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Document and Entity Information - USD ($) $ in Billions	12 Months Ended
Document and Entity Information - USD ($) $ in Billions	Dec. 31, 2018	Jan. 18, 2019	Jun. 30, 2018
Document Document And Entity Information [Abstract]
Entity Registrant Name	INTUITIVE SURGICAL INC
Entity Central Index Key	0001035267
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Document Type	10-K
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Trading Symbol	ISRG
Amendment Flag	false
Entity Common Stock, Shares Outstanding		114,488,602
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Public Float			$ 53.9

Consolidated Balance Sheets - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 857.9	$ 648.2
Short-term investments	2,205.2	1,312.4
Accounts receivable, net of allowances of $8.2 and $4.6 as of December 31, 2018, and 2017, respectively	682.3	507.9
Inventory	409.0	241.2
Prepaids and other current assets	178.8	99.2
Total current assets	4,333.2	2,808.9
Property, plant, and equipment, net	812.0	613.1
Long-term investments	1,771.3	1,885.9
Deferred tax assets	428.6	72.0
Intangible and other assets, net	261.0	195.8
Goodwill	240.6	201.1
Total assets	7,846.7	5,776.8
Current liabilities:
Accounts payable	100.7	82.5
Accrued compensation and employee benefits	193.8	167.6
Deferred revenue	294.3	243.8
Other accrued liabilities	231.8	168.9
Total current liabilities	820.6	662.8
Other long-term liabilities	338.6	333.6
Total liabilities	1,159.2	996.4
Commitments and contingencies (Note 7)
Stockholders’ equity:
Preferred stock, 2.5 shares authorized, $0.001 par value, issuable in series; no shares issued and outstanding as of December 31, 2018, and 2017	0.0	0.0
Common stock, 300.0 shares authorized, $0.001 par value, 114.5 shares and 112.3 shares issued and outstanding as of December 31, 2018, and 2017, respectively	0.1	0.1
Additional paid-in capital	5,170.3	4,679.2
Retained earnings	1,521.7	115.0
Accumulated other comprehensive loss	(13.3)	(15.5)
Total Intuitive Surgical, Inc. stockholders’ equity	6,678.8	4,778.8
Noncontrolling interest in joint venture	8.7	1.6
Total stockholders’ equity	6,687.5	4,780.4
Total liabilities and stockholders’ equity	$ 7,846.7	$ 5,776.8

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Allowance	$ 8.2	$ 4.6
Preferred stock, shares authorized	2,500,000.0	2,500,000.0
Preferred stock, par value (usd per share)	$ 0.001	$ 0.001
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, shares authorized	300,000,000.0	300,000,000.0
Common stock, par value (usd per share)	$ 0.001	$ 0.001
Common stock, shares issued	114,500,000	112,300,000
Common stock, shares outstanding	114,500,000	112,300,000

Consolidated Statements Of Income - USD ($) shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue:
Total revenue	$ 3,724.2	$ 3,138.2	$ 2,706.5
Cost of revenue:
Total cost of revenue	1,120.1	936.2	813.6
Gross profit	2,604.1	2,202.0	1,892.9
Operating expenses:
Selling, general and administrative	986.6	810.5	703.6
Research and development	418.1	328.6	239.6
Total operating expenses	1,404.7	1,139.1	943.2
Income from operations	1,199.4	1,062.9	949.7
Interest and other income, net	80.1	41.9	35.6
Income before taxes	1,279.5	1,104.8	985.3
Income tax expense	154.5	433.9	247.0
Net income	1,125.0	670.9	738.3
Less: net loss attributable to noncontrolling interest in joint venture	(2.9)	(0.4)
Net income attributable to Intuitive Surgical, Inc.	$ 1,127.9	$ 670.9	$ 738.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (usd per share)	$ 9.92	$ 6.01	$ 6.43
Diluted (usd per share)	$ 9.49	$ 5.77	$ 6.26
Shares used in computing net income per share attributable to Intuitive Surgical, Inc.:
Basic (shares)	113.7	111.7	114.9
Diluted (shares)	118.8	116.3	117.9
Total comprehensive income attributable to Intuitive Surgical, Inc.	$ 1,130.1	$ 664.3	$ 738.9
Joint venture
Operating expenses:
Less: net loss attributable to noncontrolling interest in joint venture	(2.9)	0.0	0.0
Product
Revenue:
Total revenue	3,089.1	2,565.3	2,195.8
Cost of revenue:
Total cost of revenue	906.2	756.3	662.6
Service
Revenue:
Total revenue	635.1	572.9	510.7
Cost of revenue:
Total cost of revenue	$ 213.9	$ 179.9	$ 151.0

Consolidated Statements Of Comprehensive Income - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement of Comprehensive Income [Abstract]
Net income attributable to Intuitive Surgical, Inc.	$ 1,127.9	$ 670.9	$ 738.3
Other comprehensive income (loss):
Change in foreign currency translation gains (losses)	(2.6)	3.6	2.0
Available-for-sale investments (net of tax):
Change in unrealized gains (losses)	0.3	(2.7)	(4.6)
Less: Reclassification adjustment for net losses on investments	1.2	0.0	0.2
Net change	1.5	(2.7)	(4.4)
Derivative instruments (net of tax):
Change in unrealized gains (losses)	3.6	(8.6)	4.1
Less: Reclassification adjustment for (gains) losses on derivative instruments	(1.0)	1.2	(0.6)
Net change	2.6	(7.4)	3.5
Employee benefit plans (net of tax):
Change in unrealized gains (losses)	0.4	(0.3)	(0.7)
Less: Reclassification adjustment for losses on employee benefit plans	0.3	0.2	0.2
Net change	0.7	(0.1)	(0.5)
Other comprehensive gains (losses)	2.2	(6.6)	0.6
Total comprehensive income attributable to Intuitive Surgical, Inc.	$ 1,130.1	$ 664.3	$ 738.9

Consolidated Statements Of Stockholders' Equity - USD ($)
shares in Millions, $ in Millions

Total

Common Stock

Additional Paid-In Capital

Retained Earnings

Accumulated Other Comprehensive Loss

Total Intuitive Surgical, Inc. Stockholders’ Equity

Noncontrolling Interest in Joint Venture

Beginning balances (shares) at Dec. 31, 2015

37.4

Beginning balance at Dec. 31, 2015

$ 4,319.5

$ 0.0

$ 3,429.8

$ 899.2

$ (9.5)

$ 4,319.5

$ 0.0

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Adoption of new accounting standard

^[1]

40.3

Issuance of common stock upon exercise of options and under stock purchase plan (shares)

1.5

Issuance of common stock through employee stock plans

580.9

Income tax benefit from employee stock plans

29.8

Shares withheld related to net share settlement of equity awards

(24.0)

(2.2)

(21.8)

(24.0)

Share-based compensation expense related to employee stock plans

177.6

Repurchase and retirement of common stock (shares)

(0.1)

Repurchase and retirement of common stock

(42.5)

(4.1)

(38.4)

(42.5)

Net income attributable to Intuitive Surgical, Inc.

