Intuitive Surgical (ISRG) 10-Q 19 Apr 24 2024 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2024	Apr. 15, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
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		354,705,822
Entity Central Index Key	0001035267
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 2,839.5	$ 2,750.1
Short-term investments	1,960.6	2,473.1
Accounts receivable, net	1,127.9	1,130.2
Inventory	1,299.3	1,220.6
Prepaids and other current assets	405.4	314
Total current assets	7,632.7	7,888
Property, plant, and equipment, net	3,799.6	3,537.6
Long-term investments	2,522.6	2,120
Deferred tax assets	917.8	910.5
Intangible and other assets, net	607.1	636.7
Goodwill	348.2	348.7
Total assets	15,828	15,441.5
Current liabilities:
Accounts payable	194.4	188.7
Accrued compensation and employee benefits	238.4	436.4
Deferred revenue	437.5	446.1
Other accrued liabilities	504.8	587.5
Total current liabilities	1,375.1	1,658.7
Other long-term liabilities	406.5	385.5
Total liabilities	1,781.6	2,044.2
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 March 31, 2024, and December 31, 2023	0	0
Common stock, 600.0 shares authorized, $0.001 par value, 354.7 shares and 352.3 shares issued and outstanding as of March 31, 2024, and December 31, 2023, respectively	0.4	0.4
Additional paid-in capital	8,903	8,576.4
Retained earnings	5,067.9	4,743
Accumulated other comprehensive loss	(8.7)	(12.2)
Total Intuitive Surgical, Inc. stockholders’ equity	13,962.6	13,307.6
Noncontrolling interest in joint venture	83.8	89.7
Total stockholders’ equity	14,046.4	13,397.3
Total liabilities and stockholders’ equity	$ 15,828	$ 15,441.5

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
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)	354,700,000	352,300,000
Common stock, shares outstanding (in shares)	354,700,000	352,300,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenue:
Total revenue	$ 1,890.6	$ 1,696.2
Cost of revenue:
Total cost of revenue	645.2	583.2
Gross profit	1,245.4	1,113
Operating expenses:
Selling, general and administrative	491.5	480.5
Research and development	284.5	244.9
Total operating expenses	776	725.4
Income from operations	469.4	387.6
Interest and other income, net	69.1	34.2
Income before taxes	538.5	421.8
Income tax expense (benefit)	(8.9)	61
Net income	547.4	360.8
Less: net income attributable to noncontrolling interest in joint venture	2.5	5.5
Net income attributable to Intuitive Surgical, Inc.	$ 544.9	$ 355.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (in dollars per share)	$ 1.54	$ 1.01
Diluted (in dollars per share)	$ 1.51	$ 1
Shares used in computing net income per share attributable to Intuitive Surgical, Inc.:
Basic (in shares)	353.5	350.2
Diluted (in shares)	360.5	356
Other comprehensive income, net of tax:
Unrealized gains on hedge instruments	$ 5.6	$ 2.5
Unrealized gains (losses) on available-for-sale securities	(4.2)	37.6
Foreign currency translation gains	1.8	14.2
Prior service cost for employee benefit plans	(0.1)	0
Other comprehensive income	3.1	54.3
Total comprehensive income	550.5	415.1
Less: comprehensive income attributable to noncontrolling interest	2.1	5.8
Total comprehensive income attributable to Intuitive Surgical, Inc.	548.4	409.3
Corporate Joint Venture
Operating expenses:
Less: net income attributable to noncontrolling interest in joint venture	2.5	5.5
Product
Revenue:
Total revenue	1,577.1	1,413
Cost of revenue:
Total cost of revenue	554.4	493
Service
Revenue:
Total revenue	313.5	283.2
Cost of revenue:
Total cost of revenue	$ 90.8	$ 90.2

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Operating activities:
Net income	$ 547.4	$ 360.8
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and loss on disposal of property, plant, and equipment	104.2	87.7
Amortization of intangible assets	5.1	5
Loss (gain) on investments, accretion of discounts, and amortization of premiums on investments, net	(5.9)	4.9
Deferred income taxes	(7.2)	9.3
Share-based compensation expense	153.3	139.8
Amortization of contract acquisition assets	8.5	7.4
Changes in operating assets and liabilities, net of effects of acquisitions:
Accounts receivable	2.2	16.9
Inventory	(179.6)	(127.1)
Prepaids and other assets	(4.1)	(27.3)
Accounts payable	(7.5)	16.9
Accrued compensation and employee benefits	(271.2)	(140.6)
Deferred revenue	(4)	24.2
Other liabilities	(75.8)	(6.5)
Net cash provided by operating activities	265.4	371.4
Investing activities:
Purchase of investments	(905.9)	(3.5)
Proceeds from sales of investments	100.2	26.3
Proceeds from maturities of investments	919.1	744.4
Purchase of property, plant, and equipment	(241.9)	(194.1)
Net cash provided by (used in) investing activities	(128.5)	573.1
Financing activities:
Proceeds from issuance of common stock relating to employee stock plans	180.4	100.2
Taxes paid related to net share settlement of equity awards	(226.6)	(129.7)
Repurchase of common stock	0	(350)
Payment of deferred purchase consideration	(0.5)	(1.7)
Net cash used in financing activities	(46.7)	(381.2)
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	6.8	1.8
Net increase in cash, cash equivalents, and restricted cash	97	565.1
Cash, cash equivalents, and restricted cash, beginning of period	2,770.1	1,600.7
Cash, cash equivalents, and restricted cash, end of period	$ 2,867.1	$ 2,165.8

DESCRIPTION OF THE BUSINESS

DESCRIPTION OF THE BUSINESS	3 Months Ended
	Mar. 31, 2024
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 ® endoluminal system. The Company’s products and related services enable physicians and healthcare providers to improve the quality of and access to minimally invasive care. The da Vinci surgical system consists of a surgeon console or consoles, a patient-side cart, and a high-performance vision system. The Ion endoluminal system consists of a system cart, a controller, a catheter, and a vision probe. Both systems use software, instruments, and accessories.

SUMMARY OF SIGNIFICANT ACCOUNTI

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	3 Months Ended
	Mar. 31, 2024
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, 2023, 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, 2023, which was filed with the SEC on January 31, 2024. The results of operations for the first three months of 2024 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 uncertainty surrounding macroeconomic and geopolitical factors in the U.S. and globally characterized by the supply chain environment, inflationary pressure, higher interest rates, instability in the global financial markets, significant disruptions in the commodities’ markets as a result of the conflict between Russia and Ukraine and conflicts in the Middle East, including Israel, and the introduction of or changes in tariffs or trade barriers may result in a recession, which could have a material adverse effect on the Company’s business. Supply chain constraints eased but did not fully recover in the first quarter of 2024, despite improvements in the market conditions initially faced in 2022. Notably, the supply of semiconductor materials, packaging materials, and plastics materials remained stable, while certain residual stresses remain, particularly for engineered materials and related mechanical components. Additionally, prices of materials remain elevated from historical levels due to market demand or production-related cost inflation. With higher interest rates, access to credit is more difficult, and any insolvency of certain suppliers, including sole- and single-sourced suppliers, may have heightened continuity risks. The Company is actively engaged in activities to seek to mitigate the impact of any supply chain disruptions on its operations. Supply of engineered materials and general market stress, particularly on labor- or capital-intensive manufacturing operations that produce the Company’s materials, 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, supply constraints with certain materials, which may be unavoidable, could delay the timing of finished product deliveries, 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. 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. A number of hospitals continue to experience 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, and fiscal stimulus programs enacted during the COVID-19 pandemic have ended. Hospitals may also be adversely affected by the liquidity concerns in the broader financial services industry. In addition, as overall competition for medical technologies, including robotic-assisted devices and treatment options, progresses in various markets, the Company will likely experience longer selling cycles and pricing pressures. Any or all of these factors could negatively impact the number of da Vinci procedures performed or the number of system placements and have a material adverse effect on the Company’s business, financial condition, or results of operations. Recently Issued Accounting Pronouncements In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”), which requires all public entities, including public entities with a single reportable segment, to provide in interim and annual periods one or more measures of segment profit or loss used by the chief operating decision maker to allocate resources and assess performance. Additionally, the standard requires disclosures of significant segment expenses and other segment items as well as incremental qualitative disclosures. The guidance in this update is effective for fiscal years beginning after December 15, 2023, and interim periods after December 15, 2024. The Company is currently in the process of evaluating the effects of this pronouncement on its related disclosures. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU 2023-09”), which requires enhanced income tax disclosures, including specific categories and disaggregation of information in the effective tax rate reconciliation, disaggregated information related to income taxes paid, income or loss from continuing operations before income tax expense or benefit, and income tax expense or benefit from continuing operations. The requirements of the ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently in the process of evaluating the impact of this pronouncement on its related disclosures. 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, 2023, that are of significance, or potential significance, to the Company.

