (96.6) — 3,702.6 1,084.0 1,542.4 1,076.2 Level 2: Commercial paper 20.0 — — — 20.0 — 20.0 — Corporate debt securities 2,022.0 — (76.0) (1.1) 1,944.9 — 651.8 1,293.1 U.S. government agencies 447.2 — (19.9) — 427.3 — 247.8 179.5 Municipal securities 155.5 — (6.0) — 149.5 — 74.7 74.8 Subtotal 2,644.7 — (101.9) (1.1) 2,541.7 — 994.3 1,547.4 Total assets measured at fair value $ 6,941.1 $ — $ (198.5) $ (1.1) $ 6,741.5 $ 1,581.2 $ 2,536.7 $ 2,623.6 The following table summarizes the contractual maturities of the Company’s cash equivalents and available-for-sale debt securities (excluding money market funds), as of June 30, 2023 (in millions): Amortized Fair Mature in less than one year $ 2,416.8 $ 2,363.8 Mature in one to five years 1,413.9 1,332.5 Total $ 3,830.7 $ 3,696.3 Actual maturities may differ from contractual maturities, because certain borrowers have the right to call or prepay certain obligations. Gross realized gains and losses recognized on the sale of investments were immaterial for the periods presented. As of June 30, 2023, and December 31, 2022, net unrealized losses on available-for-sale debt securities, net of tax, of $103.5 million and $154.2 million, respectively, were included in accumulated other comprehensive loss in the accompanying Consolidated Balance Sheets. The following tables present the breakdown of the available-for-sale debt securities with unrealized losses as of June 30, 2023, and December 31, 2022 (in millions): June 30, 2023 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ — $ — $ 1,799.8 $ (61.0) $ 1,799.8 $ (61.0) Corporate debt securities 84.1 (0.9) 1,344.5 (53.0) 1,428.6 (53.9) U.S. government agencies — — 346.9 (14.3) 346.9 (14.3) Municipal securities — — 107.7 (4.1) 107.7 (4.1) Total $ 84.1 $ (0.9) $ 3,598.9 $ (132.4) $ 3,683.0 $ (133.3) December 31, 2022 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ 731.7 $ (26.0) $ 1,886.9 $ (70.6) $ 2,618.6 $ (96.6) Corporate debt securities 631.4 (17.6) 1,221.9 (58.4) 1,853.3 (76.0) U.S. government agencies 102.7 (4.4) 324.6 (15.5) 427.3 (19.9) Municipal securities 44.6 (1.1) 104.9 (4.9) 149.5 (6.0) Total $ 1,510.4 $ (49.1) $ 3,538.3 $ (149.4) $ 5,048.7 $ (198.5) The Company’s investments may consist of U.S. government money market funds, U.S. treasury and U.S. government agency securities, high-quality corporate notes and bonds, commercial paper, non-U.S. government agency securities, and taxable and tax-exempt municipal notes. The Company regularly reviews its investments and evaluates the current expected credit loss by considering factors such as historical experience, market data, financial condition and near-term prospects of the investee, the extent of any losses related to the credit of the issuer, and the expected cash flows from the security. The Company segments its portfolio based on the underlying risk profiles of the securities and has a zero-loss expectation for U.S. treasury and U.S. government agency securities. The basis for this assumption is that these securities have consistently high credit ratings by rating agencies, have a long history with no credit losses, are explicitly guaranteed by a sovereign entity, which can print its own currency, and are denominated in a currency that is routinely held by central banks, used in international commerce, and commonly viewed as a reserve currency. Equity Investments The Company holds equity investments with readily determinable fair values and equity investments without readily determinable fair values. The Company generally recognizes equity investments that do not have readily determinable fair values at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer. The following table is a summary of the activity related to equity investments (in millions): Reported as: December 31, 2022 Carrying Value Changes in Fair Value (1) Purchases / Sales / Other (2) June 30, 2023 Carrying Value Prepaids and other current assets Intangible and other assets, net Equity investments with readily determinable value (Level 1) $ 4.3 $ (0.4) $ (3.9) $ — $ — $ — Equity investments without readily determinable value (Level 2) $ 59.1 $ (5.6) $ 14.3 $ 67.8 $ — $ 67.8 (1) Recorded in interest and other income, net. (2) Other includes foreign currency translation gains/(losses). Foreign Currency Derivatives The objective of the Company’s hedging program is to mitigate the impact of changes in currency exchange rates on net cash flow from foreign currency-denominated sales, expenses, intercompany balances, and other monetary assets or liabilities denominated in currencies other than the U.S. dollar (“USD”). The terms of the Company’s derivative contracts are generally thirteen months or shorter. The derivative assets and liabilities are measured using Level 2 fair value inputs. Cash Flow Hedges The Company enters into currency forward contracts as cash flow hedges to hedge certain forecasted revenue transactions denominated in currencies other than the USD, primarily the Euro (“EUR”), the British Pound (“GBP”), the Japanese Yen (“JPY”), the Korean Won (“KRW”), and the New Taiwan Dollar (“TWD”). The Company also enters into currency forward contracts as cash flow hedges to hedge certain forecasted expense transactions denominated in EUR and the Swiss Franc (“CHF”). For these derivatives, the Company reports the unrealized after-tax gain or loss from the hedge as a component of accumulated other comprehensive loss in stockholders’ equity and reclassifies the amount into earnings in the same period in which the hedged transaction affects earnings. The amounts reclassified to revenue and expenses related to the hedged transactions and the ineffective portions of cash flow hedges were not material for the periods presented. Other Derivatives Not Designated as Hedging Instruments Other derivatives not designated as hedging instruments consist primarily of forward contracts that the Company uses to hedge intercompany balances and other monetary assets or liabilities denominated in currencies other than the USD, primarily the EUR, GBP, JPY, KRW, CHF, TWD, Indian Rupee (“INR”), Mexican Peso (“MXN”), Chinese Yuan (“CNY”), Canadian Dollar (“CAD”), and Swedish Kronor (“SEK”). These derivative instruments are used to hedge against balance sheet foreign currency exposures. The related gains and losses were as follows (in millions): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Recognized gains in interest and other income, net $ 14.7 $ 21.9 $ 11.4 $ 28.7 Foreign exchange losses related to balance sheet re-measurement $ (16.3) $ (28.8) $ (10.9) $ (38.9) The notional amounts for derivative instruments provide one measure of the transaction volume. Total gross notional amounts (in USD) for outstanding derivatives and the aggregate gross fair value at the end of each period were as follows (in millions): Derivatives Designated as Hedging Instruments Derivatives Not Designated as Hedging Instruments June 30, December 31, June 30, December 31, Notional amounts: Forward contracts $ 250.3 $ 188.4 $ 578.4 $ 496.3 Gross fair value recorded in: Prepaids and other current assets $ 7.6 $ 1.8 $ 5.6 $ 4.3 Other accrued liabilities $ 1.4 $ 5.3 $ 1.8 $ 4.2

BALANCE SHEET DETAILS AND OTHER

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION	BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION Balance Sheet Details The following tables provide details of selected balance sheet line items (in millions): As of Accounts receivable, net June 30, December 31, Trade accounts receivable, net $ 825.7 $ 864.9 Unbilled accounts receivable and other 101.9 91.7 Sales returns and allowances (23.4) (14.5) Total accounts receivable, net $ 904.2 $ 942.1 As of Inventory June 30, December 31, Raw materials $ 390.2 $ 382.9 Work-in-process 145.0 159.9 Finished goods 470.0 350.4 Total inventory $ 1,005.2 $ 893.2 As of Prepaids and other current assets June 30, December 31, Net investment in sales-type leases – short-term $ 134.6 $ 131.2 Other prepaids and other current assets 188.6 168.6 Total prepaids and other current assets $ 323.2 $ 299.8 As of Other accrued liabilities – short-term June 30, December 31, Income and other taxes payable $ 230.2 $ 96.1 Accrued construction-related capital expenditures 113.7 50.3 Litigation-related accruals 3.7 23.0 Other accrued liabilities 239.3 306.8 Total other accrued liabilities – short-term $ 586.9 $ 476.2 As of Other long-term liabilities June 30, December 31, Income taxes – long-term $ 250.3 $ 288.0 Deferred revenue – long-term 45.4 41.0 Other long-term liabilities 109.5 110.3 Total other long-term liabilities $ 405.2 $ 439.3 Supplemental Cash Flow Information The following table provides supplemental non-cash investing and financing activities (in millions): Six Months Ended June 30, 2023 2022 Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment $ 198.5 $ 122.7 Acquisition of property, plant, and equipment in accounts payable and accrued liabilities $ 138.2 $ 95.8

REVENUE AND CONTRACT ACQUISITIO

REVENUE AND CONTRACT ACQUISITION COSTS	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
REVENUE AND CONTRACT ACQUISITION COSTS	REVENUE AND CONTRACT ACQUISITION COSTS The following table presents revenue disaggregated by types and geography (in millions): Three Months Ended June 30, Six Months Ended June 30, U.S. 2023 2022 2023 2022 Instruments and accessories $ 763.3 $ 625.1 $ 1,464.7 $ 1,175.7 Systems 189.8 218.0 411.6 466.3 Services 189.4 168.0 376.1 333.9 Total U.S. revenue $ 1,142.5 $ 1,011.1 $ 2,252.4 $ 1,975.9 Outside of U.S. (“OUS”) Instruments and accessories $ 312.6 $ 270.2 $ 596.8 $ 529.9 Systems 202.9 157.1 408.5 336.9 Services 97.9 83.7 194.4 167.1 Total OUS revenue $ 613.4 $ 511.0 $ 1,199.7 $ 1,033.9 Total Instruments and accessories $ 1,075.9 $ 895.3 $ 2,061.5 $ 1,705.6 Systems 392.7 375.1 820.1 803.2 Services 287.3 251.7 570.5 501.0 Total revenue $ 1,755.9 $ 1,522.1 $ 3,452.1 $ 3,009.8 Remaining Performance Obligations The transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which revenue has not yet been recognized. A significant portion of these performance obligations relate to service obligations in the Company’s system sale and lease arrangements that will be satisfied and recognized as revenue in future periods. The transaction price allocated to the remaining performance obligations was $2.14 billion as of June 30, 2023. The remaining performance obligations are expected to be satisfied over the term of the system sale, lease, and service arrangements. Approximately 43% of the remaining performance obligations are expected to be recognized in the next 12 months with the remainder recognized thereafter over the term of the system sale, lease, and service arrangements, which are generally up to 5 years. Contract Assets and Liabilities The following information summarizes the Company’s contract assets and liabilities (in millions): As of June 30, 2023 December 31, 2022 Contract assets $ 48.1 $ 45.0 Deferred revenue $ 450.6 $ 438.3 The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 to 60 days from the date of invoice. Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative standalone selling price of the related performance obligations satisfied and the contractual billing terms in the arrangements. Deferred revenue for the periods presented primarily relates to service contracts where the service fees are billed up-front, generally quarterly or annually, prior to those services having been performed. The associated deferred revenue is generally recognized over the term of the service period. The Company did not have any significant impairment losses on its contract assets for the periods presented. Intuitive System Leasing The following table presents product revenue from Intuitive System Leasing arrangements (in millions): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Sales-type lease revenue $ 12.3 $ 50.1 $ 35.3 $ 85.7 Operating lease revenue* $ 122.7 $ 93.0 $ 234.7 $ 176.2 *Variable lease revenue relating to usage-based arrangements included within operating lease revenue $ 53.2 $ 33.6 $ 99.2 $ 58.5 Trade Accounts Receivable The allowance for doubtful accounts is based on the Company’s assessment of the collectibility of customer accounts. The Company regularly reviews the allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. For the three and six months ended June 30, 2023, and 2022, bad debt expense was not material.

LEASES

LEASES	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
LEASES	LEASES Lessor Information related to Intuitive System Leasing Sales-type Leases. Lease receivables relating to sales-type lease arrangements are presented on the Condensed Consolidated Balance Sheets as follows (in millions): As of June 30, 2023 December 31, 2022 Gross lease receivables $ 414.1 $ 449.4 Unearned income (14.3) (14.4) Subtotal 399.8 435.0 Allowance for credit loss (3.0) (3.0) Net investment in sales-type leases $ 396.8 $ 432.0 Reported as: Prepaids and other current assets $ 134.6 $ 131.2 Intangible and other assets, net 262.2 300.8 Net investment in sales-type leases $ 396.8 $ 432.0 Contractual maturities of gross lease receivables as of June 30, 2023, are as follows (in millions): Fiscal Year Amount Remainder of 2023 $ 70.3 2024 134.0 2025 103.5 2026 66.6 2027 33.3 2028 and thereafter 6.4 Total $ 414.1 The Company enters into sales-type leases with certain qualified customers to purchase its systems. Sales-type leases have terms that generally range from 24 to 84 months and are usually collateralized by a security interest in the underlying assets. The allowance for loan loss is based on the Company’s assessment of current expected lifetime losses on lease receivables. The Company regularly reviews the allowance by considering factors such as historical experience, credit quality, age of the lease receivable balances, and current economic conditions that may affect a customer’s ability to pay. Lease receivables are considered past due 90 days after invoice. The Company manages the credit risk in net investment in sales-type leases using a number of factors, including, but not limited to the following: size of operations; profitability, liquidity, and debt ratios; payment history; and past due amounts. The Company also uses credit scores obtained from external providers as a key indicator for the purposes of determining credit quality. The following table summarizes the amortized cost basis by year of origination and by credit quality for the net investment in sales-type leases as of June 30, 2023 (in millions): 2023 2022 2021 2020 2019 Prior Net Investment Credit Rating: High $ 27.1 $ 86.2 $ 70.9 $ 32.9 $ 10.0 $ 0.6 $ 227.7 Moderate 9.8 57.2 58.7 28.4 6.8 3.0 163.9 Low — 3.3 3.0 1.9 — — 8.2 Total $ 36.9 $ 146.7 $ 132.6 $ 63.2 $ 16.8 $ 3.6 $ 399.8 For the three and six months ended June 30, 2023, and 2022, credit losses related to net investment in sales-type leases were not material.