738.3

Other comprehensive loss

0.6

Ending balances (shares) at Dec. 31, 2016

38.8

Beginning balance at Dec. 31, 2016

5,820.5

$ 0.0

4,211.8

1,617.6

(8.9)

5,820.5

0.0

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Three-for-one stock split (shares)

77.6

Three-for-one stock split

0.0

$ 0.1

(0.1)

Issuance of common stock upon exercise of options and under stock purchase plan (shares)

3.4

Issuance of common stock through employee stock plans

415.5

Shares withheld related to net share settlement of equity awards (shares)

(0.2)

Shares withheld related to net share settlement of equity awards

(56.6)

(5.1)

(51.5)

(56.6)

Share-based compensation expense related to employee stock plans

209.1

Repurchase and retirement of common stock (shares)

(7.3)

Repurchase and retirement of common stock

(2,274.0)

(152.0)

(2,122.0)

(2,274.0)

Net income attributable to Intuitive Surgical, Inc.

670.9

Other comprehensive loss

(6.6)

Capital contribution from noncontrolling interest

2.0

Loss in noncontrolling interest

$ (0.4)

(0.4)

Ending balances (shares) at Dec. 31, 2017

112.3

Beginning balance at Dec. 31, 2017

$ 4,780.4

$ 0.1

4,679.2

115.0

(15.5)

4,778.8

1.6

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Adoption of new accounting standard

^[1]

390.8

392.1

(1.3)

390.8

Issuance of common stock upon exercise of options and under stock purchase plan (shares)

2.5

Issuance of common stock through employee stock plans

236.6

Shares withheld related to net share settlement of equity awards (shares)

(0.3)

Shares withheld related to net share settlement of equity awards

(120.0)

(6.7)

(113.3)

(120.0)

Share-based compensation expense related to employee stock plans

261.2

Net income attributable to Intuitive Surgical, Inc.

1,127.9

Other Comprehensive Income (Loss), Including Cumulative Effect of New Accounting Principle in Period of Adoption, Net of Tax

^[1]

3.5

Other comprehensive loss

2.2

Capital contribution from noncontrolling interest

10.0

Loss in noncontrolling interest

$ (2.9)

(2.9)

Ending balances (shares) at Dec. 31, 2018

114.5

Beginning balance at Dec. 31, 2018

$ 6,687.5

$ 0.1

$ 5,170.3

$ 1,521.7

$ (13.3)

$ 6,678.8

$ 8.7

[1]	Represents the adjustments related to the adoption of new accounting standards. See Note 2 for details.

Consolidated Statements Of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement of Cash Flows [Abstract]
Net income	$ 1,125.0	$ 670.9	$ 738.3
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and loss on disposal of property, plant, and equipment, net	108.6	86.2	73.9
Amortization of intangible assets	14.2	12.9	18.2
Loss on investment, accretion of discounts, and amortization of premiums on investments, net	1.8	21.2	35.9
Deferred income taxes	31.9	60.2	20.9
Income tax benefits from employee stock plans	0.0	0.0	29.8
Share-based compensation expense	261.2	209.1	177.6
Amortization of contract acquisition asset	10.6	10.9	10.1
Changes in operating assets and liabilities, net of effects of acquisitions:
Accounts receivable	(161.3)	(81.4)	(34.2)
Inventory	(279.0)	(115.5)	(46.7)
Prepaids and other assets	(77.7)	(38.9)	(39.2)
Accounts payable	16.7	14.0	15.9
Accrued compensation and employee benefits	26.2	31.2	18.7
Deferred revenue	54.3	43.7	14.1
Other liabilities	37.1	219.4	53.7
Net cash provided by operating activities	1,169.6	1,143.9	1,087.0
Investing activities:
Purchase of investments	(2,581.9)	(1,995.0)	(2,585.5)
Proceeds from sales of investments	274.0	1,861.3	389.9
Proceeds from maturities of investments	1,533.6	703.1	970.1
Purchase of property, plant and equipment, and intellectual property	(187.4)	(190.7)	(53.9)
Acquisition of businesses, net of cash	87.9	0.0	0.0
Net cash provided by (used in) investing activities	(1,049.6)	378.7	(1,279.4)
Financing activities:
Proceeds from issuance of common stock relating to employee stock plans	236.6	415.5	580.9
Taxes paid related to net share settlement of equity awards	(120.0)	(56.6)	(24.0)
Repurchase common stock	0.0	(2,274.0)	(42.5)
Other financing activities	9.7	2.0	0.0
Net cash provided by (used in) financing activities	126.3	(1,913.1)	514.4
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	(0.1)	2.1	0.0
Net increase (decrease) in cash, cash equivalents, and restricted cash	246.2	(388.4)	322.0
Cash, cash equivalents, and restricted cash, beginning of year	663.2	1,051.6	729.6
Cash, cash equivalents, and restricted cash, end of year	$ 909.4	$ 663.2	$ 1,051.6

Description of the Business	12 Months Ended
Description of the Business	Dec. 31, 2018
Accounting Policies [Abstract]
Description of the Business	DESCRIPTION OF THE BUSINESS Intuitive Surgical, Inc. (“Intuitive” or the “Company”) develops, manufactures, and markets the da Vinci^® Surgical 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, a high-performance vision system, and proprietary instruments and accessories.

Summary Of Significant Accounting Policies

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Summary Of Significant Accounting Policies

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Basis of Presentation

The accompanying Consolidated Financial Statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its wholly- and majority-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

The Consolidated Financial Statements include the results and the balances of the Company’s majority-owned joint venture (“Joint Venture”) with Shanghai Fosun Pharmaceutical (Group) Co., Ltd. (“Fosun Pharma”). Chindex Medical Limited (“Chindex”), a subsidiary of Fosun Pharma, has been its distribution partner for da Vinci Surgical Systems in China. 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 Consolidated Statements of Income for the year ended December 31, 2018, while the amount was inconsequential for the year ended December 31, 2017, and was included as a component of interest and other income, net in the Consolidated Statements of Income.

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the Consolidated Financial Statements and accompanying Notes to the Consolidated Financial Statements. The accounting estimates that require management’s most significant, difficult, and subjective judgments include the valuation and recognition of investments, the valuation of revenue and allowance for sales returns and doubtful accounts, the estimation of hedging transactions, the valuation of inventory, the valuation of and assessment of recoverability of intangible assets and their estimated useful lives, revenue recognition, the valuation and recognition of share-based compensation, the recognition and measurement of current and deferred income tax assets, along with the assessment of recoverability, and liabilities, and legal contingencies estimates. Actual results could differ materially from these estimates.