FINANCIAL INSTRUMENTS

FINANCIAL INSTRUMENTS	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024, and December 31, 2023 (in millions): Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- March 31, 2024 Cash $ 608.9 $ — $ — $ — $ 608.9 $ 608.9 $ — $ — Level 1: Money market funds 2,153.9 — — — 2,153.9 2,153.9 — — U.S. treasuries 3,164.7 6.3 (25.5) — 3,145.5 76.7 962.5 2,106.3 Subtotal 5,318.6 6.3 (25.5) — 5,299.4 2,230.6 962.5 2,106.3 Level 2: Corporate debt securities 938.5 — (17.6) (1.1) 919.8 — 731.2 188.6 U.S. government agencies 431.0 0.7 (6.5) — 425.2 — 198.8 226.4 Municipal securities 70.6 — (1.2) — 69.4 — 68.1 1.3 Subtotal 1,440.1 0.7 (25.3) (1.1) 1,414.4 — 998.1 416.3 Total assets measured at fair value $ 7,367.6 $ 7.0 $ (50.8) $ (1.1) $ 7,322.7 $ 2,839.5 $ 1,960.6 $ 2,522.6 Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- December 31, 2023 Cash $ 526.2 $ — $ — $ — $ 526.2 $ 526.2 $ — $ — Level 1: Money market funds 2,223.9 — — — 2,223.9 2,223.9 — — U.S. treasuries 2,850.2 20.1 (25.4) — 2,844.9 — 1,276.0 1,568.9 Subtotal 5,074.1 20.1 (25.4) — 5,068.8 2,223.9 1,276.0 1,568.9 Level 2: Corporate debt securities 1,300.4 — (25.8) (1.1) 1,273.5 — 974.6 298.9 U.S. government agencies 402.6 2.0 (7.3) — 397.3 — 149.5 247.8 Municipal securities 79.4 — (2.0) — 77.4 — 73.0 4.4 Subtotal 1,782.4 2.0 (35.1) (1.1) 1,748.2 — 1,197.1 551.1 Total assets measured at fair value $ 7,382.7 $ 22.1 $ (60.5) $ (1.1) $ 7,343.2 $ 2,750.1 $ 2,473.1 $ 2,120.0 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 March 31, 2024 (in millions): Amortized Fair Mature in less than one year $ 2,063.3 $ 2,037.3 Mature in one to five years 2,541.5 2,522.6 Total $ 4,604.8 $ 4,559.9 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 March 31, 2024, and December 31, 2023, net unrealized losses on available-for-sale debt securities, net of tax, of $33.9 million and $29.7 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 March 31, 2024, and December 31, 2023 (in millions): March 31, 2024 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ 1,214.8 $ (7.5) $ 705.5 $ (18.0) $ 1,920.3 $ (25.5) Corporate debt securities 16.0 — 828.8 (17.6) 844.8 (17.6) U.S. government agencies 92.7 (0.4) 179.4 (6.1) 272.1 (6.5) Municipal securities — — 69.4 (1.2) 69.4 (1.2) Total $ 1,323.5 $ (7.9) $ 1,783.1 $ (42.9) $ 3,106.6 $ (50.8) December 31, 2023 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ 48.5 $ — $ 1,112.9 $ (25.4) $ 1,161.4 $ (25.4) Corporate debt securities 54.2 (0.1) 1,219.2 (25.8) 1,273.4 (25.9) U.S. government agencies 29.8 — 185.6 (7.3) 215.4 (7.3) Municipal securities — — 77.4 (1.9) 77.4 (1.9) Total $ 132.5 $ (0.1) $ 2,595.1 $ (60.4) $ 2,727.6 $ (60.5) The Company’s investments may, at any time, consist of 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 securities in an unrealized loss position 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 the loss 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. Additionally, all of the Company’s investments in corporate debt securities and municipal securities are in securities with high-quality credit ratings, which have historically experienced low rates of default. The current unrealized losses on the Company’s available-for-sale debt securities were caused by interest rate increases. The contractual terms of those investments do not permit the issuer to settle the securities at a price less than the amortized cost basis of the investments. As of March 31, 2024, the Company does not intend to sell the investments in unrealized loss positions, and it is not more-likely-than-not that the Company will be required to sell any of the investments before recovery of their amortized cost basis, which may be at maturity. Therefore, the Company does not expect to realize any losses on these available-for-sale debt securities. Additional factors considered in determining the treatment of unrealized losses include the financial condition and near-term prospects of the investee, the extent of the loss related to the credit of the issuer, and the expected cash flows from the security. For the three months ended March 31, 2024, and 2023, credit losses related to available-for-sales debt securities were not material. Equity Investments The Company’s equity investments may, at any time, consist of equity investments with and 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, 2023 Carrying Value Changes in Fair Value (1) Purchases / Sales / Other (2) March 31, 2024 Carrying Value Prepaids and other current assets Intangible and other assets, net Equity investments without readily determinable value (Level 2) $ 74.5 $ (3.4) $ 0.2 $ 71.3 $ — $ 71.3 (1) Recorded in interest and other income, net. (2) Other includes foreign currency translation gains/(losses). For the three months ended March 31, 2024, the Company did not hold any equity investments with readily determinable market values (Level 1). For the three months ended March 31, 2024, the Company recognized a net decrease in fair value of $3.4 million, primarily due to impairments of certain equity investments that lack readily determinable market values (Level 2), which was reflected in interest and other income, net. 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”), and Canadian Dollar (“CAD”). 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 March 31, 2024 2023 Recognized gains (losses) in interest and other income, net $ 18.3 $ (3.3) Foreign exchange gains (losses) related to balance sheet re-measurement $ (19.4) $ 5.4 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 March 31, December 31, March 31, December 31, Notional amounts: Forward contracts $ 343.9 $ 292.1 $ 643.7 $ 699.7 Gross fair value recorded in: Prepaids and other current assets $ 5.0 $ 3.1 $ 6.2 $ 5.0 Other accrued liabilities $ 1.5 $ 5.9 $ 1.9 $ 6.6

BALANCE SHEET DETAILS AND OTHER

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION	3 Months Ended
	Mar. 31, 2024
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 Condensed Consolidated Balance Sheet line items (in millions): As of Accounts receivable, net March 31, December 31, Trade accounts receivable, net $ 1,028.6 $ 1,042.2 Unbilled accounts receivable and other 115.5 105.0 Sales returns and allowances (16.2) (17.0) Total accounts receivable, net $ 1,127.9 $ 1,130.2 As of Inventory March 31, December 31, Raw materials $ 469.8 $ 454.7 Work-in-process 181.3 159.9 Finished goods 648.2 606.0 Total inventory $ 1,299.3 $ 1,220.6 As of Prepaids and other current assets March 31, December 31, Net investment in sales-type leases – short-term $ 132.5 $ 137.3 Other prepaids and other current assets 272.9 176.7 Total prepaids and other current assets $ 405.4 $ 314.0 As of Other accrued liabilities – short-term March 31, December 31, Income and other taxes payable $ 51.8 $ 111.4 Accrued construction-related capital expenditures 163.1 143.3 Other accrued liabilities 289.9 332.8 Total other accrued liabilities – short-term $ 504.8 $ 587.5 As of Other long-term liabilities March 31, December 31, Income taxes – long-term $ 250.5 $ 233.8 Deferred revenue – long-term 50.2 45.6 Other long-term liabilities 105.8 106.1 Total other long-term liabilities $ 406.5 $ 385.5 Supplemental Cash Flow Information The following table provides supplemental non-cash investing and financing activities (in millions): Three Months Ended March 31, 2024 2023 Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment $ 110.7 $ 89.6 Acquisition of property, plant, and equipment in accounts payable and accrued liabilities $ 177.9 $ 80.2

REVENUE AND CONTRACT ACQUISITIO

REVENUE AND CONTRACT ACQUISITION COSTS	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
REVENUE AND CONTRACT ACQUISITION COSTS	REVENUE AND CONTRACT ACQUISITION COSTS The following table presents revenue disaggregated by type and geography (in millions): Three Months Ended March 31, U.S. 2024 2023 Instruments and accessories $ 822.4 $ 701.4 Systems 212.5 221.8 Services 203.6 186.7 Total U.S. revenue $ 1,238.5 $ 1,109.9 OUS Instruments and accessories $ 336.5 $ 284.2 Systems 205.7 205.6 Services 109.9 96.5 Total OUS revenue $ 652.1 $ 586.3 Total Instruments and accessories $ 1,158.9 $ 985.6 Systems 418.2 427.4 Services 313.5 283.2 Total revenue $ 1,890.6 $ 1,696.2 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 $2.34 billion as of March 31, 2024. The remaining performance obligations are expected to be satisfied over the term of the system sale, lease, and service arrangements. Approximately 44% 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 March 31, 2024 December 31, 2023 Contract assets $ 17.4 $ 20.2 Deferred revenue $ 487.7 $ 491.7 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. During the three months ended March 31, 2024, the Company recognized $189 million of revenue that was included in the deferred revenue balance as of December 31, 2023. During the three months ended March 31, 2023, the Company recognized $185 million of revenue that was included in the deferred revenue balance as of December 31, 2022. Intuitive System Leasing The following table presents product revenue from Intuitive System Leasing arrangements (in millions): Three Months Ended March 31, 2024 2023 Sales-type lease revenue $ 13.3 $ 23.0 Operating lease revenue* $ 148.0 $ 112.0 *Variable lease revenue related to usage-based arrangements included within operating lease revenue $ 70.0 $ 46.0 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, age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. For the three months ended March 31, 2024, and 2023, bad debt expense was not material. The Company’s exposure to credit losses may increase if its customers are adversely affected by changes in healthcare laws, procedure coverage and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, or other customer-specific factors. Although the Company has historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of lease and trade receivables as hospital cash flows are impacted by macroeconomic factors, including inflation, high interest rates, and staffing shortages.

LEASES

LEASES	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024 December 31, 2023 Gross lease receivables $ 356.6 $ 384.5 Unearned income (12.2) (12.9) Subtotal 344.4 371.6 Allowance for credit loss (2.6) (2.7) Net investment in sales-type leases $ 341.8 $ 368.9 Reported as: Prepaids and other current assets $ 132.5 $ 137.3 Intangible and other assets, net 209.3 231.6 Net investment in sales-type leases $ 341.8 $ 368.9 Contractual maturities of gross lease receivables as of March 31, 2024, are as follows (in millions): Fiscal Year Amount Remainder of 2024 $ 107.9 2025 114.3 2026 76.9 2027 41.4 2028 12.5 2029 and thereafter 3.6 Total $ 356.6 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 the current expected lifetime loss 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 of the net investment in sales-type leases using a number of factors relating to its customers, 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 March 31, 2024 (in millions): 2024 2023 2022 2021 2020 Prior Net Investment Credit Rating: High $ 5.4 $ 35.9 $ 56.6 $ 55.3 $ 19.7 $ 6.1 $ 179.0 Moderate 7.7 34.8 53.2 36.9 20.1 3.3 156.0 Low — 1.4 5.5 2.3 0.2 — 9.4 Total $ 13.1 $ 72.1 $ 115.3 $ 94.5 $ 40.0 $ 9.4 $ 344.4 For the three months ended March 31, 2024, and 2023, credit losses related to the net investment in sales-type leases were not material.

