Stock Analysis on Net

Intuitive Surgical Inc. (NASDAQ:ISRG)

Price to FCFE (P/FCFE) 

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Free Cash Flow to Equity (FCFE)

Intuitive Surgical Inc., FCFE calculation

US$ in thousands

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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. 2,322,600 1,798,000 1,322,300 1,704,600 1,060,600
Net income attributable to noncontrolling interest in joint venture 14,900 19,300 22,100 23,500 6,200
Net noncash charges 996,800 774,100 765,500 729,400 691,200
Changes in operating assets and liabilities, net of effects of acquisitions (919,300) (777,600) (619,100) (368,100) (273,200)
Net cash provided by operating activities 2,415,000 1,813,800 1,490,800 2,089,400 1,484,800
Purchase of property, plant, and equipment (1,111,200) (1,064,200) (532,400) (339,500) (341,500)
Free cash flow to equity (FCFE) 1,303,800 749,600 958,400 1,749,900 1,143,300

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).


Net cash provided by operating activities

The net cash provided by operating activities exhibited a generally increasing trend over the observed period. Starting at approximately 1.48 billion US dollars in 2020, it rose significantly to about 2.09 billion in 2021. Subsequently, there was a decline to 1.49 billion in 2022, followed by a recovery to 1.81 billion in 2023. The most recent figure in 2024 showed a strong increase to around 2.42 billion US dollars, the highest in the reported years, indicating improved operational cash generation capacity over time with some volatility.

Free cash flow to equity (FCFE)

Free cash flow to equity demonstrated a more volatile trajectory throughout the period under review. It increased from approximately 1.14 billion US dollars in 2020 to a peak of nearly 1.75 billion in 2021, reflecting strong cash available to shareholders. However, this was followed by notable decreases in the next two years, falling to 958 million in 2022 and further down to 750 million in 2023. There was a partial recovery in 2024, where FCFE rose to approximately 1.3 billion US dollars, yet it remained below peak levels seen in 2021. The fluctuations suggest variability in capital expenditures, debt repayments, or other financing activities affecting the cash flow available to equity holders.


Price to FCFE Ratio, Current

Intuitive Surgical Inc., current P/FCFE calculation, comparison to benchmarks

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No. shares of common stock outstanding 358,476,506
Selected Financial Data (US$)
Free cash flow to equity (FCFE) (in thousands) 1,303,800
FCFE per share 3.64
Current share price (P) 446.13
Valuation Ratio
P/FCFE 122.66
Benchmarks
P/FCFE, Competitors1
Abbott Laboratories 38.48
Elevance Health Inc. 7.30
Medtronic PLC 16.77
UnitedHealth Group Inc. 9.13
P/FCFE, Sector
Health Care Equipment & Services 15.26
P/FCFE, Industry
Health Care 18.73

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

1 Click competitor name to see calculations.

If the company P/FCFE is lower then the P/FCFE of benchmark then company is relatively undervalued.
Otherwise, if the company P/FCFE is higher then the P/FCFE of benchmark then company is relatively overvalued.


Price to FCFE Ratio, Historical

Intuitive Surgical Inc., historical P/FCFE calculation, comparison to benchmarks

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Dec 31, 2024 Dec 31, 2023 Dec 31, 2022 Dec 31, 2021 Dec 31, 2020
No. shares of common stock outstanding1 356,656,964 352,325,863 350,389,679 357,744,031 353,154,894
Selected Financial Data (US$)
Free cash flow to equity (FCFE) (in thousands)2 1,303,800 749,600 958,400 1,749,900 1,143,300
FCFE per share3 3.66 2.13 2.74 4.89 3.24
Share price1, 4 571.88 378.22 245.27 285.60 262.70
Valuation Ratio
P/FCFE5 156.44 177.77 89.67 58.39 81.15
Benchmarks
P/FCFE, Competitors6
Abbott Laboratories 40.25 76.56 26.11 24.52 38.42
Elevance Health Inc. 8.26 16.04 14.26 11.07 7.75
Medtronic PLC 16.39 29.20 19.71 38.91 23.06
UnitedHealth Group Inc. 12.12 15.33 12.57 20.11 13.93
P/FCFE, Sector
Health Care Equipment & Services 17.78 22.95 16.47 22.14 18.61
P/FCFE, Industry
Health Care 19.35 18.18 18.40 17.94 17.51

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 Data adjusted for splits and stock dividends.

2 See details »

3 2024 Calculation
FCFE per share = FCFE ÷ No. shares of common stock outstanding
= 1,303,800,000 ÷ 356,656,964 = 3.66

4 Closing price as at the filing date of Intuitive Surgical Inc. Annual Report.

5 2024 Calculation
P/FCFE = Share price ÷ FCFE per share
= 571.88 ÷ 3.66 = 156.44

6 Click competitor name to see calculations.


The financial data reveals notable fluctuations in the market valuation and free cash flow to equity (FCFE) per share over the five-year period. The share price experienced an overall upward trend, increasing significantly from $262.7 at the end of 2020 to $571.88 by the end of 2024. The most prominent acceleration in share price growth occurred between 2022 and 2024, with the price rising from $245.27 to $571.88.

In contrast, the FCFE per share showed variability without a consistent upward or downward trajectory. After increasing from $3.24 in 2020 to a peak of $4.89 in 2021, it declined sharply to $2.74 in 2022 and further to $2.13 in 2023, before recovering somewhat to $3.66 in 2024. This pattern indicates periods of both growth and contraction in free cash flow generation relative to equity holders.

The price-to-FCFE (P/FCFE) ratio exhibits a pattern reflecting changes in market valuation relative to FCFE per share. After a decrease from 81.15 in 2020 to 58.39 in 2021, the ratio rose dramatically to 89.67 in 2022 and surged further to 177.77 in 2023, before slightly declining to 156.44 in 2024. This suggests that the market was pricing the stock at increasingly higher multiples of free cash flow despite the decrease in FCFE per share after 2021, indicating heightened investor optimism or expectations for future growth not yet realized in cash flow metrics.

Share Price Trend
Consistent growth with acceleration in recent years, particularly from 2022 onward.
FCFE per Share Pattern
Initial growth followed by decline and partial recovery; lacks steady upward trend.
P/FCFE Ratio Movement
Overall increase with volatility, reaching a peak in 2023 and remaining elevated in 2024.
Interpretation of Valuation
Market valuation appears to outpace actual cash flow growth, suggesting speculative or growth-driven price appreciation.