Concentrations of Credit Risk and Other Risks and Uncertainties

The carrying amounts for financial instruments consisting of cash and cash equivalents, accounts receivable, accounts payable, and accrued liabilities approximate fair value due to their short maturities. Marketable securities and derivative instruments are stated at their estimated fair values, based on quoted market prices for the same or similar instruments. The counterparties to the agreements relating to the Company’s investment securities and derivative instruments consist of various major corporations, financial institutions, municipalities, and government agencies of high credit standing.

The Company’s accounts receivable are derived from net revenue to customers and distributors located throughout the world. The Company performs credit evaluations of its customers’ financial condition and, generally, requires no collateral from its customers. The Company provides reserves for potential credit losses but has not experienced significant losses to date. As of December 31, 2018, and 2017, 71% and 69%, respectively, of accounts receivable were from domestic customers. No single customer represented more than 10% of total revenue for the years ended December 31, 2018, 2017, and 2016.

During the years ended December 31, 2018, 2017, and 2016, domestic revenue accounted for 71%, 73%, and 72% of total revenue, respectively, while outside of the U.S. revenue accounted for 29%, 27%, and 28%, respectively, of total revenue for each of the years then ended.

Cash and Cash Equivalents

The Company considers all highly liquid investments with an original maturity from date of purchase of 90 days or less to be cash equivalents.

Investments

Available-for-sale investments. The Company’s investments may consist of U.S. treasury and U.S. government agency securities, taxable and tax exempt municipal notes, corporate notes and bonds, commercial paper, non-U.S. government agency securities, and money market funds. The Company has designated all investments as available-for-sale and, therefore, such investments are reported at fair value, with unrealized gains and losses recorded in accumulated other comprehensive income (loss). For securities sold prior to maturity, the cost of securities sold is based on the specific identification method. Realized gains and losses on the sale of investments are recorded in interest and other income, net in the Consolidated Statements of Income. Investments with remaining maturities at date of purchase greater than approximately three months and remaining maturities as of the reporting period less than one year are classified as short-term investments. Investments with remaining maturities greater than one year are classified as long-term investments.

Other-than-temporary impairment. All of the Company’s investments are subject to a periodic impairment review. The Company recognizes an impairment charge when a decline in the fair value of its investments below the cost basis is judged to be other-than-temporary. Factors considered in determining whether a loss is temporary included the extent and length of time the investment’s fair value has been lower than its cost basis, the financial condition and near-term prospects of the investee, extent of the loss related to credit of the issuer, the expected cash flows from the security, the Company’s intent to sell the security, and whether or not the Company will be required to sell the security prior to the expected recovery of the investment’s amortized cost basis. No significant charges were recorded during the years ended December 31, 2018, 2017, and 2016.

Fair Value Measurements

The Company measures the fair value of money market funds and certain U.S. treasury securities based on quoted prices in active markets for identical assets as Level 1 securities. Marketable securities measured at fair value using Level 2 inputs are primarily comprised of commercial paper, corporate notes and bonds, U.S. and non-U.S. government agencies, and municipal notes. The Company reviews trading activity and pricing for these investments as of the measurement date. When sufficient quoted pricing for identical securities is not available, the Company uses market pricing and other observable market inputs for similar securities obtained from various third-party data providers. These inputs either represent quoted prices for similar assets in active markets or have been derived from observable market data. This approach results in the Level 2 classification of these securities within the fair value hierarchy.

Inventory

Inventory is stated at the lower of standard cost, which approximates actual costs, or net realizable value, on a first-in, first-out basis. Inventory costs include direct materials, direct labor, and normal manufacturing overhead. The cost basis of the Company’s inventory is reduced for any products that are considered excessive or obsolete based upon assumptions about future demand and market conditions.

Property, Plant, and Equipment

Property, plant, and equipment are stated at cost, net of accumulated depreciation. Depreciation is computed on a straight-line basis over the estimated useful lives of the assets generally as follows:



	Useful Lives
Building	Up to 30 years
Building improvements	Up to 15 years
Leasehold improvements	Lesser of useful life or term of lease
Equipment and furniture	5 years
Operating lease assets	Greater of lease term or 1 to 5 years
Computer and office equipment	3 years
Enterprise-wide software	5 years
Purchased software	Lesser of 3 years or life of license

Depreciation expense for the years ended December 31, 2018, 2017, and 2016, was $105.9 million, $82.1 million, and $70.7 million, respectively.

Capitalized Software Costs for Internal Use

Internally developed software primarily includes enterprise-level business software that the Company customizes to meet its specific operational needs. The Company capitalized costs for internal use software of $17.4 million, $22.4 million, and $11.8 million during the years ended December 31, 2018, 2017, and 2016, respectively. Upon being placed in service, these costs are depreciated over an estimated useful life of up to 5 years.

Business Combinations

The Company includes the results of operations of the businesses that are acquired as of the acquisition date. The Company allocates the purchase price of acquisitions to the assets acquired and liabilities assumed based on the estimated fair values. The excess of the purchase price over the fair values of the identifiable assets and liabilities is recorded as goodwill. Acquisition related costs are recognized separately from the business combination and are expensed as incurred.

Goodwill and Intangible Assets

Goodwill and intangible assets with indefinite useful lives are not amortized, but are tested for impairment at least annually during the fourth fiscal quarter, or if circumstances indicate their value may no longer be recoverable. Goodwill represents the excess of the purchase price over the fair value of net identifiable assets and liabilities. The Company continues to operate in one segment, which is considered to be the sole reporting unit and, therefore, goodwill was tested for impairment at the enterprise level. As of December 31, 2018, there has been no impairment of goodwill.

Intangible assets are carried at cost, net of accumulated amortization. The Company does not have intangible assets with indefinite useful lives other than goodwill. Amortization is recorded on a straight-line basis over the intangible assets’ useful lives, which range from approximately 1 to 9 years.

Impairment of Long-lived Assets

The Company evaluates long-lived assets, which include amortizable intangible and tangible assets, for impairment whenever events or changes in circumstances indicate that the carrying value of long-lived assets may not be recoverable. Recoverability is measured by comparing the net book value to the future undiscounted cash flows attributable to such assets. The Company recognizes an impairment charge equal to the amount by which the net book value exceeds its fair value. No material impairment losses were incurred in the periods presented.

Revenue Recognition

The Company adopted ASC Topic 606, Revenue from Contracts with Customers, on January 1, 2018. The Company’s revenue consists of product revenue resulting from the sale of systems, system components, instruments and accessories, and service revenue. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and its customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company’s revenues are measured based on the consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities.

