Stock Analysis on Net

Intuitive Surgical Inc. (NASDAQ:ISRG)

$24.99

Economic Value Added (EVA)

Microsoft Excel

EVA is registered trademark of Stern Stewart.

Economic value added or economic profit is the difference between revenues and costs,where costs include not only expenses, but also cost of capital.

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Economic Profit

Intuitive Surgical Inc., economic profit calculation

US$ in thousands

Microsoft Excel
12 months ended: Dec 31, 2024 Dec 31, 2023 Dec 31, 2022 Dec 31, 2021 Dec 31, 2020
Net operating profit after taxes (NOPAT)1
Cost of capital2
Invested capital3
 
Economic profit4

Based on: 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), 10-K (reporting date: 2020-12-31).

1 NOPAT. See details »

2 Cost of capital. See details »

3 Invested capital. See details »

4 2024 Calculation
Economic profit = NOPAT – Cost of capital × Invested capital
= × =


The financial performance, as measured by economic profit, demonstrates considerable fluctuation over the five-year period. Net operating profit after taxes (NOPAT) initially increased significantly, then decreased, before exhibiting substantial growth again. Invested capital consistently increased throughout the period, while the cost of capital remained relatively stable. These factors combined to produce varying levels of economic profit.

NOPAT Trend
Net operating profit after taxes increased from US$1,149,207 thousand in 2020 to US$1,700,018 thousand in 2021, representing a significant rise. A subsequent decrease was observed in 2022, with NOPAT falling to US$1,187,823 thousand. This was followed by a moderate increase in 2023 to US$1,596,933 thousand, and a substantial increase in 2024, reaching US$2,242,154 thousand. This indicates a volatile, but ultimately positive, trend in operational profitability.
Cost of Capital
The cost of capital remained consistent at 18.64% in 2020, 2021, and 2022. A slight increase to 18.65% was recorded in both 2023 and 2024. This stability suggests a consistent risk profile and financing structure over the analyzed period.
Invested Capital Trend
Invested capital experienced a steady increase throughout the period. It rose from US$4,486,200 thousand in 2020 to US$4,517,800 thousand in 2021. Further increases were observed in subsequent years, reaching US$5,396,200 thousand in 2022, US$7,159,800 thousand in 2023, and US$7,798,800 thousand in 2024. This indicates ongoing investment in the business.
Economic Profit Trend
Economic profit mirrored the fluctuations in NOPAT, though moderated by the stable cost of capital and increasing invested capital. It increased significantly from US$312,760 thousand in 2020 to US$857,693 thousand in 2021. A substantial decrease was then recorded in 2022, falling to US$181,917 thousand. Economic profit increased moderately in 2023 to US$261,772 thousand, and then experienced a significant increase in 2024, reaching US$787,840 thousand. The largest economic profit occurred in 2024, despite having the highest invested capital.

The observed pattern suggests that while the company is consistently generating returns above its cost of capital, the magnitude of those returns is sensitive to changes in NOPAT. The increasing invested capital base did not consistently translate into higher economic profit, highlighting the importance of maintaining strong operational performance.


Net Operating Profit after Taxes (NOPAT)

Intuitive Surgical Inc., NOPAT calculation

US$ in thousands

Microsoft Excel
12 months ended: Dec 31, 2024 Dec 31, 2023 Dec 31, 2022 Dec 31, 2021 Dec 31, 2020
Net income attributable to Intuitive Surgical, Inc.
Deferred income tax expense (benefit)1
Increase (decrease) in allowances2
Increase (decrease) in deferred revenue3
Increase (decrease) in equity equivalents4
Interest expense
Interest expense, operating lease liability5
Adjusted interest expense
Tax benefit of interest expense6
Adjusted interest expense, after taxes7
(Gain) loss on marketable securities
Investment income, before taxes
Tax expense (benefit) of investment income8
Investment income, after taxes9
Net income (loss) attributable to noncontrolling interest
Net operating profit after taxes (NOPAT)

Based on: 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), 10-K (reporting date: 2020-12-31).