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
GOODWILL AND INTANGIBLE ASSETS	GOODWILL AND INTANGIBLE ASSETS Acquisitions There were no material acquisitions in the six months ended June 30, 2023, and 2022. Goodwill The following table summarizes the changes in the carrying amount of goodwill (in millions): Amount Balance as of December 31, 2022 $ 348.5 Acquisition activity — Translation and other 0.1 Balance as of June 30, 2023 $ 348.6 Intangible Assets The following table summarizes the components of gross intangible assets, accumulated amortization, and net intangible assets balances as of June 30, 2023, and December 31, 2022 (in millions): June 30, 2023 December 31, 2022 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents and developed technology $ 204.3 $ (171.6) $ 32.7 $ 199.1 $ (167.4) $ 31.7 Distribution rights and others 10.8 (8.3) 2.5 11.0 (7.4) 3.6 Customer relationships 32.2 (20.2) 12.0 32.6 (18.1) 14.5 Total intangible assets $ 247.3 $ (200.1) $ 47.2 $ 242.7 $ (192.9) $ 49.8 The estimated future amortization expense related to intangible assets as of June 30, 2023, is as follows (in millions): Fiscal Year Amount Remainder of 2023 $ 10.1 2024 16.7 2025 11.7 2026 5.0 2027 2.5 2028 and thereafter 1.2 Total $ 47.2 The preceding expected amortization expense is an estimate. Actual amounts of amortization expense may differ from estimated amounts due to additional intangible asset acquisitions, measurement-period adjustments to intangible assets, changes in foreign currency exchange rates, impairments of intangible assets, accelerated amortization of intangible assets, and other events.

CONTINGENCIES

CONTINGENCIES	6 Months Ended
	Jun. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
CONTINGENCIES	CONTINGENCIES From time to time, the Company is involved in a variety of claims, lawsuits, investigations, and proceedings relating to securities laws, product liability, intellectual property, commercial, insurance, contract disputes, employment, and other matters. Certain of these lawsuits and claims are described in further detail below. It is not possible to predict what the outcome of these matters will be, and the Company cannot guarantee that any resolution will be reached on commercially reasonable terms, if at all. A liability and related charge to earnings are recorded in the Financial Statements for legal contingencies when the loss is considered probable and the amount can be reasonably estimated. The assessment is re-evaluated each accounting period and is based on all available information, including the impact of negotiations, settlements, rulings, advice of legal counsel, and other information and events pertaining to each case. Nevertheless, it is possible that additional future legal costs (including settlements, judgments, legal fees, and other related defense costs) could have a material adverse effect on the Company’s business, financial condition, or future results of operations. Product Liability Litigation The Company is currently named as a defendant in a number of individual product liability lawsuits filed in various state and federal courts. The plaintiffs generally allege that they or a family member underwent surgical procedures that utilized the da Vinci surgical system and sustained a variety of personal injuries and, in some cases, death as a result of such surgery. Several of the filed cases have trial dates in the next 12 months. The cases raise a variety of allegations including, to varying degrees, that plaintiffs’ injuries resulted from purported defects in the da Vinci surgical system and/or failure on the Company’s part to provide adequate training resources to the healthcare professionals who performed plaintiffs’ surgeries. The cases further allege that the Company failed to adequately disclose and/or misrepresented the potential risks and/or benefits of the da Vinci surgical system. Plaintiffs also assert a variety of causes of action, including, for example, strict liability based on purported design defects, negligence, fraud, breach of express and implied warranties, unjust enrichment, and loss of consortium. Plaintiffs seek recovery for alleged personal injuries and, in many cases, punitive damages. The Company disputes these allegations and is defending against these claims. The Company’s estimate of the anticipated cost of resolving the pending cases is based on negotiations with attorneys for the claimants. The final outcome of the pending lawsuits and claims, and others that might arise, is dependent on many variables that are difficult to predict, and the ultimate cost associated with these product liability lawsuits and claims may be materially different than the amount of the current estimate and accruals and could have a material adverse effect on the Company’s business, financial condition, or future results of operations. Although there is a reasonable possibility that a loss in excess of the amount recognized exists, the Company is unable to estimate the possible loss or range of loss in excess of the amount recognized at this time. Patent Litigation On June 30, 2017, Ethicon LLC, Ethicon Endo-Surgery, Inc., and Ethicon US LLC (collectively, “Ethicon”) filed a complaint for patent infringement against the Company in the U.S. District Court for the District of Delaware. The complaint, which was served on the Company on July 12, 2017, alleges that the Company’s EndoWrist Stapler instruments infringe several of Ethicon’s patents. Ethicon asserts infringement of U.S. Patent Nos. 9,585,658; 8,479,969; 9,113,874; 8,998,058; 8,991,677; 9,084,601; and 8,616,431. A claim construction hearing occurred on October 1, 2018, and the Court issued a scheduling order on December 28, 2018. On March 20, 2019, the Court granted the Company’s Motion to Stay pending an Inter Partes Review to be held at the Patent Trademark and Appeals Board to review patentability of six of the seven patents noted above and vacated the trial date. On August 1, 2019, the Court granted the parties’ joint stipulation to modify the stay in light of Ethicon’s U.S. International Trade Commission (“USITC”) complaint against Intuitive involving U.S. Patent Nos. 8,479,969 and 9,113,874, discussed below. There is currently no trial date scheduled for this matter. On August 27, 2018, Ethicon filed a second complaint for patent infringement against the Company in the U.S. District Court for the District of Delaware. The complaint alleges that the Company’s SureForm 60 Staplers infringe five of Ethicon’s patents. Ethicon asserts infringement of U.S. Patent Nos. 9,884,369; 7,490,749; 8,602,288; 8,602,287; and 9,326,770. The Company filed an answer denying all claims. On March 19, 2019, Ethicon filed a Motion for Leave to File a First Amended Complaint, removing allegations related to U.S. Patent No. 9,326,770 and adding allegations related to U.S. Patent Nos. 9,844,379 and 8,479,969. On July 17, 2019, the Court entered an order denying the amendment, without prejudice, and granting the parties’ joint stipulation to stay the case in its entirety in light of the USITC investigation involving U.S. Patent Nos. 9,844,369 and 7,490,749, discussed below. There is currently no trial date scheduled for this matter. Based on currently available information, the Company is unable to make a reasonable estimate of loss or range of losses, if any, arising from these matters. On May 30, 2019, Ethicon filed a complaint with the USITC, asserting infringement of U.S. Patent Nos. 9,884,369 (“’369”); 7,490,749 (“’749”); 9,844,379 (“’379”); 9,113,874 (“’874”); and 8,479,969 (“’969”). On June 28, 2019, the USITC voted to institute an investigation (No. 337-TA-1167) with respect to the claims in this complaint. The accused products include the Company’s EndoWrist 30, EndoWrist 45, SureForm 45, and SureForm 60 Staplers, as well as the stapler reload cartridges. In March 2020, Ethicon dismissed its claims concerning the ’749 patent. The evidentiary hearing took place in February 2021. On March 26, 2021, the U.S. Patent Trial and Appeal Board (“PTAB”) issued a Final Written Decision in which it found the claims in the ’379 patent asserted against the Company in this USITC proceeding to be invalid. On October 14, 2021, the USITC issued its Opinion in which it made the following rulings: (1) the USITC absolved Intuitive from any liability regarding the ’874, ’969, and ’369 patents; and (2) the USITC found that, while the SureForm staplers and their associated reload cartridges infringe the asserted claims in the ’379 patent, it has suspended the imposition of any remedial order pending an opinion from the U.S. Court of Appeal for the Federal Circuit of whether the Patent and Trademark Office correctly found the asserted claims in this patent to be invalid. On May 23, 2022, the U.S. Court of Appeal for the Federal Circuit affirmed the earlier PTAB Final Written Decision invalidating the asserted claims in the ’379 patent. A hearing before the U.S. Court of Appeal for the Federal Circuit occurred on March 8, 2023, on Ethicon’s appeal of the USITC’s Opinion with regard to the ’369 and ’969 patents. On May 26, 2023, the Federal Circuit Court of Appeal affirmed the USITC’s decision regarding the ’369 and ’969 patents. Ethicon has indicated its intention to file a petition for the rehearing of its appeal. An adverse ruling on Ethicon’s appeal of the USITC’s Opinion could result in a prohibition on importing the accused SureForm products into the U.S. or necessitating workarounds. Based on currently available information, the Company does not believe that any losses arising from this matter would be material. On October 19, 2022, a jury rendered a verdict against the Company awarding $10 million in damages to Rex Medical, L.P. in a patent infringement lawsuit. The Company intends to appeal the decision and vigorously defend its position. Based on currently available information, the Company does not believe that any losses arising from this matter would be material. Commercial Litigation On May 10, 2021, Surgical Instrument Service Company, Inc. (“SIS”) filed a complaint in the Northern District of California Court alleging anti-trust claims against the Company relating to EndoWrist service, maintenance, and repair processes. The Court granted in part and denied in part the Company’s Motion to Dismiss, and discovery has commenced. The Company filed an answer denying the anti-trust allegations and filed counterclaims against SIS. The counterclaims allege that SIS violated the Federal Lanham Act, California’s Unfair Competition Law, and California’s False Advertising Law and that SIS is also liable to the Company for Unfair Competition and Tortious Interference with Contract. The parties have filed summary judgment and Daubert motions, and a hearing on these motions is scheduled for September 7, 2023. Based on currently available information, the Company is unable to make a reasonable estimate of loss or range of losses, if any, arising from this matter. Three class action complaints were filed against the Company in the Northern District of California Court alleging anti-trust allegations relating to the service and repair of certain instruments manufactured by the Company. A complaint by Larkin Community Hospital was filed on May 20, 2021, a complaint by Franciscan Alliance, Inc. and King County Public Hospital District No. 1 was filed on July 6, 2021, and a complaint by Kaleida Health was filed on July 8, 2021. The Court has consolidated the Franciscan Alliance, Inc. and King County Public Hospital District No. 1 and Kaleida Health cases with the Larkin Community Hospital case, which is now captioned on the Larkin docket as “In Re: da Vinci Surgical Robot Antitrust Litigation.” A Consolidated Amended Class Action Complaint has been filed on behalf of each plaintiff named in the earlier-filed cases. On January 14, 2022, Kaleida Health voluntarily dismissed itself as a party to this case. On January 18, 2022, the Company filed an answer against the plaintiffs in this matter, and discovery has commenced. The parties have filed summary judgment and Daubert motions, and a hearing on these motions is scheduled for September 7, 2023. Based on currently available information, the Company is unable to make a reasonable estimate of loss or range of losses, if any, arising from this matter.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
STOCKHOLDERS' EQUITY	STOCKHOLDERS’ EQUITY Stockholders’ Equity The following tables present the changes in stockholders’ equity (in millions): Three Months Ended June 30, 2023 Common Stock Additional Paid-In Capital Retained Earnings Accumulated Other Comprehensive Income (Loss) Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 350.4 $ 0.4 $ 7,928.4 $ 3,397.4 $ (108.5) $ 11,217.7 $ 76.5 $ 11,294.2 Issuance of common stock through employee stock plans 1.0 — 74.6 — — 74.6 — 74.6 Shares withheld related to net share settlement of equity awards (0.1) — (0.4) (10.5) — (10.9) — (10.9) Share-based compensation expense related to employee stock plans — — 148.2 — — 148.2 — 148.2 Net income attributable to Intuitive Surgical, Inc. — — — 420.8 — 420.8 — 420.8 Other comprehensive income (loss) — — — — 28.7 28.7 (1.1) 27.6 Net income attributable to noncontrolling interest in joint venture — — — — — — 5.2 5.2 Ending balance 351.3 $ 0.4 $ 8,150.8 $ 3,807.7 $ (79.8) $ 11,879.1 $ 80.6 $ 11,959.7 Three Months Ended June 30, 2022 Common Stock Additional Retained Accumulated Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 358.9 $ 0.4 $ 7,354.6 $ 4,858.0 $ (110.7) $ 12,102.3 $ 54.6 $ 12,156.9 Issuance of common stock through employee stock plans 0.4 — 26.6 — — 26.6 — 26.6 Shares withheld related to net share settlement of equity awards — — (0.6) (6.2) — (6.8) — (6.8) Share-based compensation expense related to employee stock plans — — 126.7 — — 126.7 — 126.7 Repurchase and retirement of common stock (2.2) — (23.3) (476.8) — (500.1) — (500.1) Net income attributable to Intuitive Surgical, Inc. — — — 307.8 — 307.8 — 307.8 Other comprehensive income (loss) — — — — (33.5) (33.5) (1.0) (34.5) Net income attributable to noncontrolling interest in joint venture — — — — — — 5.8 5.8 Ending balance 357.1 $ 0.4 $ 7,484.0 $ 4,682.8 $ (144.2) $ 12,023.0 $ 59.4 $ 12,082.4 Six Months Ended June 30, 2023 Common Stock Additional Paid-In Capital Retained Earnings Accumulated Other Comprehensive Income (Loss) Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 350.0 $ 0.4 $ 7,703.9 $ 3,500.1 $ (162.5) $ 11,041.9 $ 70.7 $ 11,112.6 Issuance of common stock through employee stock plans 3.4 — 174.8 — — 174.8 — 174.8 Shares withheld related to net share settlement of equity awards (0.6) — (6.3) (134.3) — (140.6) — (140.6) Share-based compensation expense related to employee stock plans — — 294.2 — — 294.2 — 294.2 Repurchase and retirement of common stock (1.5) — (15.8) (334.2) — (350.0) — (350.0) Net income attributable to Intuitive Surgical, Inc. — — — 776.1 — 776.1 — 776.1 Other comprehensive income (loss) — — — — 82.7 82.7 (0.8) 81.9 Net income attributable to noncontrolling interest in joint venture — — — — — — 10.7 10.7 Ending balance 351.3 $ 0.4 $ 8,150.8 $ 3,807.7 $ (79.8) $ 11,879.1 $ 80.6 $ 11,959.7 Six Months Ended June 30, 2022 Common Stock Additional Paid-In Capital Retained Earnings Accumulated Other Comprehensive Income (Loss) Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 357.7 $ 0.4 $ 7,164.0 $ 4,760.9 $ (24.2) $ 11,901.1 $ 50.4 $ 11,951.5 Issuance of common stock through employee stock plans 2.6 — 106.6 — — 106.6 — 106.6 Shares withheld related to net share settlement of equity awards (0.6) — (6.7) (172.3) — (179.0) — (179.0) Share-based compensation expense related to employee stock plans — — 247.5 — — 247.5 — 247.5 Repurchase and retirement of common stock (2.6) — (27.4) (579.2) — (606.6) — (606.6) Net income attributable to Intuitive Surgical, Inc. — — — 673.4 — 673.4 — 673.4 Other comprehensive income (loss) — — — — (120.0) (120.0) (0.6) (120.6) Net income attributable to noncontrolling interest in joint venture — — — — — — 9.6 9.6 Ending balance 357.1 $ 0.4 $ 7,484.0 $ 4,682.8 $ (144.2) $ 12,023.0 $ 59.4 $ 12,082.4 Stock Repurchase Program The Company’s Board of Directors (the “Board”) has authorized an aggregate of $10.0 billion of funding for the Company’s common stock repurchase program (the “Repurchase Program”) since its establishment in March 2009. The most recent authorization occurred in July 2022, when the Board increased the authorized amount available under the Repurchase Program to $3.5 billion, including amounts remaining under previous authorization. As of June 30, 2023, the remaining amount of share repurchases authorized by the Board under the Repurchase Program was approximately $1.1 billion. The following table summarizes stock repurchase activities (in millions, except per share amounts): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Shares repurchased — 2.2 1.5 2.6 Average price per share $ — $ 224.4 $ 238.1 $ 231.0 Value of shares repurchased $ — $ 500.1 $ 350.0 $ 606.6 Accumulated Other Comprehensive Loss, Net of Tax, Attributable to Intuitive Surgical, Inc. The components of accumulated other comprehensive loss, net of tax, attributable to Intuitive Surgical, Inc. are as follows (in millions): Three Months Ended June 30, 2023 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ (0.4) $ (116.6) $ 7.3 $ 1.2 $ (108.5) Other comprehensive income (loss) before reclassifications 6.9 13.1 9.6 — 29.6 Amounts reclassified from accumulated other comprehensive income (loss) (0.9) — — — (0.9) Net current-period other comprehensive income (loss) 6.0 13.1 9.6 — 28.7 Ending balance $ 5.6 $ (103.5) $ 16.9 $ 1.2 $ (79.8) Three Months Ended June 30, 2022 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ 5.5 $ (106.7) $ (4.8) $ (4.7) $ (110.7) Other comprehensive income (loss) before reclassifications (9.0) (33.3) (4.5) — (46.8) Amounts reclassified from accumulated other comprehensive income (loss) 13.4 (0.1) — — 13.3 Net current-period other comprehensive income (loss) 4.4 (33.4) (4.5) — (33.5) Ending balance $ 9.9 $ (140.1) $ (9.3) $ (4.7) $ (144.2) Six Months Ended June 30, 2023 Gains (Losses) on Hedge Instruments Unrealized Gains Foreign Currency Translation Gains (Losses) Employee Benefit Plans Total Beginning balance $ (2.9) $ (154.2) $ (6.6) $ 1.2 $ (162.5) Other comprehensive income (loss) before reclassifications 10.6 50.9 23.5 — 85.0 Amounts reclassified from accumulated other comprehensive income (loss) (2.1) (0.2) — — (2.3) Net current-period other comprehensive income (loss) 8.5 50.7 23.5 — 82.7 Ending balance $ 5.6 $ (103.5) $ 16.9 $ 1.2 $ (79.8) Six Months Ended June 30, 2022 Gains (Losses) on Hedge Instruments Unrealized Gains Foreign Currency Translation Gains (Losses) Employee Benefit Plans Total Beginning balance $ 4.5 $ (16.0) $ (7.9) $ (4.8) $ (24.2) Other comprehensive income (loss) before reclassifications (5.3) (124.1) (1.4) — (130.8) Amounts reclassified from accumulated other comprehensive income (loss) 10.7 — — 0.1 10.8 Net current-period other comprehensive income (loss) 5.4 (124.1) (1.4) 0.1 (120.0) Ending balance $ 9.9 $ (140.1) $ (9.3) $ (4.7) $ (144.2) The tax impacts for amounts recognized in other comprehensive income (loss) before reclassifications were as follows (in millions): Three Months Ended June 30, Six Months Ended June 30, Available-for-sale securities 2023 2022 2023 2022 Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income (loss) $ (3.7) $ 5.6 $ (14.6) $ 35.3 The tax impacts for amounts recognized in other comprehensive income (loss) before reclassifications for hedge instruments, foreign currency translation, and employee benefit plans for the three and six months ended June 30, 2023, and 2022, were not material to the Company’s Financial Statements. The tax impacts for amounts reclassified from accumulated other comprehensive loss relating to hedge instruments, available-for-sale securities, foreign currency translation, and employee benefit plans for the three and six months ended June 30, 2023, and 2022, were not material to the Company’s Financial Statements.