The Company’s system sale arrangements generally contain multiple products and services. For these bundled sale arrangements, the Company accounts for individual products and services as separate performance obligations if they are a distinct product or service that is separately identifiable from other items in bundled packages; and if a customer can benefit from the product or service on its own or with other resources that are readily available to the customer. The Company’s system sale arrangements include a combination of the following performance obligations: system(s); system components; system accessories; instruments; accessories; and system service. The Company’s system sale arrangements generally include a five-year period of service. The first year of service is generally free and included in the system sale arrangement and the remaining four years are generally included at a stated service price. The Company considers the service terms in the arrangements that are legally enforceable to be performance obligations. Other than service, the Company generally satisfies all of the performance obligations up-front. System components, system accessories, instruments, accessories, and service are also sold on a stand-alone basis.

The Company recognizes revenue as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations at the following points in time:

System sales. For systems (including system components and system accessories) sold directly to end customers, revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For systems sold through distributors, revenue is recognized generally at the time of shipment. The Company’s system arrangements generally do not provide a right of return. The systems are generally covered by a one-year warranty. Warranty costs were not material for the periods presented.

Instruments and accessories. Revenue from sales of instruments and accessories is recognized when control is transferred to the customers, which generally occurs at the time of shipment, but also occurs at the time of delivery depending on the customer arrangement. The Company allows its customers in the normal course of business to return unused products for a limited period of time subsequent to initial purchase and records an allowance against revenue for estimated returns.

Service. Service revenue is recognized over the term of the service period as the customer benefits from the services throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed.

The Company offers its customers the opportunity to trade in their older systems for a credit towards the purchase of a newer generation system. The Company generally does not provide specified price trade-in rights or upgrade rights at the time of system purchase. Such trade-in or upgrade transactions are separately negotiated based on the circumstances at the time of the trade-in or upgrade, based on the then fair value of the system, and are generally not based on any pre-existing rights granted by the Company. Accordingly, such trade-ins and upgrades are not considered as separate performance obligations in the arrangement for a system sale.

As part of a trade-in transaction, the customer receives a new generation system in exchange for its pre-owned system. The trade-in credit is negotiated at the time of the trade-in and is applied towards the purchase price of the new unit. Traded-in systems generally can be reconditioned and resold. The Company accounts for the fair value of the traded-in system in the total consideration in the arrangement by including the net realizable value of the traded-in system less a normal profit margin. The value of the traded-in system is determined as the amount, after reconditioning costs are added, that will allow a normal profit margin on the sale of the reconditioned unit to be generated. When there is no market for the traded-in units, no value is assigned. Traded-in units are reported as a component of inventory until resold, or otherwise disposed.

In addition, customers may also have the opportunity to upgrade their systems at a price determined at the time of the upgrade, for example, by adding a second surgeon console for use with the da Vinci Surgical System. Such upgrades are performed by completing component level upgrades at the customer’s site. Upgrade revenue is recognized when the component level upgrades are complete and all revenue recognition criteria are met.

For multiple-element arrangements, revenue is allocated to each performance obligation based on its relative standalone selling price. Standalone selling prices are based on observable prices at which the Company separately sells the products or services. If a standalone selling price is not directly observable, then the Company estimates the standalone selling price considering market conditions and entity-specific factors including, but not limited to, features and functionality of the products and services, geographies, and type of customer. The Company regularly reviews standalone selling prices and updates these estimates as necessary.

The following table presents revenue disaggregated by types and geography (in millions):



	Years Ended December 31,
U.S.	2018		2017		2016
Instruments and accessories	$	1,485.2	$	1,263.1	$	1,077.3
Systems	692.2		603.5		501.3
Services	456.1		419.2		377.8
Total U.S. revenue	$	2,633.5	$	2,285.8	$	1,956.4

Outside of U.S. (“OUS”)
Instruments and accessories	$	476.8	$	373.8	$	318.5
Systems	434.9		324.9		298.7
Services	179.0		153.7		132.9
Total OUS revenue	$	1,090.7	$	852.4	$	750.1

Total
Instruments and accessories	$	1,962.0	$	1,636.9	$	1,395.8
Systems	1,127.1		928.4		800.0
Services	635.1		572.9		510.7
Total revenue	$	3,724.2	$	3,138.2	$	2,706.5

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 this amount relates to performance obligations in the Company’s service contracts that will be satisfied and recognized as revenue in future periods. Transaction price allocated to remaining performance obligations was approximately $1,448.7 million as of December 31, 2018.

The following information summarizes the Company’s contract assets and liabilities (in millions):



	As of
	December 31, 2018		December 31, 2017
Contract assets	$	12.4	$	8.3
Deferred revenue	$	327.3	$	268.6

The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 days from 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 year ended December 31, 2018, the Company recognized $268.9 million of revenue that was included in the deferred revenue balance as of December 31, 2017. During the year ended December 31, 2017, the Company recognized $225.5 million of revenue that was included in the deferred revenue balance as of December 31, 2016.

Assets Recognized from the Costs to Obtain a Contract with a Customer

The Company has determined that certain sales incentives provided to the Company’s sales team are required to be capitalized when the Company expects to generate future economic benefits from the related revenue-generating contracts subsequent to the initial capital sales transaction. When determining the economic life of the contract acquisition assets recognized, the Company considers historical service renewal rates, expectations of future customer renewals of service contracts, and other factors that could impact the economic benefits that the Company expects to generate from the relationship with its customers. The costs capitalized as contract acquisition costs included in intangible and other assets, net in the Consolidated Balance Sheets were $34.2 million and $31.4 million as of December 31, 2018, and 2017, respectively. The Company did not incur any impairment losses during the periods presented.

Leases

The Company enters into sales-type lease and operating lease arrangements with certain qualified customers. 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. Revenue related to multiple-element arrangements are allocated to lease and non-lease elements based on their relative standalone selling prices as prescribed by the Company’s revenue recognition policy. Lease elements generally include a da Vinci Surgical System or system component, while non-lease elements generally include service, instruments and accessories. In determining whether a transaction should be classified as a sales-type or operating lease, the Company considers the following terms: (1) whether title of the system transfers automatically or for a nominal fee at the end of the term of the lease, (2) whether the present value of the minimum lease payments are equal to or greater than 90% of the fair market value of the leased asset at the inception of the lease, (3) whether the lease term exceeds 75% of the economic life of the leased asset, and (4) whether there is an option to purchase the leased asset at a “bargain price” at the end of the lease term.

The Company generally recognizes revenue from sales-type lease arrangements at the time the system is accepted by the customer, assuming all other revenue recognition criteria have been met. Revenue from sales-type leases is presented as product revenue. Revenue from operating lease arrangements is recognized as earned over the lease term, which is generally on a straight-line basis and is presented as product revenue. Operating lease revenue for the years ended December 31, 2018, 2017, and 2016, was $51.4 million, $25.9 million, and $16.6 million, respectively.