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
GOODWILL AND INTANGIBLE ASSETS	GOODWILL AND INTANGIBLE ASSETS Acquisitions There were no material acquisitions in the three months ended March 31, 2024, and 2023. Goodwill The following table summarizes the changes in the carrying amount of goodwill (in millions): Amount Balance as of December 31, 2023 $ 348.7 Acquisition activity — Translation and other (0.5) Balance as of March 31, 2024 $ 348.2 Intangible Assets The following table summarizes the components of gross intangible assets, accumulated amortization, and net intangible assets balances as of March 31, 2024, and December 31, 2023 (in millions): March 31, 2024 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents and developed technology $ 206.3 $ (181.8) $ 24.5 $ 206.3 $ (178.4) $ 27.9 Distribution rights and others 10.8 (9.7) 1.1 10.8 (9.2) 1.6 Customer relationships 31.8 (23.6) 8.2 32.5 (22.9) 9.6 Total intangible assets $ 248.9 $ (215.1) $ 33.8 $ 249.6 $ (210.5) $ 39.1 Amortization expense related to intangible assets was $5.1 million and $5.0 million for the three months ended March 31, 2024, and 2023, respectively. The estimated future amortization expense related to intangible assets as of March 31, 2024, is as follows (in millions): Fiscal Year Amount Remainder of 2024 $ 11.8 2025 11.9 2026 5.3 2027 2.8 2028 1.3 2029 and thereafter 0.7 Total $ 33.8 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	3 Months Ended
	Mar. 31, 2024
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 (“’658”); 8,479,969 (“’969”); 9,113,874 (“’874”); 8,998,058 (“’058”); 8,991,677 (“’677”); 9,084,601 (“’601”); and 8,616,431 (“’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 (“PTAB”) 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. The PTAB has issued final written decisions finding the asserted claims of Patent Nos. ’658, ’058, ’677, ’601, and ’431 unpatentable. On October 3, 2023, Ethicon confirmed that it would not further appeal the decisions by the USITC in that proceeding that claim 24 of the ’969 Patent and claim 19 of the ’874 Patent were not infringed by the asserted Intuitive products and that those patents were invalid. Outside of the above USITC proceeding, on October 4, 2023, the parties filed a Joint Status Report in the district court in which Ethicon stated that it was prepared to proceed in this case with respect to its allegations that the accused EndoWrist Stapler instruments infringe asserted claim 24 of the ’969 Patent and asserted claim 20 of the ’874 Patent. The parties completed briefing on the issue of whether the trial court will supplement the record with evidence and arguments from the USITC proceeding and are awaiting a ruling from the district court. 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. 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. On September 20, 2023, the court granted the Company’s post-trial motion and reduced the damages to Rex Medical L.P. to nominal damages of $1. On October 18, 2023, Rex Medical filed a notice of appeal to the United States Court of Appeals for the Federal Circuit and, on October 31, 2023, Intuitive filed its notice of cross appeal. 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 antitrust 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 antitrust 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 the court held a hearing on these motions on September 7, 2023. On March 31, 2024, the Court granted-in-part and denied-in-part both Intuitive’s and plaintiff’s motions for summary judgment, and issued additional rulings related to expert witnesses. The Court did not rule in favor of either party with respect to whether the U.S. Food and Drug Administration (“FDA”) requires 510(k) clearance for plaintiff’s services with respect to EndoWrists. In conjunction with this finding, the Court denied Intuitive’s motion for summary judgment on plaintiff’s antitrust claims and found that these claims could proceed to trial. In addition, the Court ruled with Intuitive in dismissing plaintiff’s false statement claims against Intuitive, and the Court ruled with plaintiff in dismissing certain of Intuitive’s counterclaims against plaintiff. The Court has set a case management conference for May 30, 2024. Intuitive expects scheduling issues to be discussed at the May 30 conference. 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, and no trial date has been set for this matter at this time. Three class action complaints were filed against the Company in the Northern District of California Court alleging antitrust 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. With regard to this class action case, on September 7, 2023, the Court heard argument on the parties’ respective motions for summary judgment and motions related to expert testimony. On March 31, 2024, the Court granted-in-part and denied-in-part plaintiffs’ motion for summary judgment on certain market definition issues, and denied Intuitive’s motion on the antitrust claims. In denying Intuitive’s motion, the Court declined to decide whether third-party companies were required to obtain 510(k) clearance for their services with respect to EndoWrists, and in the absence of a formal ruling from the FDA on that question denied Intuitive’s motion for summary judgment challenging plaintiffs’ standing on that ground. There were additional rulings on the expert witness issues as well. In the summary judgment order, the Court ruled with plaintiffs that the da Vinci robot and EndoWrist instruments occupy separate product markets for antitrust purposes. The Court also ruled that there is an antitrust aftermarket for the repair and replacement of EndoWrist instruments, and that Intuitive holds monopoly power in that aftermarket. The Court denied summary judgment for plaintiffs on the issue of whether soft-tissue surgical robots constitute a relevant antitrust market or are part of a larger market that includes laparoscopic and open surgery for antitrust purposes. The Court has set a case management conference for May 30, 2024, and a class certification hearing for October 10, 2024. Intuitive expects scheduling issues to be discussed at the May 30 conference. 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, and no trial date has been set for this matter at this time.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	3 Months Ended
	Mar. 31, 2024
Equity [Abstract]
STOCKHOLDERS' EQUITY	STOCKHOLDERS’ EQUITY Stockholders’ Equity The following tables present the changes in stockholders’ equity (in millions): Three Months Ended March 31, 2024 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 352.3 $ 0.4 $ 8,576.4 $ 4,743.0 $ (12.2) $ 13,307.6 $ 89.7 $ 13,397.3 Issuance of common stock through employee stock plans 3.0 — 180.4 — — 180.4 — 180.4 Shares withheld related to net share settlement of equity awards (0.6) — (6.6) (220.0) — (226.6) — (226.6) Share-based compensation expense related to employee stock plans — — 152.8 — — 152.8 — 152.8 Net income attributable to Intuitive Surgical, Inc. — — — 544.9 — 544.9 — 544.9 Other comprehensive income (loss) — — — — 3.5 3.5 (0.4) 3.1 Cash dividends declared and payable by joint venture — — — — — — (8.0) (8.0) Net income attributable to noncontrolling interest in joint venture — — — — — — 2.5 2.5 Ending balance 354.7 $ 0.4 $ 8,903.0 $ 5,067.9 $ (8.7) $ 13,962.6 $ 83.8 $ 14,046.4 Three Months Ended March 31, 2023 Common Stock Additional Retained Accumulated 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 2.4 — 100.2 — — 100.2 — 100.2 Shares withheld related to net share settlement of equity awards (0.5) — (5.9) (123.8) — (129.7) — (129.7) Share-based compensation expense related to employee stock plans — — 146.0 — — 146.0 — 146.0 Repurchase and retirement of common stock (1.5) — (15.8) (334.2) — (350.0) — (350.0) Net income attributable to Intuitive Surgical, Inc. — — — 355.3 — 355.3 — 355.3 Other comprehensive income (loss) — — — — 54.0 54.0 0.3 54.3 Net income attributable to noncontrolling interest in joint venture — — — — — — 5.5 5.5 Ending balance 350.4 $ 0.4 $ 7,928.4 $ 3,397.4 $ (108.5) $ 11,217.7 $ 76.5 $ 11,294.2 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 March 31, 2024, 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 March 31, 2024 2023 Shares repurchased — 1.5 Average price per share $ — $ 238.1 Value of shares repurchased $ — $ 350.0 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 March 31, 2024 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ (2.5) $ (29.7) $ 19.4 $ 0.6 $ (12.2) Other comprehensive income (loss) before reclassifications 4.1 (4.3) 2.2 — 2.0 Amounts reclassified from accumulated other comprehensive income (loss) 1.5 0.1 — (0.1) 1.5 Net current-period other comprehensive income (loss) 5.6 (4.2) 2.2 (0.1) 3.5 Ending balance $ 3.1 $ (33.9) $ 21.6 $ 0.5 $ (8.7) Three Months Ended March 31, 2023 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ (2.9) $ (154.2) $ (6.6) $ 1.2 $ (162.5) Other comprehensive income (loss) before reclassifications 3.7 37.8 13.9 — 55.4 Amounts reclassified from accumulated other comprehensive income (loss) (1.2) (0.2) — — (1.4) Net current-period other comprehensive income (loss) 2.5 37.6 13.9 — 54.0 Ending balance $ (0.4) $ (116.6) $ 7.3 $ 1.2 $ (108.5) The tax impacts for amounts recognized in other comprehensive income before reclassifications were as follows (in millions): Three Months Ended March 31, Available-for-sale securities 2024 2023 Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income $ 1.3 $ (10.9) The tax impacts for amounts recognized in other comprehensive income before reclassifications for hedge instruments, foreign currency translation gains (losses), and employee benefit plans for the three months ended March 31, 2024, and 2023, 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 gains (losses), and employee benefit plans for the three months ended March 31, 2024, and 2023, were not material to the Company’s Financial Statements.