SHARE-BASED COMPENSATION

SHARE-BASED COMPENSATION	6 Months Ended
	Jun. 30, 2023
Share-Based Payment Arrangement [Abstract]
SHARE-BASED COMPENSATION	SHARE-BASED COMPENSATION As of June 30, 2023, the total number of shares of common stock reserved for issuance under the 2010 Incentive Award Plan was 110,350,000. Approximately 21.2 million shares were reserved for future issuance under the Company’s stock plans, and a maximum of approximately 9.2 million of these shares can be awarded as restricted stock units (“RSUs”). Restricted Stock Units A summary of RSUs activity under all stock plans for the six months ended June 30, 2023, is presented as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2022 4.6 $ 241.47 RSUs granted 2.3 $ 232.89 RSUs vested (1.6) $ 222.52 RSUs forfeited (0.1) $ 246.84 Unvested balance as of June 30, 2023 5.2 $ 243.41 Stock Options A summary of stock option activity under all stock plans for the six months ended June 30, 2023, is presented as follows (in millions, except per share amounts): Stock Options Outstanding Number Weighted-Average Balance as of December 31, 2022 10.8 $ 144.86 Options granted 0.7 $ 233.50 Options exercised (1.4) $ 80.73 Options forfeited/expired (0.1) $ 254.12 Balance as of June 30, 2023 10.0 $ 159.59 As of June 30, 2023, options to purchase an aggregate of 7.9 million shares of common stock were exercisable at a weighted-average price of $136.18 per share. Performance Stock Units In 2022, the Company began granting performance stock units (“PSUs”) to officers and other key employees subject to three-year cliff vesting and pre-established, quantitative goals. Whether any PSUs vest, and the amount that does vest, is tied to completion of service over three years and the achievement of three equally-weighted, quantitative goals that directly align with or help drive the Company’s strategy and long-term total shareholder return. The 2022 PSU grant metrics are focused on relative total shareholder return (“TSR”), year-over-year da Vinci procedure growth for 2023, and two-year compound annual da Vinci procedure growth for 2024. The 2023 PSU grant metrics are focused on relative TSR, da Vinci and Ion procedure growth in 2024 compared to 2022, and da Vinci and Ion procedure growth in 2025 compared to 2022. The TSR metric is considered a market condition, and the expense is determined at the grant date. The procedure growth metrics are considered performance conditions, and the expense is recorded based on the forecasted performance, which is reassessed each reporting period based on the probability of achieving the performance conditions. The number of shares earned at the end of the three-year period will vary, based on actual performance, from 0% to 125% of the target number of PSUs granted. PSUs are subject to forfeiture if employment terminates prior to the vesting date. PSUs are not considered issued or outstanding shares of the Company. The Company calculates the fair value for each component of the PSUs individually. The fair value for the component with the TSR metric was determined using Monte Carlo simulation. The fair value per share for the components with the procedure growth metrics is equal to the closing stock price on the grant date. PSU activity for the six months ended June 30, 2023, was as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2022 0.1 $ 299.32 Granted 0.1 $ 240.45 Vested — $ — Performance change — $ — Forfeited — $ 235.84 Unvested balance as of June 30, 2023 0.2 $ 259.60 Employee Stock Purchase Plan Under the Employee Stock Purchase Plan (“ESPP”), employees purchased approximately 0.3 million shares for $59.9 million and approximately 0.2 million shares for $47.8 million during the six months ended June 30, 2023, and 2022, respectively. Share-based Compensation Expense The following table summarizes share-based compensation expense for the three and six months ended June 30, 2023, and 2022 (in millions): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Cost of sales – products (before capitalization) $ 22.7 $ 20.3 $ 45.7 $ 39.0 Amounts capitalized into inventory (1) (21.1) — (39.9) — Amounts recognized in income for amounts previously capitalized in inventory 19.3 — 31.9 — Cost of sales – products $ 20.9 $ 20.3 $ 37.7 $ 39.0 Cost of sales – services 7.0 5.8 14.0 11.4 Total cost of sales 27.9 26.1 51.7 50.4 Selling, general, and administrative 68.0 62.7 134.7 123.0 Research and development 52.3 38.5 102.4 75.3 Share-based compensation expense before income taxes 148.2 127.3 288.8 248.7 Income tax benefit 28.5 20.9 56.5 48.1 Share-based compensation expense after income taxes $ 119.7 $ 106.4 $ 232.3 $ 200.6 (1) Share-based compensation expense subject to capitalization into inventory was not material during the three and six months ended June 30, 2022, and, therefore, not recorded. The Company commenced capitalization of share-based compensation expense into inventory during the quarter ended December 31, 2022, on a prospective basis. The Black-Scholes-Merton option pricing model is used to estimate the fair value of stock options granted under the Company’s share-based compensation plans and the rights to acquire stock granted under the ESPP. The weighted-average estimated fair values of stock options and the rights to acquire stock under the ESPP, as well as the weighted-average assumptions used in calculating the fair values of stock options and the rights to acquire stock under the ESPP that were granted during the three and six months ended June 30, 2023, and 2022, were as follows: Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Stock Options Risk-free interest rate 4.3% 2.9% 4.8% 1.7% Expected term (in years) 3.2 3.3 3.4 3.4 Expected volatility 32% 38% 34% 36% Fair value at grant date $83.38 $72.35 $72.71 $80.27 ESPP Risk-free interest rate —% —% 4.7% 0.8% Expected term (in years) 0.0 0.0 1.2 1.2 Expected volatility —% —% 35% 37% Fair value at grant date $— $— $79.33 $88.85