Allowance for Sales Returns and Doubtful Accounts

The allowance for sales returns is based on the Company’s estimates of potential future returns of certain products and other allowances related to current period product revenue. The Company analyzes historical returns, current economic trends, and changes in customer demand and acceptance of the Company’s products. The allowance for doubtful accounts is based on the Company’s assessment of the collectability of customer accounts. The Company regularly reviews the allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay.

Share-Based Compensation

The Company accounts for share-based employee compensation plans using the fair value recognition and measurement provisions under U.S. GAAP. The Company’s share-based compensation cost is measured at the grant date, based on the fair value of the award, and is recognized as expense on a straight-line basis over the requisite service period. The Company estimates expected forfeitures at the time of grant and revises, if necessary, in subsequent periods if actual forfeitures differ from those estimated.

Expected Term: The expected term represents the weighted-average period that the stock options are expected to be outstanding prior to being exercised. The Company determines expected term based on historical exercise patterns and its expectation of the time it will take for employees to exercise options still outstanding.

Expected Volatility: The Company uses market-based implied volatility for purposes of valuing stock options granted. Market-based implied volatility is derived based on at least one-year traded options on the Company’s common stock. The extent to which the Company relies on market-based volatility when valuing options, depend among other things, on the availability of traded options on the Company’s stock and the term of such options. Due to sufficient volume of the traded options, the Company used 100% market-based implied volatility to value options granted, which the Company believes is more representative of future stock price trends than historical volatility.

Risk-Free Interest Rate: The risk-free interest rate is based on the U.S. treasury yield curve in effect at the time of grant for the expected term of the stock option.

The fair value of restricted stock units is determined based on the closing quoted price of the Company’s common stock on the day of the grant. See “Note 9. Share-Based Compensation,” for a detailed discussion of the Company’s stock plans and share-based compensation expense.

Computation of Net Income per Share

Basic net income per share attributable to Intuitive Surgical, Inc. is computed using the weighted average number of shares outstanding during the period. Diluted net income per share attributable to Intuitive Surgical, Inc. is computed using the weighted average number of the Company’s shares and dilutive potential shares outstanding during the period. Dilutive potential shares primarily consist of employee stock options, restricted stock units, and shares to be purchased by employees under the Company’s employee stock purchase plan.

U.S. GAAP requires that employee equity share options, non-vested shares, and similar equity instruments granted by the Company be treated as potential common shares outstanding in computing diluted earnings per share. Diluted shares outstanding include the dilutive effect of equity awards, which is calculated based on the average share price for each fiscal period using the treasury stock method. Under the treasury stock method, the amount the employee must pay for exercising stock options and the amount of compensation cost for future service that the Company has not yet recognized are assumed to be used to repurchase shares.

Research and Development Expenses

Research and development costs are expensed as incurred and include amortization of intangible assets, costs associated with co-development research and development licensing arrangements, costs of prototypes, salaries, benefits and other headcount related costs, contract and other outside service fees, and facilities and overhead costs.

Foreign Currency and Other Hedging Instruments

For subsidiaries whose local currency is their functional currency, their assets and liabilities are translated into U.S. dollars at exchange rates at the balance sheet date and revenues and expenses are translated using average exchange rates in effect during the period. Gains and losses from foreign currency translation are included in accumulated other comprehensive income (loss) within stockholders’ equity in the Consolidated Balance Sheets. For all non-functional currency account balances, the re-measurement of such balances to the functional currency results in either a foreign exchange gain or loss, which is recorded to interest and other income, net in the Consolidated Statements of Income in the same accounting period that the re-measurement occurred.

The Company uses derivatives to partially offset its business exposure to foreign currency exchange risk. The terms of the Company’s derivative contracts are generally twelve months or shorter. The Company typically hedges portions of its forecasted foreign currency exposure associated with revenue and expenses. The Company may also enter into foreign currency forward contracts to offset the foreign currency exchange gains and losses generated by re-measurement of certain assets and liabilities denominated in non-functional currencies. The hedging program is not designated for trading or speculative purposes.

The Company’s accounting policies for these instruments are based on whether the instruments are designated as hedge or non-hedge instruments. The Company records all derivatives on the Consolidated Balance Sheets at fair value. The effective portions of cash flow hedges are recorded in other comprehensive income (loss) (“OCI”) until the hedged item is recognized in earnings. Derivative instruments designated as cash flow hedges are de-designated as hedges when it is probable the forecasted hedged transaction will not occur in the initially identified time period or within a subsequent two month time period. Gains and losses in OCI associated with such derivative instruments are reclassified immediately into earnings through interest and other income, net. Any subsequent changes in fair value of such derivative instruments also are reflected in current earnings.

Derivatives that are not designated as hedging instruments and the ineffective portions of cash flow hedges are adjusted to fair value through earnings in interest and other income, net.

Income Taxes

Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the year in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts that are expected more likely than not to be realized in the future. The Company has elected to account for Global Intangible Low-Taxed Income (“GILTI”) under the Tax Cuts and Jobs Act (“2017 Tax Act”) as period costs when incurred.

The Company recognizes tax benefits from uncertain tax positions only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the financial statements from such positions are then measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement.

Segments

The Company operates in one segment. Management uses one measurement of profitability and does not segregate its business for internal reporting. As of December 31, 2018, and 2017, 88% and 88% of long-lived assets were in the United States, respectively. Revenue is attributed to a geographic region based on the location of the end customer.

Legal Contingencies

The Company is involved in a number of legal proceedings involving product liability, intellectual property, shareholder derivative actions, securities class actions, and other matters. A liability and related charge are recorded to earnings in the Company’s consolidated 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 discussion with outside legal counsel. If a reasonable estimate of a known or probable loss cannot be made, but a range of probable losses can be estimated, the low-end of the range of losses is recognized if no amount within the range is a better estimate than any other. If a material loss is reasonably possible, but not probable and can be reasonably estimated, the estimated loss or range of loss is disclosed in the notes to the consolidated financial statements. The Company expenses legal fees as incurred.

When determining the estimated probable loss or range of losses, significant judgment is required to be exercised in order to estimate the amount and timing of the loss to be recorded. Estimates of probable losses resulting from litigation are inherently difficult to make, particularly when the matters are in early procedural stages with incomplete facts and information. The final outcome of legal proceedings is dependent on many variables difficult to predict and, therefore, the ultimate cost to entirely resolve such matters may be materially different than the amount of current estimates. Consequently, new information or changes in judgments and estimates could have a material adverse effect on the Company’s business, financial condition, and results of operations or cash flows.