1 Elimination of deferred tax expense. See details »

2 Addition of increase (decrease) in allowances.

3 Addition of increase (decrease) in deferred revenue.

4 Addition of increase (decrease) in equity equivalents to net income attributable to Intuitive Surgical, Inc..

5 2024 Calculation
Interest expense on capitalized operating leases = Operating lease liability × Discount rate
= × =

6 2024 Calculation
Tax benefit of interest expense = Adjusted interest expense × Statutory income tax rate
= × 21.00% =

7 Addition of after taxes interest expense to net income attributable to Intuitive Surgical, Inc..

8 2024 Calculation
Tax expense (benefit) of investment income = Investment income, before tax × Statutory income tax rate
= × 21.00% =

9 Elimination of after taxes investment income.


The financial performance of the company over the analyzed five-year period reveals notable fluctuations and an overall upward trajectory in profitability metrics.

Net Income Attributable to the Company
The net income shows growth from 1,060,600 thousand USD in 2020 to 1,704,600 thousand USD in 2021, representing a significant increase. However, in 2022, there was a decline to 1,322,300 thousand USD. Subsequently, the net income rose again to 1,798,000 thousand USD in 2023 and further increased to 2,322,600 thousand USD in 2024. This trend suggests strong recovery and expansion in profitability following the dip in 2022.
Net Operating Profit After Taxes (NOPAT)
NOPAT began at 1,149,207 thousand USD in 2020 and increased to 1,700,018 thousand USD in 2021, indicating improved operational efficiency or performance. Similar to net income, NOPAT decreased to 1,187,823 thousand USD in 2022, followed by a recovery to 1,596,933 thousand USD in 2023. By 2024, NOPAT reached 2,242,154 thousand USD, the highest point in the period analyzed. This reflects a strengthening operational position and effective management of after-tax operating profit.

Overall, both net income and NOPAT exhibit a clear pattern of initial growth, a temporary downturn in 2022, and a subsequent robust recovery through 2024. The increase in these key profitability measures in the final two years highlights enhanced financial performance and possibly improvements in market conditions, operational efficiency, or cost management strategies.


Cash Operating Taxes

Intuitive Surgical Inc., cash operating taxes calculation

US$ in thousands

Microsoft Excel
12 months ended: Dec 31, 2024 Dec 31, 2023 Dec 31, 2022 Dec 31, 2021 Dec 31, 2020
Income tax expense
Less: Deferred income tax expense (benefit)
Add: Tax savings from interest expense
Less: Tax imposed on investment income
Cash operating taxes

Based on: 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), 10-K (reporting date: 2020-12-31).


Income Tax Expense
The income tax expense exhibited a generally upward trend over the analyzed period with some variability. Starting at 140,200 thousand USD at the end of 2020, it increased to 162,200 thousand USD in 2021. A significant jump was observed in 2022 when the value rose sharply to 262,400 thousand USD. This was followed by a notable decrease in 2023 to 141,600 thousand USD, nearly returning to the 2020 level. However, in 2024, the tax expense surged to its highest point in the period at 336,300 thousand USD. This volatility indicates fluctuating taxable income or varying tax rates and regulations affecting the tax liabilities.
Cash Operating Taxes
The cash operating taxes showed a marked increasing trend throughout the period. Beginning at 82,150 thousand USD in 2020, the figure nearly tripled by 2021 to 226,657 thousand USD. The upward trajectory continued with a sharp increase to 448,291 thousand USD in 2022, followed by a slight decline to 423,020 thousand USD in 2023. In 2024, the cash operating taxes rose again to 472,970 thousand USD. The steady rise suggests growing operational profitability or changes in tax cash payment practices. The slight dip in 2023 could reflect timing differences in tax payments or adjustments in taxable income.
Comparative Observations
The relationship between income tax expense and cash operating taxes indicates a different pattern in volatility and behavior. While the income tax expense showed significant fluctuations, cash operating taxes tended to increase consistently with minor deviations. This may suggest differences in accounting recognition versus actual cash tax payments, highlighting potential timing differences or altered tax strategies.

Invested Capital

Intuitive Surgical Inc., invested capital calculation (financing approach)

US$ in thousands

Microsoft Excel
Dec 31, 2024 Dec 31, 2023 Dec 31, 2022 Dec 31, 2021 Dec 31, 2020
Operating lease liability1
Total reported debt & leases
Total Intuitive Surgical, Inc. stockholders’ equity
Net deferred tax (assets) liabilities2
Allowances3
Deferred revenue4
Equity equivalents5
Accumulated other comprehensive (income) loss, net of tax6
Noncontrolling interest in joint venture
Adjusted total Intuitive Surgical, Inc. stockholders’ equity
Construction-in-process7
Available-for-sale marketable securities8
Invested capital

Based on: 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), 10-K (reporting date: 2020-12-31).