SHARE-BASED COMPENSATION

SHARE-BASED COMPENSATION	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
SHARE-BASED COMPENSATION	SHARE-BASED COMPENSATION As of March 31, 2024, the total number of shares of common stock reserved for issuance under the 2010 Incentive Award Plan was 110,350,000. Approximately 15.4 million shares were reserved for future issuance under the Company’s stock plans, and a maximum of approximately 6.7 million of these shares can be awarded as restricted stock units (“RSUs”). Restricted Stock Units A summary of RSU activity under all stock plans for the three months ended March 31, 2024, is presented as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2023 5.0 $ 245.75 RSUs granted 2.2 $ 388.09 RSUs vested (1.6) $ 234.60 RSUs forfeited (0.1) $ 262.23 Unvested balance as of March 31, 2024 5.5 $ 305.87 Stock Options A summary of stock option activity under all stock plans for the three months ended March 31, 2024, is presented as follows (in millions, except per share amounts): Stock Options Outstanding Number Weighted-Average Balance as of December 31, 2023 9.8 $ 174.90 Options granted — $ — Options exercised (1.1) $ 107.06 Options forfeited/expired — $ 250.01 Balance as of March 31, 2024 8.7 $ 182.70 As of March 31, 2024, options to purchase an aggregate of 7.0 million shares of common stock were exercisable at a weighted-average price of $162.35 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 do 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 2024 PSU grant metrics are focused on relative TSR, da Vinci and Ion procedure growth in 2025 compared to 2023, and da Vinci and Ion procedure growth in 2026 compared to 2023. 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. A summary of PSU activity for the three months ended March 31, 2024, is presented as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2023 0.2 $ 259.60 Granted 0.1 $ 395.92 Vested — $ 271.58 Performance change — $ 290.33 Forfeited — $ 251.44 Unvested balance as of March 31, 2024 0.3 $ 306.93 Employee Stock Purchase Plan Under the Employee Stock Purchase Plan (“ESPP”), employees purchased approximately 0.3 million shares for $68.4 million and approximately 0.3 million shares for $59.9 million during the three months ended March 31, 2024, and 2023, respectively. Share-Based Compensation Expense The following table summarizes share-based compensation expense for the three months ended March 31, 2024, and 2023 (in millions): Three Months Ended March 31, 2024 2023 Cost of revenue – products (before capitalization) $ 22.8 $ 23.0 Amounts capitalized into inventory (21.4) (18.8) Amounts recognized in income for amounts previously capitalized in inventory 21.3 12.6 Cost of revenue – products $ 22.7 $ 16.8 Cost of revenue – services 7.0 7.0 Total cost of revenue 29.7 23.8 Selling, general, and administrative 68.2 66.7 Research and development 57.7 50.1 Share-based compensation expense before income taxes 155.6 140.6 Income tax benefit 32.4 28.0 Share-based compensation expense after income taxes $ 123.2 $ 112.6 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 months ended March 31, 2024, and 2023, were as follows: Three Months Ended March 31, 2024 2023 Stock Options Risk-free interest rate — 4.8% Expected term (in years) — 3.4 Expected volatility — 34% Fair value at grant date — $72.13 ESPP Risk-free interest rate 4.6% 4.7% Expected term (in years) 1.2 1.2 Expected volatility 32% 35% Fair value at grant date $115.48 $79.33

INCOME TAXES

INCOME TAXES	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES Income tax expense (benefit) for the three months ended March 31, 2024, was $(8.9) million, or (1.7)% of income before taxes, compared to $61.0 million, or 14.5% of income before taxes, for the three months ended March 31, 2023. The effective tax rates for the three months ended March 31, 2024, and 2023, differed from the U.S. federal statutory rate of 21% primarily due to the excess tax benefits associated with employee equity plans, the federal research and development credit benefit, and the effect of income earned by certain overseas entities being taxed at rates lower than the federal statutory rate, partially offset by U.S. tax on foreign earnings and state income taxes (net of the federal benefit). The lower effective tax rate for the three months ended March 31, 2024, compared to the three months ended March 31, 2023, was primarily due to a higher tax rate benefit from excess tax benefits, as discussed below, and higher federal research and development credit benefits, partially offset by a less favorable jurisdictional earnings mix. The Company’s provision for income taxes for the three months ended March 31, 2024, and 2023, included excess tax benefits associated with employee equity plans of $111.1 million and $22.5 million, respectively, which reduced the Company’s effective tax rate by 20.6 and 5.3 percentage points, respectively. The amount of excess tax benefits or deficiencies will fluctuate from period to period based on the price of the Company’s stock, the volume of share-based awards settled or vested, and the value assigned to employee equity awards under GAAP, which results in increased income tax expense volatility. The Company files federal, state, and foreign income tax returns in many jurisdictions in the U.S. and OUS. Years before 2016 are considered closed for 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 in which 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	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024 2023 Numerator: Net income attributable to Intuitive Surgical, Inc. $ 544.9 $ 355.3 Denominator: Weighted-average shares outstanding used in basic calculation 353.5 350.2 Add: dilutive effect of potential common shares 7.0 5.8 Weighted-average shares outstanding used in diluted calculation 360.5 356.0 Net income per share attributable to Intuitive Surgical, Inc.: Basic $ 1.54 $ 1.01 Diluted $ 1.51 $ 1.00 Share-based compensation awards of approximately 0.9 million and 3.2 million shares for the three months ended March 31, 2024, and 2023, respectively, were outstanding but were not included in the computation of diluted net income per share attributable to Intuitive Surgical, Inc. common stockholders, because the effect of including such shares would have been anti-dilutive in the periods presented.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net income attributable to Intuitive Surgical, Inc.	$ 544.9	$ 355.3

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024 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
Mark J. Rubash [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On February 2, 2024, Mark J. Rubash, a member of the Company’s Board of Directors, adopted a Rule 10b5-1 trading plan. Mr. Rubash’s trading plan provides for the potential exercise and sale of up to 1,709 shares of the Company’s common stock subject to an option until February 3, 2025. 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, and the Company’s policies regarding transactions in the Company’s securities.
Name	Mark J. Rubash
Title	member of the Company’s Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	February 2, 2024
Arrangement Duration	367 days
Aggregate Available	1,709
Craig H. Barratt [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On March 4, 2024, Craig H. Barratt, Ph.D., a member of the Company’s Board of Directors, adopted a Rule 10b5-1 trading plan. Mr. Barratt’s trading plan provides for the potential exercise and sale of up to 6,696 shares of the Company’s common stock subject to an option until March 4, 2025. 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, and the Company’s policies regarding transactions in the Company’s securities.
Name	Craig H. Barratt
Title	member of the Company’s Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	March 4, 2024
Arrangement Duration	365 days
Aggregate Available	6,696

SUMMARY OF SIGNIFICANT ACCOUN_2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	3 Months Ended
	Mar. 31, 2024
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, 2023, 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, 2023, which was filed with the SEC on January 31, 2024. The results of operations for the first three months of 2024 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 Issued Accounting Pronouncements and Significant Accounting Policies	Recently Issued Accounting Pronouncements In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”), which requires all public entities, including public entities with a single reportable segment, to provide in interim and annual periods one or more measures of segment profit or loss used by the chief operating decision maker to allocate resources and assess performance. Additionally, the standard requires disclosures of significant segment expenses and other segment items as well as incremental qualitative disclosures. The guidance in this update is effective for fiscal years beginning after December 15, 2023, and interim periods after December 15, 2024. The Company is currently in the process of evaluating the effects of this pronouncement on its related disclosures. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU 2023-09”), which requires enhanced income tax disclosures, including specific categories and disaggregation of information in the effective tax rate reconciliation, disaggregated information related to income taxes paid, income or loss from continuing operations before income tax expense or benefit, and income tax expense or benefit from continuing operations. The requirements of the ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently in the process of evaluating the impact of this pronouncement on its related disclosures. 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, 2023, that are of significance, or potential significance, to the Company.

FINANCIAL INSTRUMENTS (Tables)

FINANCIAL INSTRUMENTS (Tables)	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024, and December 31, 2023 (in millions): Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- March 31, 2024 Cash $ 608.9 $ — $ — $ — $ 608.9 $ 608.9 $ — $ — Level 1: Money market funds 2,153.9 — — — 2,153.9 2,153.9 — — U.S. treasuries 3,164.7 6.3 (25.5) — 3,145.5 76.7 962.5 2,106.3 Subtotal 5,318.6 6.3 (25.5) — 5,299.4 2,230.6 962.5 2,106.3 Level 2: Corporate debt securities 938.5 — (17.6) (1.1) 919.8 — 731.2 188.6 U.S. government agencies 431.0 0.7 (6.5) — 425.2 — 198.8 226.4 Municipal securities 70.6 — (1.2) — 69.4 — 68.1 1.3 Subtotal 1,440.1 0.7 (25.3) (1.1) 1,414.4 — 998.1 416.3 Total assets measured at fair value $ 7,367.6 $ 7.0 $ (50.8) $ (1.1) $ 7,322.7 $ 2,839.5 $ 1,960.6 $ 2,522.6 Reported as: Amortized Gross Gross Allowance for Credit Loss Fair Cash and Short- Long- December 31, 2023 Cash $ 526.2 $ — $ — $ — $ 526.2 $ 526.2 $ — $ — Level 1: Money market funds 2,223.9 — — — 2,223.9 2,223.9 — — U.S. treasuries 2,850.2 20.1 (25.4) — 2,844.9 — 1,276.0 1,568.9 Subtotal 5,074.1 20.1 (25.4) — 5,068.8 2,223.9 1,276.0 1,568.9 Level 2: Corporate debt securities 1,300.4 — (25.8) (1.1) 1,273.5 — 974.6 298.9 U.S. government agencies 402.6 2.0 (7.3) — 397.3 — 149.5 247.8 Municipal securities 79.4 — (2.0) — 77.4 — 73.0 4.4 Subtotal 1,782.4 2.0 (35.1) (1.1) 1,748.2 — 1,197.1 551.1 Total assets measured at fair value $ 7,382.7 $ 22.1 $ (60.5) $ (1.1) $ 7,343.2 $ 2,750.1 $ 2,473.1 $ 2,120.0
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 March 31, 2024 (in millions): Amortized Fair Mature in less than one year $ 2,063.3 $ 2,037.3 Mature in one to five years 2,541.5 2,522.6 Total $ 4,604.8 $ 4,559.9
Debt Securities, Available-for-Sale, Unrealized Loss Position, Fair Value	The following tables present the breakdown of the available-for-sale debt securities with unrealized losses as of March 31, 2024, and December 31, 2023 (in millions): March 31, 2024 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ 1,214.8 $ (7.5) $ 705.5 $ (18.0) $ 1,920.3 $ (25.5) Corporate debt securities 16.0 — 828.8 (17.6) 844.8 (17.6) U.S. government agencies 92.7 (0.4) 179.4 (6.1) 272.1 (6.5) Municipal securities — — 69.4 (1.2) 69.4 (1.2) Total $ 1,323.5 $ (7.9) $ 1,783.1 $ (42.9) $ 3,106.6 $ (50.8) December 31, 2023 Unrealized losses less than 12 months Unrealized losses 12 months or greater Total Fair Unrealized Fair Unrealized Fair Unrealized U.S. treasuries $ 48.5 $ — $ 1,112.9 $ (25.4) $ 1,161.4 $ (25.4) Corporate debt securities 54.2 (0.1) 1,219.2 (25.8) 1,273.4 (25.9) U.S. government agencies 29.8 — 185.6 (7.3) 215.4 (7.3) Municipal securities — — 77.4 (1.9) 77.4 (1.9) Total $ 132.5 $ (0.1) $ 2,595.1 $ (60.4) $ 2,727.6 $ (60.5)
Summary of Equity Investment Activity	The following table is a summary of the activity related to equity investments (in millions): Reported as: December 31, 2023 Carrying Value Changes in Fair Value (1) Purchases / Sales / Other (2) March 31, 2024 Carrying Value Prepaids and other current assets Intangible and other assets, net Equity investments without readily determinable value (Level 2) $ 74.5 $ (3.4) $ 0.2 $ 71.3 $ — $ 71.3 (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 March 31, 2024 2023 Recognized gains (losses) in interest and other income, net $ 18.3 $ (3.3) Foreign exchange gains (losses) related to balance sheet re-measurement $ (19.4) $ 5.4
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 March 31, December 31, March 31, December 31, Notional amounts: Forward contracts $ 343.9 $ 292.1 $ 643.7 $ 699.7 Gross fair value recorded in: Prepaids and other current assets $ 5.0 $ 3.1 $ 6.2 $ 5.0 Other accrued liabilities $ 1.5 $ 5.9 $ 1.9 $ 6.6

