Intuitive Surgical Stock Falls About 7% After Hours Despite a Q3 Beat: Why a Narrower Forecast Spooked Investors

Intuitive Surgical, the company behind the da Vinci surgical robot, topped Wall Street's forecasts after the bell on Tuesday, Oct. 20. Investors sold the stock anyway, because what the company said about the rest of the year mattered more than what it did last quarter.

Shares fell about 7% in extended trading, Reuters reported. Investing.com put the drop at 7.3%, to $406, while Benzinga saw the stock down about 10.5% at one point. Here's what happened and why a small change in a forecast can move a big stock.

Why did Intuitive Surgical stock fall after earnings?

Intuitive Surgical stock fell about 7% after hours on Tuesday, Oct. 20, even though third-quarter profit and revenue beat estimates. Investors focused on a narrower 2026 forecast for da Vinci procedure growth, which removed the top of the prior range, and on a $450 million pre-tax charge tied to settling an antitrust lawsuit.

Procedure growth is the number investors watch most closely. Every da Vinci surgery uses instruments and accessories that hospitals buy again and again, so more procedures mean more repeat sales. The company kept its 14% to 15% growth range for worldwide da Vinci procedures but now expects to land near the midpoint. Its earlier range was 13.5% to 15.5%.

Management also pointed to policy factors that could weigh on patient volumes, including lower Affordable Care Act enrollment, changes to Medicaid eligibility and possible changes to the 340B drug-pricing program, according to Finimize.

What did Intuitive Surgical report for the third quarter?

On an adjusted basis, the quarter was strong. Intuitive earned $3.00 a share, above the $2.64 analysts expected, and revenue rose 22% to $3.05 billion, above the $2.91 billion estimate, according to LSEG data cited by Reuters.