INCOME TAXES

INCOME TAXES	6 Months Ended
	Jun. 30, 2023
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXESIncome tax expense for the three months ended June 30, 2023, was $73.2 million, or 14.7% of income before taxes, compared to $93.3 million, or 22.9% of income before taxes, for the three months ended June 30, 2022. Income tax expense for the six months ended June 30, 2023, was $134.2 million, or 14.6% of income before taxes, compared to $126.3 million, or 15.6% of income before taxes, for the six months ended June 30, 2022.The effective tax rate for the three months ended June 30, 2023, differed from the U.S. federal statutory rate of 21% primarily due to the tax benefits associated with employee equity plans, the effect of income earned by certain overseas entities being taxed at rates lower than the federal statutory rate, and the federal research and development credit benefit, partially offset by U.S. tax on foreign earnings and state income taxes (net of federal benefit). The effective tax rate for the three months ended June 30, 2022, differed from the U.S. federal statutory rate of 21% primarily due to U.S. tax on foreign earnings and state income taxes (net of federal benefit), partially offset by the tax benefits associated with employee equity plans, the effect of income earned by certain overseas entities being taxed at rates lower than the federal statutory rate, and the federal research and development credit benefit. The provision for income taxes for the three months ended June 30, 2023, and 2022, included excess tax benefits associated with employee equity plans of $41.7 million and $9.3 million, respectively, which reduced the Company’s effective tax rate by 8.4 and 2.3 percentage points, respectively. The effective tax rates for both the six months ended June 30, 2023, and 2022, differed from the U.S. federal statutory rate of 21% primarily due to the tax benefits associated with employee equity plans, the effect of income earned by certain overseas entities being taxed at rates lower than the federal statutory rate, and the federal research and development credit benefit, partially offset by U.S. tax on foreign earnings and state income taxes (net of federal benefit). The provision for income taxes for the six months ended June 30, 2023, and 2022, included excess tax benefits associated with employee equity plans of $64.2 million and $62.3 million, respectively, which reduced the Company’s effective tax rate by 7.0 and 7.7 percentage points, respectively. The Company files federal, state, and foreign income tax returns in many U.S. and OUS jurisdictions. Years before 2016 are closed for the significant jurisdictions. Certain of the Company’s unrecognized tax benefits could change due to activities of various tax authorities, including evolving interpretations of existing tax laws in the jurisdictions the Company operates, potential assessment of additional tax, possible settlement of audits, or through normal expiration of various statutes of limitations, which could affect the Company’s effective tax rate in the period in which they change. Due to the uncertainty related to the timing and potential outcome of audits, the Company cannot estimate the range of reasonably possible changes in unrecognized tax benefits that may occur in the next 12 months. The Company is subject to the examination of its income tax returns by the Internal Revenue Service and other tax authorities. The outcome of these audits cannot be predicted with certainty. The Company’s management regularly assesses the likelihood of adverse outcomes resulting from these examinations to determine the adequacy of the Company’s provision for income taxes. If any issues addressed in the Company’s tax audits are resolved in a manner not consistent with management’s expectations, the Company could be required to adjust its provision for income taxes in the period such resolution occurs.

NET INCOME PER SHARE

NET INCOME PER SHARE	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
NET INCOME PER SHARE	NET INCOME PER SHARE The following table presents the computation of basic and diluted net income per share attributable to Intuitive Surgical, Inc. (in millions, except per share amounts): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Numerator: Net income attributable to Intuitive Surgical, Inc. $ 420.8 $ 307.8 $ 776.1 $ 673.4 Denominator: Weighted-average shares outstanding used in basic calculation 350.9 358.1 350.6 358.2 Add: dilutive effect of potential common shares 6.4 5.8 6.0 7.1 Weighted-average shares outstanding used in diluted calculation 357.3 363.9 356.6 365.3 Net income per share attributable to Intuitive Surgical, Inc.: Basic $ 1.20 $ 0.86 $ 2.21 $ 1.88 Diluted $ 1.18 $ 0.85 $ 2.18 $ 1.84

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Pay vs Performance Disclosure
Net income attributable to Intuitive Surgical, Inc.	$ 420.8	$ 307.8	$ 776.1	$ 673.4

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	6 Months Ended
	Jun. 30, 2023 shares	Jun. 30, 2023 shares
Trading Arrangements, by Individual
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Gary S. Guthart [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On April 28, 2023, Gary S. Guthart, Ph.D., the Company’s Chief Executive Officer and a member of the Company’s Board of Directors, adopted a Rule 10b5-1 trading plan. Dr. Guthart’s trading plan provides for (i) the potential exercises of vested stock options to purchase up to 135,000 shares of the Company’s common stock, (ii) the potential sales of shares of the Company’s common stock received upon such exercises to cover exercise costs, estimated tax withholding amounts, and customary brokerage fees as well as potential additional sales of such shares, (iii) the potential donation of 16,000 shares of the Company’s common stock from a trust in which Dr. Guthart is a trustee, and (iv) the potential sales of up to 14,880 shares of the Company’s common stock held by trusts in which the beneficiaries are children of Dr. Guthart, until April 29, 2024. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and the Company’s policies regarding transactions in the Company’s securities.
Name	Gary S. Guthart
Title	Chief Executive Officer and a member of the Company’s Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	April 28, 2023
Arrangement Duration	367 days
Amal M. Johnson [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On May 1, 2023, Amal M. Johnson, a member of the Company’s Board of Directors, adopted a Rule 10b5-1 trading plan. Ms. Johnson’s trading plan provides for the potential exercise and sale of up to 16,263 shares of the Company’s common stock subject to an option until May 1, 2024. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Exchange Act and the Company’s policies regarding transactions in the Company’s securities.
Name	Amal M. Johnson
Title	member of the Company’s Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	May 1, 2023
Arrangement Duration	366 days
Aggregate Available	16,263	16,263
Jamie E. Samath [Member]
Trading Arrangements, by Individual
Name	Jamie E. Samath
Title	Chief Financial Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	May 3, 2023
Arrangement Duration	366 days
Alan J. Levy [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On May 8, 2023, Alan J. Levy, Ph.D., a member of the Company’s Board of Directors, adopted a Rule 10b5-1 trading plan. Mr. Levy’s trading plan provides for the potential exercise and sale of up to 8,000 shares of the Company’s common stock subject to stock options until May 8, 2024. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Exchange Act and the Company’s policies regarding transactions in the Company’s securities.
Name	Alan J. Levy
Title	member of the Company’s Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	May 8, 2023
Arrangement Duration	366 days
Aggregate Available	8,000	8,000
Amy L. Ladd [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On June 15, 2023, Amy L. Ladd, M.D., a member of the Company’s Board of Directors, adopted a Rule 10b5-1 trading plan. Ms. Ladd’s trading plan provides for the potential sale of up to 500 shares of the Company’s common stock until June 14, 2024. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Exchange Act and the Company’s policies regarding transactions in the Company’s securities.
Name	Amy L. Ladd
Title	member of the Company’s Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	June 15, 2023
Arrangement Duration	365 days
Aggregate Available	500	500
Gary S. Guthart Trading Arrangement, Stock Options [Member] | Gary S. Guthart [Member]
Trading Arrangements, by Individual
Aggregate Available	135,000	135,000
Gary S. Guthart Trading Arrangement, Common Stock, Donation [Member] | Gary S. Guthart [Member]
Trading Arrangements, by Individual
Aggregate Available	16,000	16,000
Gary S. Guthart Trading Arrangement, Common Stock, Sale [Member] | Gary S. Guthart [Member]
Trading Arrangements, by Individual
Aggregate Available	14,880	14,880
Jamie E. Samath Trading Arrangement, Common Stock [Member] | Jamie E. Samath [Member]
Trading Arrangements, by Individual
Aggregate Available	19,887	19,887
Jamie E. Samath Trading Arrangement, Stock Options [Member] | Jamie E. Samath [Member]
Trading Arrangements, by Individual
Aggregate Available	13,870	13,870

SUMMARY OF SIGNIFICANT ACCOUN_2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation In the opinion of management, the accompanying unaudited Condensed Consolidated Financial Statements (“Financial Statements”) of Intuitive Surgical, Inc. and its wholly and majority-owned subsidiaries have been prepared on a consistent basis with the audited Consolidated Financial Statements for the fiscal year ended December 31, 2022, and include all adjustments, consisting of only normal, recurring adjustments, necessary to fairly state the information set forth herein. The Financial Statements have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (“SEC”) and, therefore, omit certain information and footnote disclosure necessary to present the Financial Statements in accordance with United States (“U.S.”) generally accepted accounting principles (“GAAP”). These Financial Statements should be read in conjunction with the audited Consolidated Financial Statements and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, which was filed with the SEC on February 10, 2023. The results of operations for the first six months of 2023 are not necessarily indicative of the results to be expected for the entire fiscal year or any future periods.
Consolidation and Joint Ventures	The Financial Statements include the results and balances of the Company’s majority-owned joint ventures, Intuitive Surgical-Fosun Medical Technology (Shanghai) Co., Ltd. and Intuitive Surgical-Fosun (HongKong) Co., Ltd. (collectively, the “Joint Venture”) with Shanghai Fosun Pharmaceutical (Group) Co., Ltd. (“Fosun Pharma”). The Company holds a controlling financial interest in the Joint Venture, and the noncontrolling interest is reflected as a separate component of the consolidated stockholders’ equity. The noncontrolling interest’s share of the earnings in the Joint Venture is presented separately in the Condensed Consolidated Statements of Comprehensive Income.
Recently Adopted Accounting Pronouncements and Recently Issued Accounting Pronouncements	Recently Adopted Accounting Pronouncements Troubled Debt Restructurings and Vintage Disclosures In March 2022, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2022-02, Financial Instruments-Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures (“ASU 2022-02”), which eliminates the accounting guidance for troubled debt restructurings by creditors while enhancing disclosure requirements for certain loan refinancings and restructurings by creditors when a borrower is experiencing financial difficulty. Additionally, the standard requires disclosure of current-period gross write-offs by year of origination for financing receivables and net investments in leases within the scope of Subtopic ASC 326-20, Financial Instruments-Credit Losses-Measured at Amortized Cost . The Company adopted ASU 2022-02 on January 1, 2023, on a prospective basis. There was no impact of the adoption of ASU 2022-02 on the Company’s Financial Statements in the three and six months ended June 30, 2023. Recently Issued Accounting Pronouncements The Company continues to monitor new accounting pronouncements issued by the FASB and does not believe any accounting pronouncements issued through the date of this report will have a material impact on the Company’s Financial Statements. Significant Accounting Policies There have been no new or material changes to the significant accounting policies discussed in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, that are of significance, or potential significance, to the Company.

FINANCIAL INSTRUMENTS (Tables)

FINANCIAL INSTRUMENTS (Tables)	6 Months Ended
	Jun. 30, 2023
Investments, All Other Investments [Abstract]
Debt Securities, Available-for-sale	The following tables summarize the Company’s cash and available-for-sale debt securities’ amortized cost, gross unrealized gains, gross unrealized losses, allowance for credit loss, and fair value by significant investment category reported as cash and cash equivalents, short-term investments, or long-term investments as of June 30, 2023, and December 31, 2022 (in millions): Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- June 30, 2023 Cash $ 520.3 $ — $ — $ — $ 520.3 $ 520.3 $ — $ — Level 1: Money market funds 2,915.1 — — — 2,915.1 2,915.1 — — U.S. treasuries 1,860.8 — (61.0) — 1,799.8 — 1,294.2 505.6 Subtotal 4,775.9 — (61.0) — 4,714.9 2,915.1 1,294.2 505.6 Level 2: Corporate debt securities 1,490.5 — (53.9) (1.1) 1,435.5 — 829.5 606.0 U.S. government agencies 361.2 — (14.3) — 346.9 — 183.8 163.1 Municipal securities 118.2 — (4.1) — 114.1 — 56.3 57.8 Subtotal 1,969.9 — (72.3) (1.1) 1,896.5 — 1,069.6 826.9 Total assets measured at fair value $ 7,266.1 $ — $ (133.3) $ (1.1) $ 7,131.7 $ 3,435.4 $ 2,363.8 $ 1,332.5 Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- December 31, 2022 Cash $ 497.2 $ — $ — $ — $ 497.2 $ 497.2 $ — $ — Level 1: Money market funds 1,084.0 — — — 1,084.0 1,084.0 — — U.S. treasuries 2,715.2 — (96.6) — 2,618.6 — 1,542.4 1,076.2 Subtotal 3,799.2 — (96.6) — 3,702.6 1,084.0 1,542.4 1,076.2 Level 2: Commercial paper 20.0 — — — 20.0 — 20.0 — Corporate debt securities 2,022.0 — (76.0) (1.1) 1,944.9 — 651.8 1,293.1 U.S. government agencies 447.2 — (19.9) — 427.3 — 247.8 179.5 Municipal securities 155.5 — (6.0) — 149.5 — 74.7 74.8 Subtotal 2,644.7 — (101.9) (1.1) 2,541.7 — 994.3 1,547.4 Total assets measured at fair value $ 6,941.1 $ — $ (198.5) $ (1.1) $ 6,741.5 $ 1,581.2 $ 2,536.7 $ 2,623.6
Summary of Contractual Maturities of Cash Equivalents and Available-For-Sale Investments	The following table summarizes the contractual maturities of the Company’s cash equivalents and available-for-sale debt securities (excluding money market funds), as of June 30, 2023 (in millions): Amortized Fair Mature in less than one year $ 2,416.8 $ 2,363.8 Mature in one to five years 1,413.9 1,332.5 Total $ 3,830.7 $ 3,696.3
Schedule of Unrealized Loss on Investments	The following tables present the breakdown of the available-for-sale debt securities with unrealized losses as of June 30, 2023, and December 31, 2022 (in millions): June 30, 2023 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ — $ — $ 1,799.8 $ (61.0) $ 1,799.8 $ (61.0) Corporate debt securities 84.1 (0.9) 1,344.5 (53.0) 1,428.6 (53.9) U.S. government agencies — — 346.9 (14.3) 346.9 (14.3) Municipal securities — — 107.7 (4.1) 107.7 (4.1) Total $ 84.1 $ (0.9) $ 3,598.9 $ (132.4) $ 3,683.0 $ (133.3) December 31, 2022 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ 731.7 $ (26.0) $ 1,886.9 $ (70.6) $ 2,618.6 $ (96.6) Corporate debt securities 631.4 (17.6) 1,221.9 (58.4) 1,853.3 (76.0) U.S. government agencies 102.7 (4.4) 324.6 (15.5) 427.3 (19.9) Municipal securities 44.6 (1.1) 104.9 (4.9) 149.5 (6.0) Total $ 1,510.4 $ (49.1) $ 3,538.3 $ (149.4) $ 5,048.7 $ (198.5)
Summary of Equity Investment Activity	The following table is a summary of the activity related to equity investments (in millions): Reported as: December 31, 2022 Carrying Value Changes in Fair Value (1) Purchases / Sales / Other (2) June 30, 2023 Carrying Value Prepaids and other current assets Intangible and other assets, net Equity investments with readily determinable value (Level 1) $ 4.3 $ (0.4) $ (3.9) $ — $ — $ — Equity investments without readily determinable value (Level 2) $ 59.1 $ (5.6) $ 14.3 $ 67.8 $ — $ 67.8 (1) Recorded in interest and other income, net. (2) Other includes foreign currency translation gains/(losses).
Derivatives Not Designated as Hedging Instruments	These derivative instruments are used to hedge against balance sheet foreign currency exposures. The related gains and losses were as follows (in millions): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Recognized gains in interest and other income, net $ 14.7 $ 21.9 $ 11.4 $ 28.7 Foreign exchange losses related to balance sheet re-measurement $ (16.3) $ (28.8) $ (10.9) $ (38.9)
Gross Notional Amounts for Derivatives and Aggregate Gross Fair Value Outstanding	Total gross notional amounts (in USD) for outstanding derivatives and the aggregate gross fair value at the end of each period were as follows (in millions): Derivatives Designated as Hedging Instruments Derivatives Not Designated as Hedging Instruments June 30, December 31, June 30, December 31, Notional amounts: Forward contracts $ 250.3 $ 188.4 $ 578.4 $ 496.3 Gross fair value recorded in: Prepaids and other current assets $ 7.6 $ 1.8 $ 5.6 $ 4.3 Other accrued liabilities $ 1.4 $ 5.3 $ 1.8 $ 4.2