BALANCE SHEET DETAILS AND OTH_2

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION (Tables)	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accounts Receivable, Net	As of Accounts receivable, net March 31, December 31, Trade accounts receivable, net $ 1,028.6 $ 1,042.2 Unbilled accounts receivable and other 115.5 105.0 Sales returns and allowances (16.2) (17.0) Total accounts receivable, net $ 1,127.9 $ 1,130.2
Inventory	As of Inventory March 31, December 31, Raw materials $ 469.8 $ 454.7 Work-in-process 181.3 159.9 Finished goods 648.2 606.0 Total inventory $ 1,299.3 $ 1,220.6
Prepaids and Other Current Assets	As of Prepaids and other current assets March 31, December 31, Net investment in sales-type leases – short-term $ 132.5 $ 137.3 Other prepaids and other current assets 272.9 176.7 Total prepaids and other current assets $ 405.4 $ 314.0
Other Accrued Liabilities - Short-term	As of Other accrued liabilities – short-term March 31, December 31, Income and other taxes payable $ 51.8 $ 111.4 Accrued construction-related capital expenditures 163.1 143.3 Other accrued liabilities 289.9 332.8 Total other accrued liabilities – short-term $ 504.8 $ 587.5
Other Long-term Liabilities	As of Other long-term liabilities March 31, December 31, Income taxes – long-term $ 250.5 $ 233.8 Deferred revenue – long-term 50.2 45.6 Other long-term liabilities 105.8 106.1 Total other long-term liabilities $ 406.5 $ 385.5
Supplemental Cash Flow Information	The following table provides supplemental non-cash investing and financing activities (in millions): Three Months Ended March 31, 2024 2023 Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment $ 110.7 $ 89.6 Acquisition of property, plant, and equipment in accounts payable and accrued liabilities $ 177.9 $ 80.2

REVENUE AND CONTRACT ACQUISIT_2

REVENUE AND CONTRACT ACQUISITION COSTS (Tables)	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenue Disaggregated by Types and Geography	The following table presents revenue disaggregated by type and geography (in millions): Three Months Ended March 31, U.S. 2024 2023 Instruments and accessories $ 822.4 $ 701.4 Systems 212.5 221.8 Services 203.6 186.7 Total U.S. revenue $ 1,238.5 $ 1,109.9 OUS Instruments and accessories $ 336.5 $ 284.2 Systems 205.7 205.6 Services 109.9 96.5 Total OUS revenue $ 652.1 $ 586.3 Total Instruments and accessories $ 1,158.9 $ 985.6 Systems 418.2 427.4 Services 313.5 283.2 Total revenue $ 1,890.6 $ 1,696.2
Summary of Contract Assets and Liabilities	The following information summarizes the Company’s contract assets and liabilities (in millions): As of March 31, 2024 December 31, 2023 Contract assets $ 17.4 $ 20.2 Deferred revenue $ 487.7 $ 491.7
Sales-type Lease Revenue	The following table presents product revenue from Intuitive System Leasing arrangements (in millions): Three Months Ended March 31, 2024 2023 Sales-type lease revenue $ 13.3 $ 23.0 Operating lease revenue* $ 148.0 $ 112.0 *Variable lease revenue related to usage-based arrangements included within operating lease revenue $ 70.0 $ 46.0
Operating Lease Revenue	The following table presents product revenue from Intuitive System Leasing arrangements (in millions): Three Months Ended March 31, 2024 2023 Sales-type lease revenue $ 13.3 $ 23.0 Operating lease revenue* $ 148.0 $ 112.0 *Variable lease revenue related to usage-based arrangements included within operating lease revenue $ 70.0 $ 46.0

LEASES (Tables)

LEASES (Tables)	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024 December 31, 2023 Gross lease receivables $ 356.6 $ 384.5 Unearned income (12.2) (12.9) Subtotal 344.4 371.6 Allowance for credit loss (2.6) (2.7) Net investment in sales-type leases $ 341.8 $ 368.9 Reported as: Prepaids and other current assets $ 132.5 $ 137.3 Intangible and other assets, net 209.3 231.6 Net investment in sales-type leases $ 341.8 $ 368.9
Schedule of Contractual Maturities of Gross Lease Receivables	Contractual maturities of gross lease receivables as of March 31, 2024, are as follows (in millions): Fiscal Year Amount Remainder of 2024 $ 107.9 2025 114.3 2026 76.9 2027 41.4 2028 12.5 2029 and thereafter 3.6 Total $ 356.6
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 March 31, 2024 (in millions): 2024 2023 2022 2021 2020 Prior Net Investment Credit Rating: High $ 5.4 $ 35.9 $ 56.6 $ 55.3 $ 19.7 $ 6.1 $ 179.0 Moderate 7.7 34.8 53.2 36.9 20.1 3.3 156.0 Low — 1.4 5.5 2.3 0.2 — 9.4 Total $ 13.1 $ 72.1 $ 115.3 $ 94.5 $ 40.0 $ 9.4 $ 344.4

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS (Tables)	3 Months Ended
	Mar. 31, 2024
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, 2023 $ 348.7 Acquisition activity — Translation and other (0.5) Balance as of March 31, 2024 $ 348.2
Schedule of Intangible Assets	The following table summarizes the components of gross intangible assets, accumulated amortization, and net intangible assets balances as of March 31, 2024, and December 31, 2023 (in millions): March 31, 2024 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents and developed technology $ 206.3 $ (181.8) $ 24.5 $ 206.3 $ (178.4) $ 27.9 Distribution rights and others 10.8 (9.7) 1.1 10.8 (9.2) 1.6 Customer relationships 31.8 (23.6) 8.2 32.5 (22.9) 9.6 Total intangible assets $ 248.9 $ (215.1) $ 33.8 $ 249.6 $ (210.5) $ 39.1
Schedule Of Estimated Future Amortization Expense Of Intangible Assets	The estimated future amortization expense related to intangible assets as of March 31, 2024, is as follows (in millions): Fiscal Year Amount Remainder of 2024 $ 11.8 2025 11.9 2026 5.3 2027 2.8 2028 1.3 2029 and thereafter 0.7 Total $ 33.8

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	3 Months Ended
	Mar. 31, 2024
Equity [Abstract]
Schedule of Stockholders Equity	The following tables present the changes in stockholders’ equity (in millions): Three Months Ended March 31, 2024 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 352.3 $ 0.4 $ 8,576.4 $ 4,743.0 $ (12.2) $ 13,307.6 $ 89.7 $ 13,397.3 Issuance of common stock through employee stock plans 3.0 — 180.4 — — 180.4 — 180.4 Shares withheld related to net share settlement of equity awards (0.6) — (6.6) (220.0) — (226.6) — (226.6) Share-based compensation expense related to employee stock plans — — 152.8 — — 152.8 — 152.8 Net income attributable to Intuitive Surgical, Inc. — — — 544.9 — 544.9 — 544.9 Other comprehensive income (loss) — — — — 3.5 3.5 (0.4) 3.1 Cash dividends declared and payable by joint venture — — — — — — (8.0) (8.0) Net income attributable to noncontrolling interest in joint venture — — — — — — 2.5 2.5 Ending balance 354.7 $ 0.4 $ 8,903.0 $ 5,067.9 $ (8.7) $ 13,962.6 $ 83.8 $ 14,046.4 Three Months Ended March 31, 2023 Common Stock Additional Retained Accumulated 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 2.4 — 100.2 — — 100.2 — 100.2 Shares withheld related to net share settlement of equity awards (0.5) — (5.9) (123.8) — (129.7) — (129.7) Share-based compensation expense related to employee stock plans — — 146.0 — — 146.0 — 146.0 Repurchase and retirement of common stock (1.5) — (15.8) (334.2) — (350.0) — (350.0) Net income attributable to Intuitive Surgical, Inc. — — — 355.3 — 355.3 — 355.3 Other comprehensive income (loss) — — — — 54.0 54.0 0.3 54.3 Net income attributable to noncontrolling interest in joint venture — — — — — — 5.5 5.5 Ending balance 350.4 $ 0.4 $ 7,928.4 $ 3,397.4 $ (108.5) $ 11,217.7 $ 76.5 $ 11,294.2
Schedule of Share Repurchase Activities	The following table summarizes stock repurchase activities (in millions, except per share amounts): Three Months Ended March 31, 2024 2023 Shares repurchased — 1.5 Average price per share $ — $ 238.1 Value of shares repurchased $ — $ 350.0
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 March 31, 2024 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ (2.5) $ (29.7) $ 19.4 $ 0.6 $ (12.2) Other comprehensive income (loss) before reclassifications 4.1 (4.3) 2.2 — 2.0 Amounts reclassified from accumulated other comprehensive income (loss) 1.5 0.1 — (0.1) 1.5 Net current-period other comprehensive income (loss) 5.6 (4.2) 2.2 (0.1) 3.5 Ending balance $ 3.1 $ (33.9) $ 21.6 $ 0.5 $ (8.7) Three Months Ended March 31, 2023 Gains (Losses) Unrealized Gains Foreign Employee Benefit Plans Total Beginning balance $ (2.9) $ (154.2) $ (6.6) $ 1.2 $ (162.5) Other comprehensive income (loss) before reclassifications 3.7 37.8 13.9 — 55.4 Amounts reclassified from accumulated other comprehensive income (loss) (1.2) (0.2) — — (1.4) Net current-period other comprehensive income (loss) 2.5 37.6 13.9 — 54.0 Ending balance $ (0.4) $ (116.6) $ 7.3 $ 1.2 $ (108.5)
Schedule of Amounts Recognized in Other Comprehensive Income (Loss)	The tax impacts for amounts recognized in other comprehensive income before reclassifications were as follows (in millions): Three Months Ended March 31, Available-for-sale securities 2024 2023 Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income $ 1.3 $ (10.9)