1 Addition of capitalized operating leases.

2 Elimination of deferred taxes from assets and liabilities. See details »

3 Addition of allowance for doubtful accounts receivable.

4 Addition of deferred revenue.

5 Addition of equity equivalents to total Intuitive Surgical, Inc. stockholders’ equity.

6 Removal of accumulated other comprehensive income.

7 Subtraction of construction-in-process.

8 Subtraction of available-for-sale marketable securities.


Total reported debt & leases
The total reported debt and leases showed a gradual increase from 79,900 thousand USD at the end of 2020 to 93,800 thousand USD by the end of 2022. In 2023, there was a slight decline to 89,800 thousand USD, followed by a significant rise to 146,000 thousand USD in 2024. This pattern indicates a generally upward trend in liabilities with a notable acceleration in debt levels during the most recent year.
Total stockholders’ equity
Stockholders' equity grew consistently over the analyzed period, starting from 9,731,500 thousand USD in 2020 and rising to 16,433,700 thousand USD by the end of 2024. There was a dip observed in 2022, where equity decreased to 11,041,900 thousand USD from 11,901,100 thousand USD in 2021. However, this was followed by substantial growth in the subsequent years, reaching the highest recorded value in 2024. Overall, the equity position strengthened considerably, reflecting a growing net asset base.
Invested capital
Invested capital displayed a steady increase throughout the period. It began at 4,486,200 thousand USD in 2020 and moved marginally to 4,517,800 thousand USD in 2021. From 2022 onwards, there was significant expansion, with invested capital reaching 5,396,200 thousand USD, then sharply increasing to 7,159,800 thousand USD in 2023 and further to 7,798,800 thousand USD in 2024. This demonstrates an intensifying commitment of resources into operations or assets over these years.

Cost of Capital

Intuitive Surgical Inc., cost of capital calculations

Capital (fair value)1 Weights Cost of capital
Equity2 ÷ = × =
Operating lease liability3 ÷ = × × (1 – 21.00%) =
Total:

Based on: 10-K (reporting date: 2024-12-31).

1 US$ in thousands

2 Equity. See details »

3 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 ÷ = × =
Operating lease liability3 ÷ = × × (1 – 21.00%) =
Total:

Based on: 10-K (reporting date: 2023-12-31).

1 US$ in thousands

2 Equity. See details »

3 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 ÷ = × =
Operating lease liability3 ÷ = × × (1 – 21.00%) =
Total:

Based on: 10-K (reporting date: 2022-12-31).

1 US$ in thousands

2 Equity. See details »

3 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 ÷ = × =
Operating lease liability3 ÷ = × × (1 – 21.00%) =
Total:

Based on: 10-K (reporting date: 2021-12-31).

1 US$ in thousands

2 Equity. See details »

3 Operating lease liability. See details »

Capital (fair value)1 Weights Cost of capital
Equity2 ÷ = × =
Operating lease liability3 ÷ = × × (1 – 21.00%) =
Total:

Based on: 10-K (reporting date: 2020-12-31).

1 US$ in thousands

2 Equity. See details »

3 Operating lease liability. See details »


Economic Spread Ratio

Intuitive Surgical Inc., economic spread ratio calculation, comparison to benchmarks

Microsoft Excel
Dec 31, 2024 Dec 31, 2023 Dec 31, 2022 Dec 31, 2021 Dec 31, 2020
Selected Financial Data (US$ in thousands)
Economic profit1
Invested capital2
Performance Ratio
Economic spread ratio3
Benchmarks
Economic Spread Ratio, Competitors4
Abbott Laboratories
Elevance Health Inc.
Medtronic PLC
UnitedHealth Group Inc.

Based on: 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), 10-K (reporting date: 2020-12-31).

1 Economic profit. See details »

2 Invested capital. See details »

3 2024 Calculation
Economic spread ratio = 100 × Economic profit ÷ Invested capital
= 100 × ÷ =

4 Click competitor name to see calculations.


The economic spread ratio demonstrates considerable fluctuation over the five-year period. Initial values indicate a healthy spread, which then experiences a significant decline before recovering strongly. Economic profit exhibits a similar pattern of volatility, though with a generally positive trend over the period.

