Cash Flow Statement

The cash flow statement provides information about a company cash receipts and cash payments during an accounting period, showing how these cash flows link the ending cash balance to the beginning balance shown on the company balance sheet.

The cash flow statement consists of three parts: cash flows provided by (used in) operating activities, cash flows provided by (used in) investing activities, and cash flows provided by (used in) financing activities.

Intuitive Surgical Inc., consolidated cash flow statement

US$ in thousands

12 months ended:	Dec 31, 2025	Dec 31, 2024	Dec 31, 2023	Dec 31, 2022	Dec 31, 2021
Net income	2,876,600)	2,337,500)	1,817,300)	1,344,400)	1,728,100)
Depreciation and loss on disposal of property, plant, and equipment, net	614,700)	445,300)	401,600)	338,000)	282,800)
Amortization of intangible and other assets	62,400)	54,400)	53,200)	54,400)	49,400)
Gain on sale of business	(1,000)	(1,100)	—)	(3,800)	—)
(Gain) loss on investments and (accretion) amortization of investment discounts and premiums, net	(57,200)	(43,300)	7,300)	49,000)	10,600)
Deferred income taxes	19,100)	(135,300)	(280,800)	(185,300)	(62,600)
Share-based compensation expense	788,200)	676,800)	592,800)	513,200)	449,200)
Accounts receivable	(301,700)	(95,900)	(186,300)	(159,300)	(142,300)
Inventory	(1,063,400)	(830,000)	(712,500)	(546,600)	(256,000)
Prepaids and other assets	(187,100)	(231,800)	24,200)	(129,200)	(204,900)
Accounts payable	57,900)	(400)	41,700)	21,300)	36,000)
Accrued compensation and employee benefits	112,700)	99,300)	34,800)	51,500)	115,100)
Deferred revenue	75,200)	31,200)	53,400)	21,500)	32,600)
Other liabilities	34,100)	108,300)	(32,900)	121,700)	51,400)
Changes in operating assets and liabilities, net of effects of acquisitions	(1,272,300)	(919,300)	(777,600)	(619,100)	(368,100)
Adjustments to reconcile net income to net cash provided by operating activities	153,900)	77,500)	(3,500)	146,400)	361,300)
Net cash provided by operating activities	3,030,500)	2,415,000)	1,813,800)	1,490,800)	2,089,400)
Purchase of investments	(1,215,900)	(5,139,600)	(2,207,400)	(1,399,500)	(6,452,000)
Proceeds from sales of investments	259,900)	100,200)	230,300)	61,100)	84,900)
Proceeds from maturities of investments	2,175,500)	2,878,800)	2,690,100)	3,254,400)	4,267,800)
Purchase of property, plant, and equipment	(539,800)	(1,111,200)	(1,064,200)	(532,400)	(339,500)
Acquisition of businesses, net of cash, and intellectual property and other investing activities	(13,900)	(1,000)	(8,900)	(12,800)	(22,700)
Net cash (used in) provided by investing activities	665,800)	(3,272,800)	(360,100)	1,370,800)	(2,461,500)
Proceeds from issuance of common stock relating to employee stock plans	350,300)	429,400)	296,300)	233,800)	276,500)
Taxes paid related to net share settlement of equity awards	(419,100)	(270,000)	(164,700)	(194,200)	(211,600)
Repurchases of common stock	(2,295,300)	—)	(416,300)	(2,607,400)	—)
Cash dividends paid by joint venture to noncontrolling interest	—)	(8,000)	—)	—)	—)
Payment of deferred purchase consideration	—)	(500)	(2,900)	(4,500)	(21,900)
Net cash provided by (used in) financing activities	(2,364,100)	150,900)	(287,600)	(2,572,300)	43,000)
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	12,800)	(800)	3,300)	5,400)	(3,400)
Net increase (decrease) in cash, cash equivalents, and restricted cash	1,345,000)	(707,700)	1,169,400)	294,700)	(332,500)
Cash, cash equivalents, and restricted cash, beginning of year	2,062,400)	2,770,100)	1,600,700)	1,306,000)	1,638,500)
Cash, cash equivalents, and restricted cash, end of year	3,407,400)	2,062,400)	2,770,100)	1,600,700)	1,306,000)

Based on: 10-K (reporting date: 2025-12-31), 10-K (reporting date: 2024-12-31), 10-K (reporting date: 2023-12-31), 10-K (reporting date: 2022-12-31), 10-K (reporting date: 2021-12-31).

The cash flow statement reveals a dynamic pattern of cash generation and utilization over the five-year period. While operating activities consistently provide a net cash inflow, investing and financing activities demonstrate significant fluctuations, impacting the overall cash position.

Operating Activities: Net cash provided by operating activities generally increased from US$2,089.4 million in 2021 to US$3,030.5 million in 2025. This positive trend indicates improving core business performance and efficient working capital management, although adjustments to reconcile net income show variability. Notably, adjustments were relatively high in 2021 at US$361.3 million, decreasing to US$146.4 million in 2022, then becoming negative in 2023 before recovering in subsequent years. Changes in operating assets and liabilities consistently represent a significant cash outflow, increasing in magnitude each year, suggesting growing working capital needs.
Investing Activities: Investing activities are characterized by substantial cash outflows, primarily related to the purchase of investments and property, plant, and equipment. The purchase of investments dominated cash usage, peaking at US$6,452 million in 2021, and remaining significant throughout the period. While proceeds from maturities and sales of investments partially offset these outflows, a net cash outflow was observed in all years except 2022, which saw a net cash inflow of US$1,370.8 million. The level of investment in property, plant, and equipment increased significantly from 2021 to 2023, before decreasing in 2024 and 2025.
Financing Activities: Financing activities exhibited considerable volatility. 2022 saw a large net cash outflow of US$2,572.3 million, largely driven by repurchases of common stock. Repurchases continued to be a significant outflow in 2025. Proceeds from employee stock plans consistently provided a cash inflow, but were insufficient to offset the outflows from stock repurchases and other financing uses. Taxes paid related to net share settlement of equity awards also represent a consistent, growing cash outflow. A notable shift occurred in 2024, with net cash provided by financing activities reaching US$150.9 million.
Cash Position: The net increase or decrease in cash, cash equivalents, and restricted cash fluctuated significantly. A decrease was observed in 2021, followed by increases in 2022 and 2023. 2024 saw a decrease, and 2025 experienced a substantial increase, resulting in a final cash balance of US$3,407.4 million. The beginning cash balance increased from US$1,638.5 million in 2021 to US$2,062.4 million in 2024, before increasing again in 2025.
Non-Recurring Items: Gains on the sale of businesses and investments, along with deferred income taxes, introduced variability. Gains on sales were relatively small and negative in 2022, 2024, and 2025. Deferred income taxes were consistently negative until 2025, when they became positive, indicating a change in tax-related cash flows.

Overall, the company demonstrates a capacity to generate cash from operations, but this is frequently offset by substantial investments and financing activities, particularly stock repurchases. The increasing investment in property, plant, and equipment and growing working capital needs suggest a period of expansion and growth.

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Intuitive Surgical Inc. (NASDAQ:ISRG)

Cash Flow Statement