SHARE-BASED COMPENSATION (Table

SHARE-BASED COMPENSATION (Tables)	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Summary of RSU Activity	A summary of RSU activity under all stock plans for the three months ended March 31, 2024, is presented as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2023 5.0 $ 245.75 RSUs granted 2.2 $ 388.09 RSUs vested (1.6) $ 234.60 RSUs forfeited (0.1) $ 262.23 Unvested balance as of March 31, 2024 5.5 $ 305.87
Summary of Stock Option Activity Under All Stock Plans	A summary of stock option activity under all stock plans for the three months ended March 31, 2024, is presented as follows (in millions, except per share amounts): Stock Options Outstanding Number Weighted-Average Balance as of December 31, 2023 9.8 $ 174.90 Options granted — $ — Options exercised (1.1) $ 107.06 Options forfeited/expired — $ 250.01 Balance as of March 31, 2024 8.7 $ 182.70
Share-Based Payment Arrangement, Performance Shares, Activity	A summary of PSU activity for the three months ended March 31, 2024, is presented as follows (in millions, except per share amounts): Shares Weighted-Average Unvested balance as of December 31, 2023 0.2 $ 259.60 Granted 0.1 $ 395.92 Vested — $ 271.58 Performance change — $ 290.33 Forfeited — $ 251.44 Unvested balance as of March 31, 2024 0.3 $ 306.93
Summary of Share-Based Compensation Expense	The following table summarizes share-based compensation expense for the three months ended March 31, 2024, and 2023 (in millions): Three Months Ended March 31, 2024 2023 Cost of revenue – products (before capitalization) $ 22.8 $ 23.0 Amounts capitalized into inventory (21.4) (18.8) Amounts recognized in income for amounts previously capitalized in inventory 21.3 12.6 Cost of revenue – products $ 22.7 $ 16.8 Cost of revenue – services 7.0 7.0 Total cost of revenue 29.7 23.8 Selling, general, and administrative 68.2 66.7 Research and development 57.7 50.1 Share-based compensation expense before income taxes 155.6 140.6 Income tax benefit 32.4 28.0 Share-based compensation expense after income taxes $ 123.2 $ 112.6
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 months ended March 31, 2024, and 2023, were as follows: Three Months Ended March 31, 2024 2023 Stock Options Risk-free interest rate — 4.8% Expected term (in years) — 3.4 Expected volatility — 34% Fair value at grant date — $72.13 ESPP Risk-free interest rate 4.6% 4.7% Expected term (in years) 1.2 1.2 Expected volatility 32% 35% Fair value at grant date $115.48 $79.33

NET INCOME PER SHARE (Tables)

NET INCOME PER SHARE (Tables)	3 Months Ended
	Mar. 31, 2024
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 March 31, 2024 2023 Numerator: Net income attributable to Intuitive Surgical, Inc. $ 544.9 $ 355.3 Denominator: Weighted-average shares outstanding used in basic calculation 353.5 350.2 Add: dilutive effect of potential common shares 7.0 5.8 Weighted-average shares outstanding used in diluted calculation 360.5 356.0 Net income per share attributable to Intuitive Surgical, Inc.: Basic $ 1.54 $ 1.01 Diluted $ 1.51 $ 1.00

FINANCIAL INSTRUMENTS - Summary

FINANCIAL INSTRUMENTS - Summary of Cash and Available-For-Sale Securities (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	$ 2,839.5	$ 2,750.1
Total	4,604.8
Gross Unrealized Gains	7	22.1
Gross Unrealized Losses	(50.8)	(60.5)
Allowance for Credit Loss	(1.1)	(1.1)
Fair Value	4,559.9
Short- term Investments	1,960.6	2,473.1
Long- term Investments	2,522.6	2,120
Total assets measured at fair value, amortized cost	7,367.6	7,382.7
Total assets measured at fair value, fair value	7,322.7	7,343.2
Cash
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	608.9	526.2
Fair Value	608.9	526.2
Level 1
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	2,230.6	2,223.9
Total	5,318.6	5,074.1
Gross Unrealized Gains	6.3	20.1
Gross Unrealized Losses	(25.5)	(25.4)
Allowance for Credit Loss	0	0
Fair Value	5,299.4	5,068.8
Short- term Investments	962.5	1,276
Long- term Investments	2,106.3	1,568.9
Level 1 | Money market funds
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	2,153.9	2,223.9
Fair Value	2,153.9	2,223.9
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	76.7	0
Total	3,164.7	2,850.2
Gross Unrealized Gains	6.3	20.1
Gross Unrealized Losses	(25.5)	(25.4)
Allowance for Credit Loss	0	0
Fair Value	3,145.5	2,844.9
Short- term Investments	962.5	1,276
Long- term Investments	2,106.3	1,568.9
Level 2
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	1,440.1	1,782.4
Gross Unrealized Gains	0.7	2
Gross Unrealized Losses	(25.3)	(35.1)
Allowance for Credit Loss	(1.1)	(1.1)
Fair Value	1,414.4	1,748.2
Short- term Investments	998.1	1,197.1
Long- term Investments	416.3	551.1
Level 2 | Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	938.5	1,300.4
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(17.6)	(25.8)
Allowance for Credit Loss	(1.1)	(1.1)
Fair Value	919.8	1,273.5
Short- term Investments	731.2	974.6
Long- term Investments	188.6	298.9
Level 2 | U.S. government agencies
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	431	402.6
Gross Unrealized Gains	0.7	2
Gross Unrealized Losses	(6.5)	(7.3)
Allowance for Credit Loss	0	0
Fair Value	425.2	397.3
Short- term Investments	198.8	149.5
Long- term Investments	226.4	247.8
Level 2 | Municipal securities
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	0	0
Total	70.6	79.4
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(1.2)	(2)
Allowance for Credit Loss	0	0
Fair Value	69.4	77.4
Short- term Investments	68.1	73
Long- term Investments	$ 1.3	$ 4.4

FINANCIAL INSTRUMENTS - Summa_2

FINANCIAL INSTRUMENTS - Summary of Contractual Maturities of Cash Equivalents and Available-For-Sale Investments (Details) $ in Millions	Mar. 31, 2024 USD ($)
Amortized Cost
Mature in less than one year	$ 2,063.3
Mature in one to five years	2,541.5
Total	4,604.8
Fair Value
Mature in less than one year	2,037.3
Mature in one to five years	2,522.6
Total	$ 4,559.9

FINANCIAL INSTRUMENTS - Narrati

FINANCIAL INSTRUMENTS - Narrative (Details) - USD ($)	3 Months Ended	6 Months Ended	12 Months Ended
	Mar. 31, 2024	Jun. 30, 2023	Dec. 31, 2023
Debt and Equity Securities, FV-NI [Line Items]
Gross realized gains (losses)	$ 0		$ 0
Net unrealized losses on AFS debt securities, net of tax	$ 33,900,000	$ 29,700,000
Maximum
Debt and Equity Securities, FV-NI [Line Items]
Derivative term (up to)	13 months
Level 1
Debt and Equity Securities, FV-NI [Line Items]
Equity investments with readily determinable market values	$ 0
Level 2
Debt and Equity Securities, FV-NI [Line Items]
Decrease in fair value due to impairments of certain equity investments that lack readily determinable market values	$ 3,400,000

FINANCIAL INSTRUMENTS - Availab

FINANCIAL INSTRUMENTS - Available-for-Sale Debt Securities in a Continuous Unrealized Loss Position (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	$ 1,323.5	$ 132.5
Unrealized losses less than 12 months, gross unrealized losses	(7.9)	(0.1)
Unrealized losses more than 12 months, fair value	1,783.1	2,595.1
Unrealized losses more than 12 months, gross unrealized losses	(42.9)	(60.4)
Total unrealized losses, fair value	3,106.6	2,727.6
Total unrealized losses, gross unrealized losses	(50.8)	(60.5)
U.S. treasuries
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	1,214.8	48.5
Unrealized losses less than 12 months, gross unrealized losses	(7.5)	0
Unrealized losses more than 12 months, fair value	705.5	1,112.9
Unrealized losses more than 12 months, gross unrealized losses	(18)	(25.4)
Total unrealized losses, fair value	1,920.3	1,161.4
Total unrealized losses, gross unrealized losses	(25.5)	(25.4)
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	16	54.2
Unrealized losses less than 12 months, gross unrealized losses	0	(0.1)
Unrealized losses more than 12 months, fair value	828.8	1,219.2
Unrealized losses more than 12 months, gross unrealized losses	(17.6)	(25.8)
Total unrealized losses, fair value	844.8	1,273.4
Total unrealized losses, gross unrealized losses	(17.6)	(25.9)
U.S. government agencies
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	92.7	29.8
Unrealized losses less than 12 months, gross unrealized losses	(0.4)	0
Unrealized losses more than 12 months, fair value	179.4	185.6
Unrealized losses more than 12 months, gross unrealized losses	(6.1)	(7.3)
Total unrealized losses, fair value	272.1	215.4
Total unrealized losses, gross unrealized losses	(6.5)	(7.3)
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Unrealized losses less than 12 months, fair value	0	0
Unrealized losses less than 12 months, gross unrealized losses	0	0
Unrealized losses more than 12 months, fair value	69.4	77.4
Unrealized losses more than 12 months, gross unrealized losses	(1.2)	(1.9)
Total unrealized losses, fair value	69.4	77.4
Total unrealized losses, gross unrealized losses	$ (1.2)	$ (1.9)