BALANCE SHEET DETAILS AND OTH_2

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION (Tables)	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accounts Receivable, Net	The following tables provide details of selected balance sheet line items (in millions): As of Accounts receivable, net June 30, December 31, Trade accounts receivable, net $ 825.7 $ 864.9 Unbilled accounts receivable and other 101.9 91.7 Sales returns and allowances (23.4) (14.5) Total accounts receivable, net $ 904.2 $ 942.1
Inventory	As of Inventory June 30, December 31, Raw materials $ 390.2 $ 382.9 Work-in-process 145.0 159.9 Finished goods 470.0 350.4 Total inventory $ 1,005.2 $ 893.2
Prepaids and Other Current Assets	As of Prepaids and other current assets June 30, December 31, Net investment in sales-type leases – short-term $ 134.6 $ 131.2 Other prepaids and other current assets 188.6 168.6 Total prepaids and other current assets $ 323.2 $ 299.8
Other Accrued Liabilities - Short-term	As of Other accrued liabilities – short-term June 30, December 31, Income and other taxes payable $ 230.2 $ 96.1 Accrued construction-related capital expenditures 113.7 50.3 Litigation-related accruals 3.7 23.0 Other accrued liabilities 239.3 306.8 Total other accrued liabilities – short-term $ 586.9 $ 476.2
Other Long-term Liabilities	As of Other long-term liabilities June 30, December 31, Income taxes – long-term $ 250.3 $ 288.0 Deferred revenue – long-term 45.4 41.0 Other long-term liabilities 109.5 110.3 Total other long-term liabilities $ 405.2 $ 439.3
Supplemental Cash Flow Information	The following table provides supplemental non-cash investing and financing activities (in millions): Six Months Ended June 30, 2023 2022 Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment $ 198.5 $ 122.7 Acquisition of property, plant, and equipment in accounts payable and accrued liabilities $ 138.2 $ 95.8

REVENUE AND CONTRACT ACQUISIT_2

REVENUE AND CONTRACT ACQUISITION COSTS (Tables)	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue Disaggregated by Types and Geography	The following table presents revenue disaggregated by types and geography (in millions): Three Months Ended June 30, Six Months Ended June 30, U.S. 2023 2022 2023 2022 Instruments and accessories $ 763.3 $ 625.1 $ 1,464.7 $ 1,175.7 Systems 189.8 218.0 411.6 466.3 Services 189.4 168.0 376.1 333.9 Total U.S. revenue $ 1,142.5 $ 1,011.1 $ 2,252.4 $ 1,975.9 Outside of U.S. (“OUS”) Instruments and accessories $ 312.6 $ 270.2 $ 596.8 $ 529.9 Systems 202.9 157.1 408.5 336.9 Services 97.9 83.7 194.4 167.1 Total OUS revenue $ 613.4 $ 511.0 $ 1,199.7 $ 1,033.9 Total Instruments and accessories $ 1,075.9 $ 895.3 $ 2,061.5 $ 1,705.6 Systems 392.7 375.1 820.1 803.2 Services 287.3 251.7 570.5 501.0 Total revenue $ 1,755.9 $ 1,522.1 $ 3,452.1 $ 3,009.8
Summary of Contract Assets and Liabilities	The following information summarizes the Company’s contract assets and liabilities (in millions): As of June 30, 2023 December 31, 2022 Contract assets $ 48.1 $ 45.0 Deferred revenue $ 450.6 $ 438.3
Sales-type Lease Revenue	The following table presents product revenue from Intuitive System Leasing arrangements (in millions): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Sales-type lease revenue $ 12.3 $ 50.1 $ 35.3 $ 85.7 Operating lease revenue* $ 122.7 $ 93.0 $ 234.7 $ 176.2 *Variable lease revenue relating to usage-based arrangements included within operating lease revenue $ 53.2 $ 33.6 $ 99.2 $ 58.5
Operating Lease Revenue	The following table presents product revenue from Intuitive System Leasing arrangements (in millions): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Sales-type lease revenue $ 12.3 $ 50.1 $ 35.3 $ 85.7 Operating lease revenue* $ 122.7 $ 93.0 $ 234.7 $ 176.2 *Variable lease revenue relating to usage-based arrangements included within operating lease revenue $ 53.2 $ 33.6 $ 99.2 $ 58.5

LEASES (Tables)

LEASES (Tables)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Schedule of Lease Receivables	Lease receivables relating to sales-type lease arrangements are presented on the Condensed Consolidated Balance Sheets as follows (in millions): As of June 30, 2023 December 31, 2022 Gross lease receivables $ 414.1 $ 449.4 Unearned income (14.3) (14.4) Subtotal 399.8 435.0 Allowance for credit loss (3.0) (3.0) Net investment in sales-type leases $ 396.8 $ 432.0 Reported as: Prepaids and other current assets $ 134.6 $ 131.2 Intangible and other assets, net 262.2 300.8 Net investment in sales-type leases $ 396.8 $ 432.0
Schedule of Contractual Maturities of Gross Lease Receivables	Contractual maturities of gross lease receivables as of June 30, 2023, are as follows (in millions): Fiscal Year Amount Remainder of 2023 $ 70.3 2024 134.0 2025 103.5 2026 66.6 2027 33.3 2028 and thereafter 6.4 Total $ 414.1
Amortized Cost Basis by Year of Origination and Credit Quality Indicator	The following table summarizes the amortized cost basis by year of origination and by credit quality for the net investment in sales-type leases as of June 30, 2023 (in millions): 2023 2022 2021 2020 2019 Prior Net Investment Credit Rating: High $ 27.1 $ 86.2 $ 70.9 $ 32.9 $ 10.0 $ 0.6 $ 227.7 Moderate 9.8 57.2 58.7 28.4 6.8 3.0 163.9 Low — 3.3 3.0 1.9 — — 8.2 Total $ 36.9 $ 146.7 $ 132.6 $ 63.2 $ 16.8 $ 3.6 $ 399.8

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS (Tables)	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Summary of Changes in Goodwill	The following table summarizes the changes in the carrying amount of goodwill (in millions): Amount Balance as of December 31, 2022 $ 348.5 Acquisition activity — Translation and other 0.1 Balance as of June 30, 2023 $ 348.6
Schedule of Intangible Assets	The following table summarizes the components of gross intangible assets, accumulated amortization, and net intangible assets balances as of June 30, 2023, and December 31, 2022 (in millions): June 30, 2023 December 31, 2022 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents and developed technology $ 204.3 $ (171.6) $ 32.7 $ 199.1 $ (167.4) $ 31.7 Distribution rights and others 10.8 (8.3) 2.5 11.0 (7.4) 3.6 Customer relationships 32.2 (20.2) 12.0 32.6 (18.1) 14.5 Total intangible assets $ 247.3 $ (200.1) $ 47.2 $ 242.7 $ (192.9) $ 49.8
Schedule Of Estimated Future Amortization Expense Of Intangible Assets	The estimated future amortization expense related to intangible assets as of June 30, 2023, is as follows (in millions): Fiscal Year Amount Remainder of 2023 $ 10.1 2024 16.7 2025 11.7 2026 5.0 2027 2.5 2028 and thereafter 1.2 Total $ 47.2