Economic Spread Ratio
The economic spread ratio began at 6.97% in 2020, representing a moderate return on invested capital above the cost of capital. A substantial increase was observed in 2021, reaching 18.98%, indicating a significantly improved profitability relative to invested capital. However, this was followed by a marked decrease to 3.37% in 2022, suggesting a considerable reduction in the margin by which returns exceeded the cost of capital. A slight recovery to 3.66% occurred in 2023, but the ratio experienced a strong resurgence in 2024, climbing to 10.10%. This final value suggests a return to a more robust economic spread.

Invested capital consistently increased throughout the period, rising from US$4,486,200 thousand in 2020 to US$7,798,800 thousand in 2024. This growth in invested capital occurred alongside the fluctuations in the economic spread ratio, influencing the absolute value of economic profit.

Economic Profit and Invested Capital Relationship
While invested capital steadily increased, economic profit did not follow a consistent upward trajectory. The peak in economic profit occurred in 2021 (US$857,693 thousand), coinciding with the highest economic spread ratio. The decline in economic profit to US$181,917 thousand in 2022 mirrored the drop in the economic spread ratio, despite the increase in invested capital. The subsequent increases in both economic profit and the economic spread ratio in 2023 and 2024 suggest a strengthening relationship between capital deployment and value creation.

The observed patterns suggest a sensitivity of profitability to factors impacting the economic spread. The company’s ability to maintain or improve this spread is crucial for generating value as it continues to expand its invested capital base.


Economic Profit Margin

Intuitive Surgical Inc., economic profit margin calculation, comparison to benchmarks

Microsoft Excel
Dec 31, 2024 Dec 31, 2023 Dec 31, 2022 Dec 31, 2021 Dec 31, 2020
Selected Financial Data (US$ in thousands)
Economic profit1
 
Revenue
Add: Increase (decrease) in deferred revenue
Adjusted revenue
Performance Ratio
Economic profit margin2
Benchmarks
Economic Profit Margin, Competitors3
Abbott Laboratories
Elevance Health Inc.
Medtronic PLC
UnitedHealth Group Inc.

Based on: 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), 10-K (reporting date: 2020-12-31).

1 Economic profit. See details »

2 2024 Calculation
Economic profit margin = 100 × Economic profit ÷ Adjusted revenue
= 100 × ÷ =

3 Click competitor name to see calculations.


The economic profit margin exhibited considerable fluctuation between 2020 and 2024. Initial values demonstrated growth, followed by a significant decline, and then a substantial recovery. A detailed examination of the trends is presented below.

Economic Profit Margin Trend
In 2020, the economic profit margin stood at 7.15%. This figure increased substantially to 14.94% in 2021, representing a period of strong economic profit generation relative to adjusted revenue. However, 2022 witnessed a marked decrease, with the margin falling to 2.91%. A modest recovery occurred in 2023, with the margin reaching 3.65%. The most recent year, 2024, showed a significant improvement, with the economic profit margin rising to 9.40%, indicating a return to more robust economic profitability.

The volatility in the economic profit margin suggests a sensitivity to changes in either economic profit or adjusted revenue, or both. The substantial increase in 2021, followed by the decline in 2022, warrants further investigation into the underlying drivers of these changes. The strong rebound observed in 2024 is a positive indicator, but continued monitoring is necessary to assess the sustainability of this trend.

Relationship to Economic Profit
The economic profit margin’s fluctuations correlate with the absolute values of economic profit. The peak in margin in 2021 aligns with the highest reported economic profit of US$857,693 thousand. Conversely, the lowest margin in 2022 corresponds with the lowest economic profit of US$181,917 thousand within the observed period. The substantial increase in both economic profit and margin in 2024 suggests a strong positive relationship between these two metrics.
Relationship to Adjusted Revenue
Adjusted revenue consistently increased throughout the period, from US$4,375,500 thousand in 2020 to US$8,383,300 thousand in 2024. However, revenue growth alone does not explain the margin fluctuations. The margin decrease in 2022 occurred despite increasing revenue, indicating that economic profit did not grow at the same rate as revenue during that year. The margin increase in 2024 occurred alongside continued revenue growth, suggesting that economic profit grew at a faster rate than revenue.