FINANCIAL INSTRUMENTS - Summa_3

FINANCIAL INSTRUMENTS - Summary of Equity Investment Activity (Details) - Level 2 $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($)
Fair Value, Level 2 [Abstract]
Beginning balance, carrying value	$ 74.5
Changes in Fair Value	(3.4)
Purchases / Sales / Other	0.2
Ending balance, carrying value	71.3
Prepaids and other current assets
Fair Value, Level 2 [Abstract]
Ending balance, carrying value	0
Intangible and other assets, net
Fair Value, Level 2 [Abstract]
Ending balance, carrying value	$ 71.3

FINANCIAL INSTRUMENTS - Derivat

FINANCIAL INSTRUMENTS - Derivative Instruments Used to Hedge against Balance Sheet Foreign Currency Exposures (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign exchange gains (losses) related to balance sheet re-measurement	$ (19.4)	$ 5.4
Forward contracts | Derivatives Not Designated as Hedging Instruments
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Recognized gains (losses) in interest and other income, net	$ 18.3	$ (3.3)

FINANCIAL INSTRUMENTS - Gross N

FINANCIAL INSTRUMENTS - Gross Notional Amounts for Outstanding Derivatives (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
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	$ 5	$ 3.1
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	1.5	5.9
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	6.2	5
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	1.9	6.6
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	343.9	292.1
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	$ 643.7	$ 699.7

BALANCE SHEET DETAILS AND OTH_3

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Accounts Receivable, Net (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Trade accounts receivable, net	$ 1,028.6	$ 1,042.2
Unbilled accounts receivable and other	115.5	105
Sales returns and allowances	(16.2)	(17)
Accounts receivable, net	$ 1,127.9	$ 1,130.2

BALANCE SHEET DETAILS AND OTH_4

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Inventory (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 469.8	$ 454.7
Work-in-process	181.3	159.9
Finished goods	648.2	606
Total inventory	$ 1,299.3	$ 1,220.6

BALANCE SHEET DETAILS AND OTH_5

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Prepaids and Other Current Assets (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Net investment in sales-type leases – short-term	$ 132.5	$ 137.3
Other prepaids and other current assets	272.9	176.7
Total prepaids and other current assets	$ 405.4	$ 314

BALANCE SHEET DETAILS AND OTH_6

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Other Accrued Liabilities - Short-term (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income and other taxes payable	$ 51.8	$ 111.4
Accrued construction-related capital expenditures	163.1	143.3
Other accrued liabilities	289.9	332.8
Total other accrued liabilities – short-term	$ 504.8	$ 587.5

BALANCE SHEET DETAILS AND OTH_7

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Other Long-term Liabilities (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income taxes – long-term	$ 250.5	$ 233.8
Deferred revenue – long-term	50.2	45.6
Other long-term liabilities	105.8	106.1
Total other long-term liabilities	$ 406.5	$ 385.5

BALANCE SHEET DETAILS AND OTH_8

BALANCE SHEET DETAILS AND OTHER FINANCIAL INFORMATION - Supplemental Cash Flow Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment	$ 110.7	$ 89.6
Acquisition of property, plant, and equipment in accounts payable and accrued liabilities	$ 177.9	$ 80.2

REVENUE AND CONTRACT ACQUISIT_3

REVENUE AND CONTRACT ACQUISITION COSTS - Revenue Disaggregated by Types and Geography (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Disaggregation of Revenue [Line Items]
Total revenue	$ 1,890.6	$ 1,696.2
Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	1,158.9	985.6
Systems
Disaggregation of Revenue [Line Items]
Total revenue	418.2	427.4
Services
Disaggregation of Revenue [Line Items]
Total revenue	313.5	283.2
U.S.
Disaggregation of Revenue [Line Items]
Total revenue	1,238.5	1,109.9
U.S. | Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	822.4	701.4
U.S. | Systems
Disaggregation of Revenue [Line Items]
Total revenue	212.5	221.8
U.S. | Services
Disaggregation of Revenue [Line Items]
Total revenue	203.6	186.7
OUS
Disaggregation of Revenue [Line Items]
Total revenue	652.1	586.3
OUS | Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	336.5	284.2
OUS | Systems
Disaggregation of Revenue [Line Items]
Total revenue	205.7	205.6
OUS | Services
Disaggregation of Revenue [Line Items]
Total revenue	$ 109.9	$ 96.5

REVENUE AND CONTRACT ACQUISIT_4

REVENUE AND CONTRACT ACQUISITION COSTS - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue recognized	$ 189	$ 185
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-04-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Price allocated to remaining performance obligations	$ 2,340
Remaining performance obligations, percent	44%
Remaining performance obligations, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-04-01 | Maximum
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligations, expected timing of satisfaction, period	5 years
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2025-04-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligations, expected timing of satisfaction, period

REVENUE AND CONTRACT ACQUISIT_5

REVENUE AND CONTRACT ACQUISITION COSTS - Summary of Contract Assets and Liabilities (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Revenue from Contract with Customer [Abstract]
Contract assets	$ 17.4	$ 20.2
Deferred revenue	$ 487.7	$ 491.7

REVENUE AND CONTRACT ACQUISIT_6

REVENUE AND CONTRACT ACQUISITION COSTS - Sales-type and Operating Lease Revenue (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Deferred Revenue Arrangement [Line Items]
Sales-type lease revenue	$ 13.3	$ 23
Operating lease revenue	148	112
Variable Lease Revenue, Usage-Based Arrangements
Deferred Revenue Arrangement [Line Items]
Operating lease revenue	$ 70	$ 46

LEASES - Lease Receivables (Det

LEASES - Lease Receivables (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Capital Leased Assets [Line Items]
Gross lease receivables	$ 356.6	$ 384.5
Unearned income	(12.2)	(12.9)
Subtotal	344.4	371.6
Allowance for credit loss	(2.6)	(2.7)
Sales-type lease, lease receivable	341.8	368.9
Prepaids and other current assets
Capital Leased Assets [Line Items]
Sales-type lease, lease receivable	132.5	137.3
Intangible and other assets, net
Capital Leased Assets [Line Items]
Sales-type lease, lease receivable	$ 209.3	$ 231.6

LEASES - Schedule of Contractua

LEASES - Schedule of Contractual Maturities of Gross Lease Receivables (Details) $ in Millions	Mar. 31, 2024 USD ($)
Leases [Abstract]
Remainder of 2024	$ 107.9
2025	114.3
2026	76.9
2027	41.4
2028	12.5
2029 and thereafter	3.6
Total	$ 356.6

LEASES - Additional Information

LEASES - Additional Information (Details)	Mar. 31, 2024
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	Mar. 31, 2024	Dec. 31, 2023
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2024	$ 13.1
2023	72.1
2022	115.3
2021	94.5
2020	40
Prior	9.4
Subtotal	344.4	$ 371.6
High
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2024	5.4
2023	35.9
2022	56.6
2021	55.3
2020	19.7
Prior	6.1
Subtotal	179
Moderate
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2024	7.7
2023	34.8
2022	53.2
2021	36.9
2020	20.1
Prior	3.3
Subtotal	156
Low
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2024	0
2023	1.4
2022	5.5
2021	2.3
2020	0.2
Prior	0
Subtotal	$ 9.4

GOODWILL AND INTANGIBLE ASSET_2

GOODWILL AND INTANGIBLE ASSETS - Schedule of Summary of Changes in Goodwill (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($)
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 348.7
Acquisition activity	0
Translation and other	(0.5)
Goodwill, ending balance	$ 348.2

GOODWILL AND INTANGIBLE ASSET_3

GOODWILL AND INTANGIBLE ASSETS - Schedule of Intangible Assets (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 248.9	$ 249.6
Accumulated Amortization	(215.1)	(210.5)
Net Carrying Amount	33.8	39.1
Patents and developed technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	206.3	206.3
Accumulated Amortization	(181.8)	(178.4)
Net Carrying Amount	24.5	27.9
Distribution rights and others
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	10.8	10.8
Accumulated Amortization	(9.7)	(9.2)
Net Carrying Amount	1.1	1.6
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	31.8	32.5
Accumulated Amortization	(23.6)	(22.9)
Net Carrying Amount	$ 8.2	$ 9.6

GOODWILL AND INTANGIBLE ASSET_4

GOODWILL AND INTANGIBLE ASSETS - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 5.1	$ 5

GOODWILL AND INTANGIBLE ASSET_5

GOODWILL AND INTANGIBLE ASSETS - Schedule Of Estimated Future Amortization Expense Of Intangible Assets (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2024	$ 11.8
2025	11.9
2026	5.3
2027	2.8
2028	1.3
2029 and thereafter	0.7
Net Carrying Amount	$ 33.8	$ 39.1

CONTINGENCIES (Details)

CONTINGENCIES (Details)	Sep. 20, 2023 USD ($)	Oct. 19, 2022 USD ($)	May 20, 2021 claim
Other Commitments [Line Items]
Number of class action complaints | claim			3
Rex Medical, L.P.
Other Commitments [Line Items]
Loss contingency, damages awarded | $	$ 1	$ 10,000,000