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Schedule of Stockholders Equity	The following tables present the changes in stockholders’ equity (in millions): Three Months Ended June 30, 2023 Common Stock Additional Paid-In Capital Retained Earnings Accumulated Other Comprehensive Income (Loss) Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 350.4 $ 0.4 $ 7,928.4 $ 3,397.4 $ (108.5) $ 11,217.7 $ 76.5 $ 11,294.2 Issuance of common stock through employee stock plans 1.0 — 74.6 — — 74.6 — 74.6 Shares withheld related to net share settlement of equity awards (0.1) — (0.4) (10.5) — (10.9) — (10.9) Share-based compensation expense related to employee stock plans — — 148.2 — — 148.2 — 148.2 Net income attributable to Intuitive Surgical, Inc. — — — 420.8 — 420.8 — 420.8 Other comprehensive income (loss) — — — — 28.7 28.7 (1.1) 27.6 Net income attributable to noncontrolling interest in joint venture — — — — — — 5.2 5.2 Ending balance 351.3 $ 0.4 $ 8,150.8 $ 3,807.7 $ (79.8) $ 11,879.1 $ 80.6 $ 11,959.7 Three Months Ended June 30, 2022 Common Stock Additional Retained Accumulated Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 358.9 $ 0.4 $ 7,354.6 $ 4,858.0 $ (110.7) $ 12,102.3 $ 54.6 $ 12,156.9 Issuance of common stock through employee stock plans 0.4 — 26.6 — — 26.6 — 26.6 Shares withheld related to net share settlement of equity awards — — (0.6) (6.2) — (6.8) — (6.8) Share-based compensation expense related to employee stock plans — — 126.7 — — 126.7 — 126.7 Repurchase and retirement of common stock (2.2) — (23.3) (476.8) — (500.1) — (500.1) Net income attributable to Intuitive Surgical, Inc. — — — 307.8 — 307.8 — 307.8 Other comprehensive income (loss) — — — — (33.5) (33.5) (1.0) (34.5) Net income attributable to noncontrolling interest in joint venture — — — — — — 5.8 5.8 Ending balance 357.1 $ 0.4 $ 7,484.0 $ 4,682.8 $ (144.2) $ 12,023.0 $ 59.4 $ 12,082.4 Six Months Ended June 30, 2023 Common Stock Additional Paid-In Capital Retained Earnings Accumulated Other Comprehensive Income (Loss) Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 350.0 $ 0.4 $ 7,703.9 $ 3,500.1 $ (162.5) $ 11,041.9 $ 70.7 $ 11,112.6 Issuance of common stock through employee stock plans 3.4 — 174.8 — — 174.8 — 174.8 Shares withheld related to net share settlement of equity awards (0.6) — (6.3) (134.3) — (140.6) — (140.6) Share-based compensation expense related to employee stock plans — — 294.2 — — 294.2 — 294.2 Repurchase and retirement of common stock (1.5) — (15.8) (334.2) — (350.0) — (350.0) Net income attributable to Intuitive Surgical, Inc. — — — 776.1 — 776.1 — 776.1 Other comprehensive income (loss) — — — — 82.7 82.7 (0.8) 81.9 Net income attributable to noncontrolling interest in joint venture — — — — — — 10.7 10.7 Ending balance 351.3 $ 0.4 $ 8,150.8 $ 3,807.7 $ (79.8) $ 11,879.1 $ 80.6 $ 11,959.7 Six Months Ended June 30, 2022 Common Stock Additional Paid-In Capital Retained Earnings Accumulated Other Comprehensive Income (Loss) Total Intuitive Surgical, Inc. Stockholders’ Equity Noncontrolling Interest in Joint Venture Total Stockholders’ Equity Shares Amount Beginning balance 357.7 $ 0.4 $ 7,164.0 $ 4,760.9 $ (24.2) $ 11,901.1 $ 50.4 $ 11,951.5 Issuance of common stock through employee stock plans 2.6 — 106.6 — — 106.6 — 106.6 Shares withheld related to net share settlement of equity awards (0.6) — (6.7) (172.3) — (179.0) — (179.0) Share-based compensation expense related to employee stock plans — — 247.5 — — 247.5 — 247.5 Repurchase and retirement of common stock (2.6) — (27.4) (579.2) — (606.6) — (606.6) Net income attributable to Intuitive Surgical, Inc. — — — 673.4 — 673.4 — 673.4 Other comprehensive income (loss) — — — — (120.0) (120.0) (0.6) (120.6) Net income attributable to noncontrolling interest in joint venture — — — — — — 9.6 9.6 Ending balance 357.1 $ 0.4 $ 7,484.0 $ 4,682.8 $ (144.2) $ 12,023.0 $ 59.4 $ 12,082.4
Schedule of Share Repurchase Activities	The following table summarizes stock repurchase activities (in millions, except per share amounts): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Shares repurchased — 2.2 1.5 2.6 Average price per share $ — $ 224.4 $ 238.1 $ 231.0 Value of shares repurchased $ — $ 500.1 $ 350.0 $ 606.6
Components of Accumulated Other Comprehensive Income, Net of Tax	The components of accumulated other comprehensive loss, net of tax, attributable to Intuitive Surgical, Inc. are as follows (in millions): Three Months Ended June 30, 2023 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ (0.4) $ (116.6) $ 7.3 $ 1.2 $ (108.5) Other comprehensive income (loss) before reclassifications 6.9 13.1 9.6 — 29.6 Amounts reclassified from accumulated other comprehensive income (loss) (0.9) — — — (0.9) Net current-period other comprehensive income (loss) 6.0 13.1 9.6 — 28.7 Ending balance $ 5.6 $ (103.5) $ 16.9 $ 1.2 $ (79.8) Three Months Ended June 30, 2022 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ 5.5 $ (106.7) $ (4.8) $ (4.7) $ (110.7) Other comprehensive income (loss) before reclassifications (9.0) (33.3) (4.5) — (46.8) Amounts reclassified from accumulated other comprehensive income (loss) 13.4 (0.1) — — 13.3 Net current-period other comprehensive income (loss) 4.4 (33.4) (4.5) — (33.5) Ending balance $ 9.9 $ (140.1) $ (9.3) $ (4.7) $ (144.2) Six Months Ended June 30, 2023 Gains (Losses) on Hedge Instruments Unrealized Gains Foreign Currency Translation Gains (Losses) Employee Benefit Plans Total Beginning balance $ (2.9) $ (154.2) $ (6.6) $ 1.2 $ (162.5) Other comprehensive income (loss) before reclassifications 10.6 50.9 23.5 — 85.0 Amounts reclassified from accumulated other comprehensive income (loss) (2.1) (0.2) — — (2.3) Net current-period other comprehensive income (loss) 8.5 50.7 23.5 — 82.7 Ending balance $ 5.6 $ (103.5) $ 16.9 $ 1.2 $ (79.8) Six Months Ended June 30, 2022 Gains (Losses) on Hedge Instruments Unrealized Gains Foreign Currency Translation Gains (Losses) Employee Benefit Plans Total Beginning balance $ 4.5 $ (16.0) $ (7.9) $ (4.8) $ (24.2) Other comprehensive income (loss) before reclassifications (5.3) (124.1) (1.4) — (130.8) Amounts reclassified from accumulated other comprehensive income (loss) 10.7 — — 0.1 10.8 Net current-period other comprehensive income (loss) 5.4 (124.1) (1.4) 0.1 (120.0) Ending balance $ 9.9 $ (140.1) $ (9.3) $ (4.7) $ (144.2)
Schedule of Amounts Recognized in Other Comprehensive Income (Loss)	The tax impacts for amounts recognized in other comprehensive income (loss) before reclassifications were as follows (in millions): Three Months Ended June 30, Six Months Ended June 30, Available-for-sale securities 2023 2022 2023 2022 Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income (loss) $ (3.7) $ 5.6 $ (14.6) $ 35.3

SHARE-BASED COMPENSATION (Table

SHARE-BASED COMPENSATION (Tables)	6 Months Ended
	Jun. 30, 2023
Share-Based Payment Arrangement [Abstract]
Summary of RSU Activity	A summary of RSUs activity under all stock plans for the six months ended June 30, 2023, is presented as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2022 4.6 $ 241.47 RSUs granted 2.3 $ 232.89 RSUs vested (1.6) $ 222.52 RSUs forfeited (0.1) $ 246.84 Unvested balance as of June 30, 2023 5.2 $ 243.41
Summary of Stock Option Activity Under All Stock Plans	A summary of stock option activity under all stock plans for the six months ended June 30, 2023, is presented as follows (in millions, except per share amounts): Stock Options Outstanding Number Weighted-Average Balance as of December 31, 2022 10.8 $ 144.86 Options granted 0.7 $ 233.50 Options exercised (1.4) $ 80.73 Options forfeited/expired (0.1) $ 254.12 Balance as of June 30, 2023 10.0 $ 159.59
Share-Based Payment Arrangement, Performance Shares, Activity	PSU activity for the six months ended June 30, 2023, was as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2022 0.1 $ 299.32 Granted 0.1 $ 240.45 Vested — $ — Performance change — $ — Forfeited — $ 235.84 Unvested balance as of June 30, 2023 0.2 $ 259.60
Summary of Share-Based Compensation Expense	The following table summarizes share-based compensation expense for the three and six months ended June 30, 2023, and 2022 (in millions): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Cost of sales – products (before capitalization) $ 22.7 $ 20.3 $ 45.7 $ 39.0 Amounts capitalized into inventory (1) (21.1) — (39.9) — Amounts recognized in income for amounts previously capitalized in inventory 19.3 — 31.9 — Cost of sales – products $ 20.9 $ 20.3 $ 37.7 $ 39.0 Cost of sales – services 7.0 5.8 14.0 11.4 Total cost of sales 27.9 26.1 51.7 50.4 Selling, general, and administrative 68.0 62.7 134.7 123.0 Research and development 52.3 38.5 102.4 75.3 Share-based compensation expense before income taxes 148.2 127.3 288.8 248.7 Income tax benefit 28.5 20.9 56.5 48.1 Share-based compensation expense after income taxes $ 119.7 $ 106.4 $ 232.3 $ 200.6 (1) Share-based compensation expense subject to capitalization into inventory was not material during the three and six months ended June 30, 2022, and, therefore, not recorded. The Company commenced capitalization of share-based compensation expense into inventory during the quarter ended December 31, 2022, on a prospective basis.
Schedule of Estimated Fair Value of the Option Using Black-Scholes Option Pricing Model, Weighted Average Assumptions	The weighted-average estimated fair values of stock options and the rights to acquire stock under the ESPP, as well as the weighted-average assumptions used in calculating the fair values of stock options and the rights to acquire stock under the ESPP that were granted during the three and six months ended June 30, 2023, and 2022, were as follows: Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Stock Options Risk-free interest rate 4.3% 2.9% 4.8% 1.7% Expected term (in years) 3.2 3.3 3.4 3.4 Expected volatility 32% 38% 34% 36% Fair value at grant date $83.38 $72.35 $72.71 $80.27 ESPP Risk-free interest rate —% —% 4.7% 0.8% Expected term (in years) 0.0 0.0 1.2 1.2 Expected volatility —% —% 35% 37% Fair value at grant date $— $— $79.33 $88.85

NET INCOME PER SHARE (Tables)

NET INCOME PER SHARE (Tables)	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Computation of Basic and Diluted Net Income Per Share	The following table presents the computation of basic and diluted net income per share attributable to Intuitive Surgical, Inc. (in millions, except per share amounts): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Numerator: Net income attributable to Intuitive Surgical, Inc. $ 420.8 $ 307.8 $ 776.1 $ 673.4 Denominator: Weighted-average shares outstanding used in basic calculation 350.9 358.1 350.6 358.2 Add: dilutive effect of potential common shares 6.4 5.8 6.0 7.1 Weighted-average shares outstanding used in diluted calculation 357.3 363.9 356.6 365.3 Net income per share attributable to Intuitive Surgical, Inc.: Basic $ 1.20 $ 0.86 $ 2.21 $ 1.88 Diluted $ 1.18 $ 0.85 $ 2.18 $ 1.84

FINANCIAL INSTRUMENTS - Summary

FINANCIAL INSTRUMENTS - Summary of Cash and Available-For-Sale Securities (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	$ 3,435.4	$ 1,581.2
Total	3,830.7
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(133.3)	(198.5)
Allowance for Credit Loss	(1.1)	(1.1)
Fair Value	3,696.3
Short- term Investments	2,363.8	2,536.7
Long- term Investments	1,332.5	2,623.6
Total assets measured at fair value, amortized cost	7,266.1	6,941.1
Total assets measured at fair value, fair value	7,131.7	6,741.5
Cash
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	520.3	497.2
Fair Value	520.3	497.2
Level 1
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	2,915.1	1,084
Total	4,775.9	3,799.2
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(61)	(96.6)
Allowance for Credit Loss	0	0
Fair Value	4,714.9	3,702.6
Short- term Investments	1,294.2	1,542.4
Long- term Investments	505.6	1,076.2
Level 1 | Money market funds
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	2,915.1	1,084
Fair Value	2,915.1	1,084
Short- term Investments	0	0
Long- term Investments	0	0
Level 1 | U.S. treasuries
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	1,860.8	2,715.2
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(61)	(96.6)
Allowance for Credit Loss	0	0
Fair Value	1,799.8	2,618.6
Short- term Investments	1,294.2	1,542.4
Long- term Investments	505.6	1,076.2
Level 2
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	1,969.9	2,644.7
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(72.3)	(101.9)
Allowance for Credit Loss	(1.1)	(1.1)
Fair Value	1,896.5	2,541.7
Short- term Investments	1,069.6	994.3
Long- term Investments	826.9	1,547.4
Level 2 | Commercial paper
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents		0
Total		20
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Allowance for Credit Loss		0
Fair Value		20
Short- term Investments		20
Long- term Investments		0
Level 2 | Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	1,490.5	2,022
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(53.9)	(76)
Allowance for Credit Loss	(1.1)	(1.1)
Fair Value	1,435.5	1,944.9
Short- term Investments	829.5	651.8
Long- term Investments	606	1,293.1
Level 2 | U.S. government agencies
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	361.2	447.2
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(14.3)	(19.9)
Allowance for Credit Loss	0	0
Fair Value	346.9	427.3
Short- term Investments	183.8	247.8
Long- term Investments	163.1	179.5
Level 2 | Municipal securities
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	118.2	155.5
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(4.1)	(6)
Allowance for Credit Loss	0	0
Fair Value	114.1	149.5
Short- term Investments	56.3	74.7
Long- term Investments	$ 57.8	$ 74.8

FINANCIAL INSTRUMENTS - Summa_2

FINANCIAL INSTRUMENTS - Summary of Contractual Maturities of Cash Equivalents and Available-For-Sale Investments (Details) $ in Millions	Jun. 30, 2023 USD ($)
Amortized Cost
Mature in less than one year	$ 2,416.8
Mature in one to five years	1,413.9
Total	3,830.7
Fair Value
Mature in less than one year	2,363.8
Mature in one to five years	1,332.5
Total	$ 3,696.3

FINANCIAL INSTRUMENTS - Narrati

FINANCIAL INSTRUMENTS - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended	12 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2023	Dec. 31, 2022
Debt and Equity Securities, FV-NI [Line Items]
Realized Investment Gains (Losses)		$ 0	$ 0
Net unrealized gains/(losses) on investments			(103,500,000)	$ (154,200,000)
Level 2
Debt and Equity Securities, FV-NI [Line Items]
Changes in Fair Value	$ (6,100,000)		$ (5,600,000)

FINANCIAL INSTRUMENTS - Availab

FINANCIAL INSTRUMENTS - Available-for-Sale Debt Securities in a Continuous Unrealized Loss Position (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	$ 84.1	$ 1,510.4
Unrealized losses less than 12 months, gross unrealized losses	(0.9)	(49.1)
Unrealized losses more than 12 months, fair value	3,598.9	3,538.3
Unrealized losses more than 12 months, gross unrealized losses	(132.4)	(149.4)
Total unrealized losses, fair value	3,683	5,048.7
Total unrealized losses, gross unrealized losses	(133.3)	(198.5)
U.S. treasuries
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	0	731.7
Unrealized losses less than 12 months, gross unrealized losses	0	(26)
Unrealized losses more than 12 months, fair value	1,799.8	1,886.9
Unrealized losses more than 12 months, gross unrealized losses	(61)	(70.6)
Total unrealized losses, fair value	1,799.8	2,618.6
Total unrealized losses, gross unrealized losses	(61)	(96.6)
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	84.1	631.4
Unrealized losses less than 12 months, gross unrealized losses	(0.9)	(17.6)
Unrealized losses more than 12 months, fair value	1,344.5	1,221.9
Unrealized losses more than 12 months, gross unrealized losses	(53)	(58.4)
Total unrealized losses, fair value	1,428.6	1,853.3
Total unrealized losses, gross unrealized losses	(53.9)	(76)
U.S. government agencies
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	0	102.7
Unrealized losses less than 12 months, gross unrealized losses	0	(4.4)
Unrealized losses more than 12 months, fair value	346.9	324.6
Unrealized losses more than 12 months, gross unrealized losses	(14.3)	(15.5)
Total unrealized losses, fair value	346.9	427.3
Total unrealized losses, gross unrealized losses	(14.3)	(19.9)
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	0	44.6
Unrealized losses less than 12 months, gross unrealized losses	0	(1.1)
Unrealized losses more than 12 months, fair value	107.7	104.9
Unrealized losses more than 12 months, gross unrealized losses	(4.1)	(4.9)
Total unrealized losses, fair value	107.7	149.5
Total unrealized losses, gross unrealized losses	$ (4.1)	$ (6)

FINANCIAL INSTRUMENTS - Summa_3

FINANCIAL INSTRUMENTS - Summary of Equity Investment Activity (Details) - USD ($) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2023
Level 1
Fair Value, Level 1 [Abstract]
Beginning balance, carrying value		$ 4.3
Purchases / Sales / Other (2)		(3.9)
Ending balance, carrying value	$ 0	0
Level 1 | Broncus Holding Corporation
Fair Value, Level 1 [Abstract]
Changes in fair value		(0.4)
Level 2
Fair Value, Level 2 [Abstract]
Beginning balance, carrying value		59.1
Changes in Fair Value	(6.1)	(5.6)
Purchases / Sales / Other (2)		14.3
Ending balance, carrying value	67.8	67.8
Prepaids and other current assets | Level 1
Fair Value, Level 1 [Abstract]
Ending balance, carrying value	0	0
Prepaids and other current assets | Level 2
Fair Value, Level 2 [Abstract]
Ending balance, carrying value	0	0
Intangible and other assets, net | Level 1
Fair Value, Level 1 [Abstract]
Ending balance, carrying value	0	0
Intangible and other assets, net | Level 2
Fair Value, Level 2 [Abstract]
Ending balance, carrying value	$ 67.8	$ 67.8

FINANCIAL INSTRUMENTS - Derivat

FINANCIAL INSTRUMENTS - Derivative Instruments Used to Hedge against Balance Sheet Foreign Currency Exposures (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign exchange losses related to balance sheet re-measurement	$ (16.3)	$ (28.8)	$ (10.9)	$ (38.9)
Forward contracts | Derivatives Not Designated as Hedging Instruments
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Recognized gains in interest and other income, net	$ 14.7	$ 21.9	$ 11.4	$ 28.7

FINANCIAL INSTRUMENTS - Gross N

FINANCIAL INSTRUMENTS - Gross Notional Amounts for Outstanding Derivatives (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Derivatives Designated as Hedging Instruments | Prepaids and other current assets
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	$ 7.6	$ 1.8
Derivatives Designated as Hedging Instruments | Other accrued liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	1.4	5.3
Derivatives Not Designated as Hedging Instruments | Prepaids and other current assets
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	5.6	4.3
Derivatives Not Designated as Hedging Instruments | Other accrued liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	1.8	4.2
Forward contracts | Derivatives Designated as Hedging Instruments
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	250.3	188.4
Forward contracts | Derivatives Not Designated as Hedging Instruments
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	$ 578.4	$ 496.3

BALANCE SHEET DETAILS AND OTH_3

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Accounts Receivable, Net (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Trade accounts receivable, net	$ 825.7	$ 864.9
Unbilled accounts receivable and other	101.9	91.7
Sales returns and allowances	(23.4)	(14.5)
Accounts receivable, net	$ 904.2	$ 942.1

BALANCE SHEET DETAILS AND OTH_4

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Inventory (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 390.2	$ 382.9
Work-in-process	145	159.9
Finished goods	470	350.4
Total inventory	$ 1,005.2	$ 893.2

BALANCE SHEET DETAILS AND OTH_5

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Prepaids and Other Current Assets (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Net investment in sales-type leases – short-term	$ 134.6	$ 131.2
Other prepaids and other current assets	188.6	168.6
Total prepaids and other current assets	$ 323.2	$ 299.8

BALANCE SHEET DETAILS AND OTH_6

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Other Accrued Liabilities - Short-term (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income and other taxes payable	$ 230.2	$ 96.1
Accrued construction-related capital expenditures	113.7	50.3
Litigation-related accruals	3.7	23
Other accrued liabilities	239.3	306.8
Total other accrued liabilities – short-term	$ 586.9	$ 476.2

BALANCE SHEET DETAILS AND OTH_7

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Other Long-term Liabilities (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income taxes – long-term	$ 250.3	$ 288
Deferred revenue – long-term	45.4	41
Other long-term liabilities	109.5	110.3
Total other long-term liabilities	$ 405.2	$ 439.3

BALANCE SHEET DETAILS AND OTH_8

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Supplemental Cash Flow Information (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment	$ 198.5	$ 122.7
Acquisition of property, plant, and equipment in accounts payable and accrued liabilities	$ 138.2	$ 95.8

REVENUE AND CONTRACT ACQUISIT_3

REVENUE AND CONTRACT ACQUISITION COSTS - Revenue Disaggregated by Types and Geography (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Total revenue	$ 1,755.9	$ 1,522.1	$ 3,452.1	$ 3,009.8
Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	1,075.9	895.3	2,061.5	1,705.6
Systems
Disaggregation of Revenue [Line Items]
Total revenue	392.7	375.1	820.1	803.2
Services
Disaggregation of Revenue [Line Items]
Total revenue	287.3	251.7	570.5	501
U.S.
Disaggregation of Revenue [Line Items]
Total revenue	1,142.5	1,011.1	2,252.4	1,975.9
U.S. | Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	763.3	625.1	1,464.7	1,175.7
U.S. | Systems
Disaggregation of Revenue [Line Items]
Total revenue	189.8	218	411.6	466.3
U.S. | Services
Disaggregation of Revenue [Line Items]
Total revenue	189.4	168	376.1	333.9
Outside of U.S. (“OUS”)
Disaggregation of Revenue [Line Items]
Total revenue	613.4	511	1,199.7	1,033.9
Outside of U.S. (“OUS”) | Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	312.6	270.2	596.8	529.9
Outside of U.S. (“OUS”) | Systems
Disaggregation of Revenue [Line Items]
Total revenue	202.9	157.1	408.5	336.9
Outside of U.S. (“OUS”) | Services
Disaggregation of Revenue [Line Items]
Total revenue	$ 97.9	$ 83.7	$ 194.4	$ 167.1

REVENUE AND CONTRACT ACQUISIT_4

REVENUE AND CONTRACT ACQUISITION COSTS - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue recognized	$ 112	$ 107	$ 297	$ 279
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-07-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Price allocated to remaining performance obligations	$ 2,140		$ 2,140
Remaining performance obligations, percent	43%		43%
Remaining performance obligations, expected timing of satisfaction, period	5 years		5 years

REVENUE AND CONTRACT ACQUISIT_5

REVENUE AND CONTRACT ACQUISITION COSTS - Summary of Contract Assets and Liabilities (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Contract assets	$ 48.1	$ 45
Deferred revenue	$ 450.6	$ 438.3

REVENUE AND CONTRACT ACQUISIT_6

REVENUE AND CONTRACT ACQUISITION COSTS - Sales-type and Operating Lease Revenue (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Deferred Revenue Arrangement [Line Items]
Sales-type lease revenue	$ 12.3	$ 50.1	$ 35.3	$ 85.7
Operating lease revenue	122.7	93	234.7	176.2
Variable Lease Revenue, Usage-Based Arrangements
Deferred Revenue Arrangement [Line Items]
Operating lease revenue	$ 53.2	$ 33.6	$ 99.2	$ 58.5

LEASES - Lease Receivables (Det

LEASES - Lease Receivables (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Capital Leased Assets [Line Items]
Gross lease receivables	$ 414.1	$ 449.4
Unearned income	(14.3)	(14.4)
Subtotal	399.8	435
Allowance for credit loss	(3)	(3)
Sales-type lease, lease receivable	396.8	432
Prepaids and other current assets
Capital Leased Assets [Line Items]
Sales-type lease, lease receivable	134.6	131.2
Intangible and other assets, net
Capital Leased Assets [Line Items]
Sales-type lease, lease receivable	$ 262.2	$ 300.8

LEASES - Schedule of Contractua

LEASES - Schedule of Contractual Maturities of Gross Lease Receivables (Details) $ in Millions	Jun. 30, 2023 USD ($)
Leases [Abstract]
Remainder of 2023	$ 70.3
2024	134
2025	103.5
2026	66.6
2027	33.3
2028 and thereafter	6.4
Total	$ 414.1

LEASES - Additional Information

LEASES - Additional Information (Details)	Jun. 30, 2023
Minimum
Lessee, Lease, Description [Line Items]
Sales-type leases terms	24 months
Maximum
Lessee, Lease, Description [Line Items]
Sales-type leases terms	84 months

LEASES - Credit Quality Indicat

LEASES - Credit Quality Indicator (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	$ 36.9
2022	146.7
2021	132.6
2020	63.2
2019	16.8
Prior	3.6
Subtotal	399.8	$ 435
High
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	27.1
2022	86.2
2021	70.9
2020	32.9
2019	10
Prior	0.6
Subtotal	227.7
Moderate
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	9.8
2022	57.2
2021	58.7
2020	28.4
2019	6.8
Prior	3
Subtotal	163.9
Low
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	0
2022	3.3
2021	3
2020	1.9
2019	0
Prior	0
Subtotal	$ 8.2

GOODWILL AND INTANGIBLE ASSET_2

GOODWILL AND INTANGIBLE ASSETS - Schedule of Summary of Changes in Goodwill (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($)
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 348.5
Acquisition activity	0
Translation and other	0.1
Goodwill, ending balance	$ 348.6

GOODWILL AND INTANGIBLE ASSET_3

GOODWILL AND INTANGIBLE ASSETS - Schedule of Intangible Assets (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 247.3	$ 242.7
Accumulated Amortization	(200.1)	(192.9)
Net Carrying Amount	47.2	49.8
Patents and developed technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	204.3	199.1
Accumulated Amortization	(171.6)	(167.4)
Net Carrying Amount	32.7	31.7
Distribution rights and others
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	10.8	11
Accumulated Amortization	(8.3)	(7.4)
Net Carrying Amount	2.5	3.6
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	32.2	32.6
Accumulated Amortization	(20.2)	(18.1)
Net Carrying Amount	$ 12	$ 14.5

GOODWILL AND INTANGIBLE ASSET_4

GOODWILL AND INTANGIBLE ASSETS - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 5	$ 6.2	$ 10	$ 12.3

GOODWILL AND INTANGIBLE ASSET_5

GOODWILL AND INTANGIBLE ASSETS - Schedule Of Estimated Future Amortization Expense Of Intangible Assets (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2023	$ 10.1
2024	16.7
2025	11.7
2026	5
2027	2.5
2028 and thereafter	1.2
Net Carrying Amount	$ 47.2	$ 49.8

CONTINGENCIES (Details)

CONTINGENCIES (Details) $ in Millions	Oct. 19, 2022 USD ($)
Rex Medical, L.P.
Other Commitments [Line Items]
Loss contingency, damages awarded	$ 10

STOCKHOLDERS' EQUITY - Schedule

STOCKHOLDERS' EQUITY - Schedule of Stockholders Equity (Details) - USD ($) shares in Millions, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)			350
Beginning balance	$ 11,294.2	$ 12,156.9	$ 11,112.6	$ 11,951.5
Issuance of common stock through employee stock plans	74.6	26.6	174.8	106.6
Shares withheld related to net share settlement of equity awards	(10.9)	(6.8)	(140.6)	(179)
Share-based compensation expense related to employee stock plans	148.2	126.7	294.2	247.5
Repurchase and retirement of common stock		(500.1)	(350)	(606.6)
Net income attributable to Intuitive Surgical, Inc.	420.8	307.8	776.1	673.4
Other comprehensive income (loss)	27.6	(34.5)	81.9	(120.6)
Net income attributable to noncontrolling interest in joint venture	$ 5.2	5.8	$ 10.7	9.6
Ending balance (in shares)	351.3		351.3
Ending balance	$ 11,959.7	12,082.4	$ 11,959.7	12,082.4
Total Intuitive Surgical, Inc. Stockholders’ Equity
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	11,217.7	12,102.3	11,041.9	11,901.1
Issuance of common stock through employee stock plans	74.6	26.6	174.8	106.6
Shares withheld related to net share settlement of equity awards	(10.9)	(6.8)	(140.6)	(179)
Share-based compensation expense related to employee stock plans	148.2	126.7	294.2	247.5
Repurchase and retirement of common stock		(500.1)	(350)	(606.6)
Net income attributable to Intuitive Surgical, Inc.	420.8	307.8	776.1	673.4
Other comprehensive income (loss)	28.7	(33.5)	82.7	(120)
Ending balance	$ 11,879.1	$ 12,023	$ 11,879.1	$ 12,023
Common Stock
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)	350.4	358.9	350	357.7
Beginning balance	$ 0.4	$ 0.4	$ 0.4	$ 0.4
Issuance of common stock through employee stock plans (in shares)	1	0.4	3.4	2.6
Shares withheld related to net share settlement of equity awards (in shares)	(0.1)	0	(0.6)	(0.6)
Repurchase and retirement of common stock (in shares)		(2.2)	(1.5)	(2.6)
Ending balance (in shares)	351.3	357.1	351.3	357.1
Ending balance	$ 0.4	$ 0.4	$ 0.4	$ 0.4
Additional Paid-In Capital
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	7,928.4	7,354.6	7,703.9	7,164
Issuance of common stock through employee stock plans	74.6	26.6	174.8	106.6
Shares withheld related to net share settlement of equity awards	(0.4)	(0.6)	(6.3)	(6.7)
Share-based compensation expense related to employee stock plans	148.2	126.7	294.2	247.5
Repurchase and retirement of common stock		(23.3)	(15.8)	(27.4)
Ending balance	8,150.8	7,484	8,150.8	7,484
Retained Earnings
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	3,397.4	4,858	3,500.1	4,760.9
Shares withheld related to net share settlement of equity awards	(10.5)	(6.2)	(134.3)	(172.3)
Repurchase and retirement of common stock		(476.8)	(334.2)	(579.2)
Net income attributable to Intuitive Surgical, Inc.	420.8	307.8	776.1	673.4
Ending balance	3,807.7	4,682.8	3,807.7	4,682.8
Accumulated Other Comprehensive Income (Loss)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(108.5)	(110.7)	(162.5)	(24.2)
Other comprehensive income (loss)	28.7	(33.5)	82.7	(120)
Ending balance	(79.8)	(144.2)	(79.8)	(144.2)
Noncontrolling Interest in Joint Venture
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	76.5	54.6	70.7	50.4
Other comprehensive income (loss)	(1.1)	(1)	(0.8)	(0.6)
Net income attributable to noncontrolling interest in joint venture	5.2	5.8	10.7	9.6
Ending balance	$ 80.6	$ 59.4	$ 80.6	$ 59.4