STOCKHOLDERS' EQUITY - Schedule

STOCKHOLDERS' EQUITY - Schedule of Stockholders Equity (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)	352,300,000
Beginning balance	$ 13,397.3	$ 11,112.6
Issuance of common stock through employee stock plans	180.4	100.2
Shares withheld related to net share settlement of equity awards	(226.6)	(129.7)
Share-based compensation expense related to employee stock plans	152.8	146
Repurchase and retirement of common stock		(350)
Net income attributable to Intuitive Surgical, Inc.	544.9	355.3
Other comprehensive income (loss)	3.1	54.3
Cash dividends declared and payable by joint venture	(8)
Net income attributable to noncontrolling interest in joint venture	$ 2.5	5.5
Ending balance (in shares)	354,700,000
Ending balance	$ 14,046.4	11,294.2
Total Intuitive Surgical, Inc. Stockholders’ Equity
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	13,307.6	11,041.9
Issuance of common stock through employee stock plans	180.4	100.2
Shares withheld related to net share settlement of equity awards	(226.6)	(129.7)
Share-based compensation expense related to employee stock plans	152.8	146
Repurchase and retirement of common stock		(350)
Net income attributable to Intuitive Surgical, Inc.	544.9	355.3
Other comprehensive income (loss)	3.5	54
Ending balance	$ 13,962.6	$ 11,217.7
Common Stock
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance (in shares)	352,300,000	350,000,000
Beginning balance	$ 0.4	$ 0.4
Issuance of common stock through employee stock plans (in shares)	3,000,000	2,400,000
Shares withheld related to net share settlement of equity awards (in shares)	(600,000)	(500,000)
Repurchase and retirement of common stock (in shares)		(1,500,000)
Ending balance (in shares)	354,700,000	350,400,000
Ending balance	$ 0.4	$ 0.4
Additional Paid-In Capital
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	8,576.4	7,703.9
Issuance of common stock through employee stock plans	180.4	100.2
Shares withheld related to net share settlement of equity awards	(6.6)	(5.9)
Share-based compensation expense related to employee stock plans	152.8	146
Repurchase and retirement of common stock		(15.8)
Ending balance	8,903	7,928.4
Retained Earnings
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	4,743	3,500.1
Shares withheld related to net share settlement of equity awards	(220)	(123.8)
Repurchase and retirement of common stock		(334.2)
Net income attributable to Intuitive Surgical, Inc.	544.9	355.3
Ending balance	5,067.9	3,397.4
Accumulated Other Comprehensive Income (Loss)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	(12.2)	(162.5)
Other comprehensive income (loss)	3.5	54
Ending balance	(8.7)	(108.5)
Noncontrolling Interest in Joint Venture
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning balance	89.7	70.7
Other comprehensive income (loss)	(0.4)	0.3
Cash dividends declared and payable by joint venture	(8)
Net income attributable to noncontrolling interest in joint venture	2.5	5.5
Ending balance	$ 83.8	$ 76.5

STOCKHOLDERS' EQUITY - Stock Re

STOCKHOLDERS' EQUITY - Stock Repurchase Program (Details) - Repurchase Program - Common Stock - USD ($) $ in Billions	Mar. 31, 2024	Jul. 20, 2022
Equity, Class of Treasury Stock [Line Items]
Amount of share repurchases authorized	$ 10
Remaining amount of share repurchases authorized	$ 1.1	$ 3.5

STOCKHOLDERS' EQUITY - Schedu_2

STOCKHOLDERS' EQUITY - Schedule of Share Repurchase Activities (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Equity, Class of Treasury Stock [Line Items]
Value of shares repurchased		$ 350
Common Stock
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)		1.5
Common Stock | Repurchase Program
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)	0	1.5
Average price per share (in dollars per share)	$ 0	$ 238.1
Value of shares repurchased	$ 0	$ 350

STOCKHOLDERS' EQUITY - Componen

STOCKHOLDERS' EQUITY - Components of Accumulated Other Comprehensive Income, Net of Tax (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	$ 13,397.3	$ 11,112.6
Other comprehensive income	3.1	54.3
Ending balance	14,046.4	11,294.2
Total
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(12.2)	(162.5)
Other comprehensive income (loss) before reclassifications	2	55.4
Amounts reclassified from accumulated other comprehensive income (loss)	1.5	(1.4)
Other comprehensive income	3.5	54
Ending balance	(8.7)	(108.5)
Gains (Losses) on Hedge Instruments
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(2.5)	(2.9)
Other comprehensive income (loss) before reclassifications	4.1	3.7
Amounts reclassified from accumulated other comprehensive income (loss)	1.5	(1.2)
Other comprehensive income	5.6	2.5
Ending balance	3.1	(0.4)
Unrealized Gains (Losses) on Available-for-Sale Securities
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(29.7)	(154.2)
Other comprehensive income (loss) before reclassifications	(4.3)	37.8
Amounts reclassified from accumulated other comprehensive income (loss)	0.1	(0.2)
Other comprehensive income	(4.2)	37.6
Ending balance	(33.9)	(116.6)
Foreign Currency Translation Gains (Losses)
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	19.4	(6.6)
Other comprehensive income (loss) before reclassifications	2.2	13.9
Amounts reclassified from accumulated other comprehensive income (loss)	0	0
Other comprehensive income	2.2	13.9
Ending balance	21.6	7.3
Employee Benefit Plans
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	0.6	1.2
Other comprehensive income (loss) before reclassifications	0	0
Amounts reclassified from accumulated other comprehensive income (loss)	(0.1)	0
Other comprehensive income	(0.1)	0
Ending balance	$ 0.5	$ 1.2

STOCKHOLDERS' EQUITY - Other Co

STOCKHOLDERS' EQUITY - Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Text Block [Abstract]
Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income	$ 1.3	$ (10.9)

SHARE-BASED COMPENSATION - Addi

SHARE-BASED COMPENSATION - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee Stock Purchase Plan, number of shares purchased by employees	300,000	300,000
Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options exercisable, number of shares	7,000,000
Options exercisable, weighted-average exercise price (usd per share)	$ 162.35
Employee Stock Purchase Plan, value of shares purchased by employees	$ 68.4	$ 59.9
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	15,400,000
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	6,700,000

SHARE-BASED COMPENSATION - Summ

SHARE-BASED COMPENSATION - Summary of RSU and PSU Activity (Details) shares in Millions	3 Months Ended
	Mar. 31, 2024 $ / shares shares
Restricted Stock Units (RSUs)
Shares
Unvested beginning balance (in shares) | shares	5
Granted (in shares) | shares	2.2
Vested (in shares) | shares	(1.6)
Forfeited (in shares) | shares	(0.1)
Unvested ending balance (in shares) | shares	5.5
Weighted-Average Grant-Date Fair Value
Unvested beginning balance (usd per share) | $ / shares	$ 245.75
Granted (usd per share) | $ / shares	388.09
Vested (usd per share) | $ / shares	234.60
Forfeited (usd per share) | $ / shares	262.23
Unvested ending balance (usd per share) | $ / shares	$ 305.87
Performance Share Units (PSUs)
Shares
Unvested beginning balance (in shares) | shares	0.2
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	0.3
Weighted-Average Grant-Date Fair Value
Unvested beginning balance (usd per share) | $ / shares	$ 259.60
Granted (usd per share) | $ / shares	395.92
Vested (usd per share) | $ / shares	271.58
Performance change (usd per share) | $ / shares	290.33
Forfeited (usd per share) | $ / shares	251.44
Unvested ending balance (usd per share) | $ / shares	$ 306.93

SHARE-BASED COMPENSATION - Su_2

SHARE-BASED COMPENSATION - Summary of Stock Option Activity Under All Stock Plans (Details) shares in Millions	3 Months Ended
	Mar. 31, 2024 $ / shares shares
Number Outstanding
Beginning balance (in shares) | shares	9.8
Options granted (in shares) | shares	0
Options exercised (in shares) | shares	(1.1)
Options forfeited/expired (in shares) | shares	0
Ending balance (in shares) | shares	8.7
Weighted-Average Exercise Price Per Share
Beginning balance (in dollars per share) | $ / shares	$ 174.90
Options granted (in dollars per share) | $ / shares	0
Options exercised (in dollars per share) | $ / shares	107.06
Options forfeited/expired (in dollars per share) | $ / shares	250.01
Ending balance (in dollars per share) | $ / shares	$ 182.70

SHARE-BASED COMPENSATION - Stoc

SHARE-BASED COMPENSATION - Stock-Based Compensation Expense (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 155.6	$ 140.6
Income tax benefit	32.4	28
Share-based compensation expense after income taxes	123.2	112.6
Cost of revenue – products | Cost of revenue – products (before capitalization)
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	22.8	23
Cost of revenue – products | Amounts capitalized into inventory
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	(21.4)	(18.8)
Cost of revenue – 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	21.3	12.6
Total cost of revenue
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	29.7	23.8
Total cost of revenue | Cost of revenue – products
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	22.7	16.8
Total cost of revenue | Cost of revenue – services
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	7	7
Selling, general, and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	68.2	66.7
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 57.7	$ 50.1

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
	Mar. 31, 2024	Mar. 31, 2023
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	0%	4.80%
Expected term (in years)		3 years 4 months 24 days
Expected volatility (percent)	0%	34%
Weighted average fair value at grant date (usd per share)	$ 0	$ 72.13
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	4.60%	4.70%
Expected term (in years)	1 year 2 months 12 days	1 year 2 months 12 days
Expected volatility (percent)	32%	35%
Weighted average fair value at grant date (usd per share)	$ 115.48	$ 79.33

INCOME TAXES (Details)

INCOME TAXES (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income tax expense (benefit)	$ (8.9)	$ 61
Income tax expense, percentage of pre-tax income (expense)	(1.70%)	14.50%
Excess tax benefits associated with employee equity plans	$ 111.1	$ 22.5
Excess tax benefits associated with employee equity plans (in percent)	20.60%	5.30%

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
	Mar. 31, 2024	Mar. 31, 2023
Numerator:
Net income attributable to Intuitive Surgical, Inc.	$ 544.9	$ 355.3
Denominator:
Weighted-average shares outstanding used in basic calculation (in shares)	353.5	350.2
Add: dilutive effect of potential common shares (in shares)	7	5.8
Weighted-average shares outstanding used in diluted calculation (in shares)	360.5	356
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (in dollars per share)	$ 1.54	$ 1.01
Diluted (in dollars per share)	$ 1.51	$ 1

NET INCOME PER SHARE - Addition

NET INCOME PER SHARE - Additional Information (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Employee stock options excluded from computation of diluted net income per share	0.9	3.2