STOCKHOLDERS' EQUITY - Stock Re

STOCKHOLDERS' EQUITY - Stock Repurchase Program (Details) - Repurchase Program - Common Stock - USD ($)	Jun. 30, 2023	Jul. 20, 2022
Equity, Class of Treasury Stock [Line Items]
Amount of share repurchases authorized	$ 10,000,000,000
Remaining amount of share repurchases authorized	$ 1,100,000,000	$ 3,500,000,000

STOCKHOLDERS' EQUITY - Schedu_2

STOCKHOLDERS' EQUITY - Schedule of Share Repurchase Activities (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Equity, Class of Treasury Stock [Line Items]
Value of shares repurchased		$ 500.1	$ 350	$ 606.6
Common Stock
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)		2.2	1.5	2.6
Common Stock | Repurchase Program
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)	0	2.2	1.5	2.6
Average price per share (in dollars per share)	$ 0	$ 224.4	$ 238.1	$ 231
Value of shares repurchased	$ 0	$ 500.1	$ 350	$ 606.6

STOCKHOLDERS' EQUITY - Componen

STOCKHOLDERS' EQUITY - Components of Accumulated Other Comprehensive Income, Net of Tax (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	$ (108.5)	$ (110.7)	$ (162.5)	$ (24.2)
Other comprehensive income (loss) before reclassifications	29.6	(46.8)	85	(130.8)
Amounts reclassified from accumulated other comprehensive income (loss)	(0.9)	13.3	(2.3)	10.8
Net current-period other comprehensive income (loss)	28.7	(33.5)	82.7	(120)
Ending balance	(79.8)	(144.2)	(79.8)	(144.2)
Gains (Losses) on Hedge Instruments
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(0.4)	5.5	(2.9)	4.5
Other comprehensive income (loss) before reclassifications	6.9	(9)	10.6	(5.3)
Amounts reclassified from accumulated other comprehensive income (loss)	(0.9)	13.4	(2.1)	10.7
Net current-period other comprehensive income (loss)	6	4.4	8.5	5.4
Ending balance	5.6	9.9	5.6	9.9
Unrealized Gains (Losses) on Available-for-Sale Securities
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(116.6)	(106.7)	(154.2)	(16)
Other comprehensive income (loss) before reclassifications	13.1	(33.3)	50.9	(124.1)
Amounts reclassified from accumulated other comprehensive income (loss)	0	(0.1)	(0.2)	0
Net current-period other comprehensive income (loss)	13.1	(33.4)	50.7	(124.1)
Ending balance	(103.5)	(140.1)	(103.5)	(140.1)
Foreign Currency Translation Gains (Losses)
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	7.3	(4.8)	(6.6)	(7.9)
Other comprehensive income (loss) before reclassifications	9.6	(4.5)	23.5	(1.4)
Amounts reclassified from accumulated other comprehensive income (loss)	0	0	0	0
Net current-period other comprehensive income (loss)	9.6	(4.5)	23.5	(1.4)
Ending balance	16.9	(9.3)	16.9	(9.3)
Employee Benefit Plans
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	1.2	(4.7)	1.2	(4.8)
Other comprehensive income (loss) before reclassifications	0	0	0	0
Amounts reclassified from accumulated other comprehensive income (loss)	0	0	0	0.1
Net current-period other comprehensive income (loss)	0	0	0	0.1
Ending balance	$ 1.2	$ (4.7)	$ 1.2	$ (4.7)

STOCKHOLDERS' EQUITY - Other Co

STOCKHOLDERS' EQUITY - Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Text Block [Abstract]
Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income (loss)	$ (3.7)	$ 5.6	$ (14.6)	$ 35.3

SHARE-BASED COMPENSATION - Addi

SHARE-BASED COMPENSATION - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended	6 Months Ended
	Mar. 31, 2023	Jun. 30, 2023	Jun. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options exercisable, number of shares		7,900,000
Options exercisable, weighted-average exercise price (usd per share)		$ 136.18
Employee Stock Purchase Plan, number of shares purchased by employees		300,000	200,000
Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee Stock Purchase Plan, value of shares purchased by employees		$ 59.9	$ 47.8
Performance Share Units (PSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Performance Share Units (PSUs) | Share-Based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage		33%
Performance Share Units (PSUs) | Share-Based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage		33%
Performance Share Units (PSUs) | Share-Based Payment Arrangement, Tranche Three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage		33%
Performance Share Units (PSUs) | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of awards vested	0%
Performance Share Units (PSUs) | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of awards vested	125%
2010 Incentive Award Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock reserved for issuance		110,350,000
Number of shares reserved for future issuance		21,200,000
2010 Incentive Award Plan | Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares reserved for future issuance		9,200,000

SHARE-BASED COMPENSATION - Summ

SHARE-BASED COMPENSATION - Summary of RSU and PSU Activity (Details) shares in Millions	6 Months Ended
	Jun. 30, 2023 $ / shares shares
Restricted Stock Units (RSUs)
Shares
Unvested beginning balance (in shares) | shares	4.6
Granted (in shares) | shares	2.3
Vested (in shares) | shares	(1.6)
Forfeited (in shares) | shares	(0.1)
Unvested ending balance (in shares) | shares	5.2
Weighted-Average Grant-Date Fair Value
Unvested beginning balance (usd per share) | $ / shares	$ 241.47
Granted (usd per share) | $ / shares	232.89
Vested (usd per share) | $ / shares	222.52
Forfeited (usd per share) | $ / shares	246.84
Unvested ending balance (usd per share) | $ / shares	$ 243.41
Performance Share Units (PSUs)
Shares
Unvested beginning balance (in shares) | shares	0.1
Granted (in shares) | shares	0.1
Vested (in shares) | shares	0
Performance change (in shares) | shares	0
Forfeited (in shares) | shares	0
Unvested ending balance (in shares) | shares	0.2
Weighted-Average Grant-Date Fair Value
Unvested beginning balance (usd per share) | $ / shares	$ 299.32
Granted (usd per share) | $ / shares	240.45
Vested (usd per share) | $ / shares	0
Performance change (usd per share) | $ / shares	0
Forfeited (usd per share) | $ / shares	235.84
Unvested ending balance (usd per share) | $ / shares	$ 259.60

SHARE-BASED COMPENSATION - Su_2

SHARE-BASED COMPENSATION - Summary of Stock Option Activity Under All Stock Plans (Details) shares in Millions	6 Months Ended
	Jun. 30, 2023 $ / shares shares
Number Outstanding
Beginning balance (in shares) | shares	10.8
Options granted (in shares) | shares	0.7
Options exercised (in shares) | shares	(1.4)
Options forfeited/expired (in shares) | shares	(0.1)
Ending balance (in shares) | shares	10
Weighted-Average Exercise Price Per Share
Beginning balance, Weighted Average Exercise Price Per Share | $ / shares	$ 144.86
Options granted, Weighted Average Exercise Price Per Share | $ / shares	233.50
Options exercised, Weighted Average Exercise Price Per Share | $ / shares	80.73
Options forfeited/expired, Weighted Average Exercise Price Per Share | $ / shares	254.12
Ending balance, Weighted Average Exercise Price Per Share | $ / shares	$ 159.59

SHARE-BASED COMPENSATION - Stoc

SHARE-BASED COMPENSATION - Stock-Based Compensation Expense (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 148.2	$ 127.3	$ 288.8	$ 248.7
Income tax benefit	28.5	20.9	56.5	48.1
Share-based compensation expense after income taxes	119.7	106.4	232.3	200.6
Cost of sales – products | Cost of sales – products (before capitalization)
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	22.7	20.3	45.7	39
Cost of sales – products | Amounts capitalized into inventory
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	(21.1)	0	(39.9)	0
Cost of sales – products | Amounts recognized in income for amounts previously capitalized in inventory
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	19.3	0	31.9	0
Total cost of sales
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	27.9	26.1	51.7	50.4
Total cost of sales | Cost of sales – products
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	20.9	20.3	37.7	39
Total cost of sales | Cost of sales – services
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	7	5.8	14	11.4
Selling, general, and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	68	62.7	134.7	123
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 52.3	$ 38.5	$ 102.4	$ 75.3

SHARE-BASED COMPENSATION - Sche

SHARE-BASED COMPENSATION - Schedule of Estimated Fair Value of Option Using Black-Scholes Option Pricing Model, Weighted Average Assumptions (Details) - $ / shares	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Stock Options
Stock Options
Risk-free interest rate	4.30%	2.90%	4.80%	1.70%
Expected term (in years)	3 years 2 months 12 days	3 years 3 months 18 days	3 years 4 months 24 days	3 years 4 months 24 days
Expected volatility (percent)	32%	38%	34%	36%
Weighted average fair value at grant date (usd per share)	$ 83.38	$ 72.35	$ 72.71	$ 80.27
Employee Stock Purchase Program [Abstract]
Risk-free interest rate	4.30%	2.90%	4.80%	1.70%
Expected term (in years)	3 years 2 months 12 days	3 years 3 months 18 days	3 years 4 months 24 days	3 years 4 months 24 days
Expected volatility (percent)	32%	38%	34%	36%
Weighted average fair value at grant date (usd per share)	$ 83.38	$ 72.35	$ 72.71	$ 80.27
ESPP
Stock Options
Risk-free interest rate	0%	0%	4.70%	0.80%
Expected term (in years)	0 years	0 years	1 year 2 months 12 days	1 year 2 months 12 days
Expected volatility (percent)	0%	0%	35%	37%
Weighted average fair value at grant date (usd per share)	$ 0	$ 0	$ 79.33	$ 88.85
Employee Stock Purchase Program [Abstract]
Risk-free interest rate	0%	0%	4.70%	0.80%
Expected term (in years)	0 years	0 years	1 year 2 months 12 days	1 year 2 months 12 days
Expected volatility (percent)	0%	0%	35%	37%
Weighted average fair value at grant date (usd per share)	$ 0	$ 0	$ 79.33	$ 88.85

INCOME TAXES - Additional Infor

INCOME TAXES - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Tax Disclosure [Abstract]
Income tax expense	$ 73.2	$ 93.3	$ 134.2	$ 126.3
Income tax expense, percentage of pre-tax income	14.70%	22.90%	14.60%	15.60%
Excess tax benefits associated with employee equity plans	$ 41.7	$ 9.3	$ 64.2	$ 62.3
Excess tax benefits associated with employee equity plans (in percent)	8.40%	2.30%	7%	7.70%

NET INCOME PER SHARE - Computat

NET INCOME PER SHARE - Computation of Basic and Diluted Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Numerator:
Net income attributable to Intuitive Surgical, Inc.	$ 420.8	$ 307.8	$ 776.1	$ 673.4
Denominator:
Weighted average shares outstanding used in basic calculation (in shares)	350.9	358.1	350.6	358.2
Add: dilutive effect of potential common shares (in shares)	6.4	5.8	6	7.1
Weighted average shares outstanding used in diluted calculation (in shares)	357.3	363.9	356.6	365.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (in dollars per share)	$ 1.20	$ 0.86	$ 2.21	$ 1.88
Diluted (in dollars per share)	$ 1.18	$ 0.85	$ 2.18	$ 1.84

NET INCOME PER SHARE - Addition

NET INCOME PER SHARE - Additional Information (Details) - shares shares in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Earnings Per Share [Abstract]
Employee stock options excluded from computation of diluted net income per share	1.1	4.3	2.1	3.4