Adopted Accounting Pronouncements

Revenue from Contracts with Customers

The Company adopted FASB Accounting Standards Codification Topic 606 (“ASC 606”), Revenue from Contracts with Customers in the first quarter of the Company’s fiscal year that began on January 1, 2018, using the full retrospective method, which required the Company to restate each prior reporting period presented. This new standard replaced the previous revenue recognition guidance in U.S. GAAP. Please see the Company’s “Revenue Recognition” policy in the “Significant Accounting Policies” section above.

The areas impacted include future contractual billings related to services included in the Company’s multi-year contracts, which are considered performance obligations that should be part of the contract consideration allocated to all performance obligations rather than being excluded due to its contingent nature as required under the previous revenue standard. Accordingly, the amount of contract consideration allocated to the performance obligations identified in the Company’s system arrangements is different from the amounts allocated under the previous revenue standard. In general, revenue is recognized earlier as a greater amount of the contract consideration is allocated to the product-related performance obligations that generally are delivered upfront, and therefore, less consideration is allocated to the service performance obligation that is generally recognized over the service period.

In addition, the Company recognized an asset associated with the incremental costs of obtaining revenue generating customer contracts that it expects to benefit from over a period longer than one year. The Company capitalized sales commissions paid in connection with system sale arrangements that include multi-year service obligations and is amortizing such asset over the economic life of those contracts. Previously, sales commissions were expensed as incurred. The impact of this change on operating expenses in any given period will depend, in part, on the amount of such commissions incurred and capitalized in relation to the amount of ongoing amortization expense.

Adoption of the standard using the full retrospective method also require the Company to restate certain previously reported results, including the impact to provision for income taxes. The adjustments to the Consolidated Statements of Comprehensive Income are as follows (in millions, except per share amounts):



	Fiscal 2017							Fiscal 2016
	As Previously Reported		Adjustments			As Restated		As Previously Reported		Adjustments			As Restated
Revenue:
Product	$	2,547.1	$	18.2		$	2,565.3	$	2,187.4	$	8.4		$	2,195.8
Service	581.8		(8.9		)	572.9		517.0		(6.3		)	510.7
Total revenue	3,128.9		9.3			3,138.2		2,704.4		2.1			2,706.5
Cost of revenue:
Product	754.9		1.4			756.3		663.3		(0.7		)	662.6
Service	179.9		—			179.9		151.0		—			151.0
Total cost of revenue	934.8		1.4			936.2		814.3		(0.7		)	813.6
Gross profit	2,194.1		7.9			2,202.0		1,890.1		2.8			1,892.9
Operating expenses:
Selling, general and administrative	810.9		(0.4		)	810.5		705.3		(1.7		)	703.6
Research and development	328.6		—			328.6		239.6		—			239.6
Total operating expenses	1,139.5		(0.4		)	1,139.1		944.9		(1.7		)	943.2
Income from operations	1,054.6		8.3			1,062.9		945.2		4.5			949.7
Interest and other income, net	41.9		—			41.9		35.6		—			35.6
Income before taxes	1,096.5		8.3			1,104.8		980.8		4.5			985.3
Income tax expense	436.5		(2.6		)	433.9		244.9		2.1			247.0
Net income attributable to Intuitive Surgical, Inc.	$	660.0	$	10.9		$	670.9	$	735.9	$	2.4		$	738.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic	$	5.91	$	0.10		$	6.01	$	6.40	$	0.03		$	6.43
Diluted	$	5.67	$	0.10		$	5.77	$	6.24	$	0.02		$	6.26
Total comprehensive income attributable to Intuitive Surgical, Inc.	$	653.4	$	10.9		$	664.3	$	736.5	$	2.4		$	738.9

The adjustments to the Consolidated Statement of Financial Position are as follows (in millions):



	December 31, 2017
	As Previously Reported		Adjustments			As Restated
ASSETS
Accounts receivable, net	$	511.9	$	(4.0	)	$	507.9
Prepaids and other current assets	$	97.2	$	2.0		$	99.2
Deferred tax assets	$	87.3	$	(15.3	)	$	72.0
Intangible and other assets, net	$	159.7	$	36.1		$	195.8

LIABILITIES AND STOCKHOLDERS’ EQUITY
Deferred revenue	$	284.5	$	(40.7	)	$	243.8
Other accrued liabilities	$	169.5	$	(0.6	)	$	168.9
Other long-term liabilities	$	327.1	$	6.5		$	333.6
Retained earnings	$	61.4	$	53.6		$	115.0

In addition, the cumulative effect of ASC 606 to the Company’s retained earnings at January 1, 2016, was $40.3 million. Adoption of the standard had no impact to total net cash from or used in operating, investing, or financing activities within the consolidated statements of cash flows.

As part of the Company’s adoption of ASC 606, the Company elected to use the following practical expedients: (i) to exclude disclosures of transaction prices allocated to remaining performance obligations when the Company expects to recognize such revenue for all periods prior to the date of initial application of ASC 606; (ii) not to adjust the promised amount of consideration for the effects of a significant financing component when the Company expects, at contract inception, that the period between the Company’s transfer of a promised product or service to a customer and when the customer pays for that product or service will be one year or less; (iii) to expense costs as incurred for costs to obtain a contract when the amortization period would have been one year or less; (iv) not to recast revenue for contracts that begin and end in the same fiscal year; and (v) not to assess whether promised goods or services are performance obligations if they are immaterial in the context of the contract with the customer.

Intra-Entity Transfer of Assets Other than Inventory

Beginning fiscal 2018, the Company adopted ASU 2016-16, Income Taxes (Topic 740): Intra-Entity Transfer of Assets Other than Inventory, which requires the recognition of the income tax consequences of an intra-entity transfer of an asset, other than inventory, when the transfer occurs. The Company adopted this standard using the modified retrospective approach, and as a result, recorded a deferred tax asset with a corresponding cumulative adjustment to retained earnings of $390.8 million as of January 1, 2018, associated with an intra-entity transfer of certain intellectual property rights related to the Company’s non-U.S. business to its Swiss entity.

Business Combinations: Clarifying the Definition of a Business

Beginning fiscal 2018, the Company adopted ASU 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business, which clarifies the definition of a business to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses, and applied the new guidance prospectively. Refer to “Note 6. Goodwill and Intangible Assets” for further information on acquisitions accounted for as business combinations during fiscal 2018.

Statement of Cash Flows: Restricted Cash

Beginning fiscal 2018, the Company adopted ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash, which requires the statement of cash flows to explain the change during the period relating to total cash, cash equivalents, and restricted cash. The Company adopted this standard using the retrospective transition method by restating its Consolidated Statements of Cash Flows to include restricted cash of $15.0 million in the beginning and ending cash, cash equivalents, and restricted cash balances for 2017 and 2016. Net cash flows for 2017 and 2016 did not change as a result of including restricted cash with cash and cash equivalents when reconciling the beginning-of-period and end-of-period amounts presented on the statements of cash flows. As of December 31, 2018, the cash, cash equivalents, and restricted cash balance includes restricted cash of $51.5 million. Restricted cash was included in prepaids and other current assets and intangible and other assets, net on the Consolidated Balance Sheets.

Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income

In 2018, the Company elected to early adopt ASU 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income, which allows a reclassification from accumulated other comprehensive income (loss) to retained earnings for stranded tax effects resulting from the 2017 Tax Act. The Company elected to reclassify such tax effects in the period of adoption and resulted in the reclassification of $1.3 million from accumulated other comprehensive loss to retained earnings.

Disclosure Framework for Fair Value Measurement

In 2018, the Company elected to early adopt ASU No. 2018-13, Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurement (“ASU 2018-13”), which amends ASC 820, Fair Value Measurement. ASU 2018-13 modified the disclosure requirements for fair value measurements by removing, modifying, and adding certain disclosures. The adoption did not have a material impact on the Consolidated Financial Statements.

Improvements to Employee Share-based Payment Accounting

In 2017, the Company adopted ASU No. 2016-09, Improvements to Employee Share-based Payment Accounting (“ASU 2016-09”), which changes among other things, how the tax effects of share-based awards are recognized. ASU 2016-09 requires excess tax benefits and tax deficiencies to be recognized in the provision for income taxes as discrete items in the period when the awards vest or are settled, whereas previously such income tax effects were generally recorded as part of additional paid-in capital. The provision for income taxes for the years ended December 31, 2018, and 2017, included excess tax benefits associated with employee equity plans of $116.2 million and $102.8 million, respectively, which reduced the Company’s effective tax rate by 9.1 and 9.3 percentage points, respectively, for the years ended December 31, 2018, and 2017. This ASU also eliminates the requirement to reclassify cash flows related to excess tax benefits from operating activities to financing activities on the Consolidated Statements of Cash Flows. In 2017, the Company adopted this provision retrospectively by reclassifying $44.1 million of excess tax benefits from financing activities to operating activities for the year ended December 31, 2016.

Recent Accounting Pronouncements Not Yet Adopted

Leases (Topic 842)

In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2016-02, Leases (Topic 842) (“ASU 842”), which amends the existing accounting standards for leases. The new standard requires lessees to record a right-of-use (“ROU”) asset and a corresponding lease liability on the balance sheet (with the exception of short-term leases), whereas under current accounting standards, the Company’s lease portfolio consists of operating leases and is not recognized on its consolidated balance sheets. The new standard also requires expanded disclosures regarding leasing arrangements. The new standard is effective for the Company beginning January 1, 2019. In July 2018, the FASB issued ASU No. 2018-11, Leases (Topic 842): Targeted Improvements, which provides an alternative modified transition method. Under this method, the cumulative-effect adjustment to the opening balance of retained earnings is recognized on the date of adoption with prior periods not restated.

The new standard provides a number of optional practical expedients in transition. The Company expects to elect: (1) the ‘package of practical expedients’, which permits it not to reassess under the new standard its prior conclusions about lease identification, lease classification, and initial direct costs; (2) the use-of-hindsight; and (3) the practical expedient pertaining to land easements. In addition, the new standard provides practical expedients for an entity’s ongoing accounting that the Company anticipates making, such as the (1) the election for certain classes of underlying asset to not separate non-lease components from lease components and (2) the election for short-term lease recognition exemption for all leases that qualify.

The Company will adopt ASU 842 as of January 1, 2019, using the alternative modified transition method. In preparation of adopting ASC 842, the Company is implementing additional internal controls to enable future preparation of financial information in accordance with ASC 842. The Company has also substantially completed its evaluation of the impact on the Company’s lease portfolio. The Company believes the largest impact will be on the consolidated balance sheets for the accounting of facilities-related leases, which represents a majority of its operating leases it has entered into as a lessee. These leases will be recognized under the new standard as ROU assets and operating lease liabilities. The Company will also be required to provide expanded disclosures for its leasing arrangements. As of December 31, 2018, the Company had $95.4 million of undiscounted future minimum operating lease commitments that are not recognized on its consolidated balance sheets as determined under the current standard. For a lessee, the results of operations are not expected to significantly change after adoption of the new standard.

In addition, the Company’s customers finance purchases of da Vinci systems and ancillary products, including directly with the Company as the lessor. For a lessor, the new standard applied is largely unchanged from the previous standard and the Company does not anticipate a material impact on its Consolidated Financial Statements.

While substantially complete, the Company is still in the process of finalizing its evaluation of the effect of ASU 842 on the Company’s financial statements and disclosures. The Company will finalize its accounting assessment and quantitative impact of the adoption during the first quarter of fiscal year 2019. As the Company completes its evaluation of this new standard, new information may arise that could change the Company’s current understanding of the impact to leases. Additionally, the Company will continue to monitor industry activities and any additional guidance provided by regulators, standards setters, or the accounting profession, and adjust the Company’s assessment and implementation plans accordingly.

Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract

In August 2018, the FASB issued ASU No. 2018-15, Intangibles (Topic 350): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract, which aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. This new standard also requires customers to expense the capitalized implementation costs of a hosting arrangement that is a service contract over the term of the hosting arrangement. This new standard becomes effective for the Company in the first quarter of fiscal year 2020, with early adoption permitted. This new standard can be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. The Company is currently evaluating the impact and timing of adopting this new standard on its Consolidated Financial Statements.

Financial Instruments

12 Months Ended

Dec. 31, 2018

Fair Value Disclosures [Abstract]

Financial Instruments

FINANCIAL INSTRUMENTS

Cash, Cash Equivalents, and Investments

The following tables summarize the Company’s cash and available-for-sale marketable securities’ amortized cost, gross unrealized gains, gross unrealized losses, and fair value by significant investment category reported as cash and cash equivalents or short-term or long-term investments as of December 31, 2018, and 2017 (in millions):



										Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses			Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2018
Cash	$	269.4	$	—	$	—		$	269.4	$	269.4	$	—	$	—
Level 1:
Money market funds	569.1		—		—			569.1		569.1		—		—
U.S. treasuries	1,477.8		1.7		(5.3		)	1,474.2		10.0		897.8		566.4
Subtotal	2,046.9		1.7		(5.3		)	2,043.3		579.1		897.8		566.4
Level 2:
Commercial paper	110.7		—		—			110.7		1.4		109.3		—
Corporate securities	1,607.8		1.3		(4.8		)	1,604.3		8.0		724.5		871.8
U.S. government agencies	791.8		0.3		(3.8		)	788.3		—		468.9		319.4
Municipal securities	18.4		—		—			18.4		—		4.7		13.7
Subtotal	2,528.7		1.6		(8.6		)	2,521.7		9.4		1,307.4		1,204.9
Total assets measured at fair value	$	4,845.0	$	3.3	$	(13.9	)	$	4,834.4	$	857.9	$	2,205.2	$	1,771.3

As of December 31, 2018, the Company also recorded $36.5 million of restricted cash equivalents (comprised of money market funds and U.S. treasuries which would be considered highly liquid investments with original maturity dates that are 90 days or less) in prepaids and other current assets in the accompanying Consolidated Balance Sheets.



										Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses			Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2017
Cash	$	197.7	$	—	$	—		$	197.7	$	197.7	$	—	$	—
Level 1:
Money market funds	445.0		—		—			445.0		445.0		—		—
U.S. treasuries	1,029.1		—		(4.7		)	1,024.4		5.5		396.2		622.7
Subtotal	1,474.1		—		(4.7		)	1,469.4		450.5		396.2		622.7
Level 2:
Commercial paper	38.4		—		—			38.4		—		38.4		—
Corporate securities	946.6		0.2		(4.4		)	942.4		—		403.9		538.5
U.S. government agencies	901.3		—		(4.4		)	896.9		—		311.7		585.2
Non-U.S. government securities	2.5		—		—			2.5		—		2.5		—
Municipal securities	301.1		—		(1.9		)	299.2		—		159.7		139.5
Subtotal	2,189.9		0.2		(10.7		)	2,179.4		—		916.2		1,263.2
Total assets measured at fair value	$	3,861.7	$	0.2	$	(15.4	)	$	3,846.5	$	648.2	$	1,312.4	$	1,885.9

During the year ended December 31, 2018, there were no changes in the valuation techniques used.

The following table summarizes the contractual maturities of the Company’s cash equivalents and available-for-sale investments (excluding cash and money market funds), at December 31, 2018 (in millions):



	Amortized Cost		Fair Value
Mature in less than one year	$	2,230.2	$	2,224.6
Mature in one to five years	1,776.3		1,771.3
Total	$	4,006.5	$	3,995.9

Realized gains and losses, net of tax, were not material for any of the periods presented.

As of December 31, 2018, and 2017, net unrealized losses on investments of $9.8 million and $11.3 million, net of tax, 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 investments with unrealized losses at December 31, 2018, and 2017 (in millions):



	Unrealized losses less than 12 months					Unrealized losses 12 months or greater					Total
December 31, 2018	Fair Value		Unrealized Losses			Fair Value		Unrealized Losses			Fair Value		Unrealized Losses
Corporate securities	$	727.4	$	(1.7	)	$	409.6	$	(3.1	)	$	1,137.0	$	(4.8	)
U.S. treasuries	478.7		(0.9		)	592.8		(4.4		)	1,071.5		(5.3		)
U.S. government agencies	228.0		(0.2		)	425.2		(3.6		)	653.2		(3.8		)
	$	1,434.1	$	(2.8	)	$	1,427.6	$	(11.1	)	$	2,861.7	$	(13.9	)
December 31, 2017
Corporate securities	$	567.6	$	(2.1	)	$	277.0	$	(2.3	)	$	844.6	$	(4.4	)
U.S. treasuries	763.5		(2.5		)	206.2		(2.2		)	969.7		(4.7		)
U.S. government agencies	428.9		(1.3		)	345.5		(3.1		)	774.4		(4.4		)
Municipal securities	236.3		(1.3		)	51.7		(0.6		)	288.0		(1.9		)
	$	1,996.3	$	(7.2	)	$	880.4	$	(8.2	)	$	2,876.7	$	(15.4	)

The unrealized losses on the available-for-sale investments are related to corporate securities and government securities. The Company determined these unrealized losses to be temporary. Factors considered in determining whether a loss is temporary included the length of time and extent to which the investment’s fair value has been less than the cost basis; the financial condition and near-term prospects of the investee; extent of the loss related to credit of the issuer; the expected cash flows from the security; the Company’s intent to sell the security; and whether or not the Company will be required to sell the security before the recovery of its amortized cost.

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, and intercompany balances and other monetary assets or liabilities denominated in currencies other than the U.S. dollar (“USD”). 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”), and the Korean Won (“KRW”). The Company also enters into currency forward contracts as cash flow hedges to hedge certain forecasted expense transactions denominated in EUR and Swiss Franc (“CHF”).

For these derivatives, the Company reports the after-tax gain or loss from the hedge as a component of accumulated other comprehensive loss in stockholders’ equity and reclassifies into earnings in the same period in which the hedge 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, and Indian Rupee (“INR”).

These derivative instruments are used to hedge against balance sheet foreign currency exposures. The related gains and losses were as follows (in millions):



	Years Ended December 31,
	2018			2017			2016
Recognized gains (losses) in interest and other income, net	$	8.7		$	(9.2	)	$	6.4
Foreign exchange gains (losses) related to balance sheet re-measurement	$	(2.6	)	$	9.7		$	(5.6	)

The notional amounts for derivative instruments provide one measure of the transaction volume. Total gross notional amounts (in USD) for derivatives and aggregate gross fair value outstanding at the end of each period were as follows (in millions):



	Derivatives Designated as Hedging Instruments				Derivatives Not Designated as Hedging Instruments
	December 31, 2018		December 31, 2017		December 31, 2018		December 31, 2017
Notional amounts:
Forward contracts	$	183.0	$	128.5	$	182.7	$	168.4
Gross fair value recorded in:
Prepaid and other current assets	$	3.1	$	0.9	$	4.1	$	1.2
Other accrued liabilities	$	0.9	$	2.9	$	1.1	$	4.6

Consolidated Financial Statement Details

12 Months Ended

Dec. 31, 2018

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Consolidated Financial Statement Details

CONSOLIDATED FINANCIAL STATEMENT DETAILS

The following tables provide details of selected consolidated financial statement items (in millions):



	December 31,
	2018		2017
Inventory:
Raw materials	$	164.1	$	80.9
Work-in-process	40.0		19.7
Finished goods	204.9		140.6
Total inventory	$	409.0	$	241.2



	December 31,
	2018			2017
Property, plant, and equipment, net:
Land	$	184.6		$	174.8
Building and building/leasehold improvements	266.2			230.5
Machinery and equipment	280.1			224.8
Operating lease assets	150.2			66.1
Computer and office equipment	52.6			44.8
Capitalized software	157.8			135.6
Construction-in-process	156.7			83.5
Gross property, plant, and equipment	1,248.2			960.1
Less: Accumulated depreciation*	(436.2		)	(347.0		)
Total property, plant, and equipment, net	$	812.0		$	613.1

*Accumulated depreciation associated with operating lease assets	$	(32.1	)	$	(13.8	)



	December 31,
	2018		2017
Other accrued liabilities—short-term:
Taxes payable	$	39.1	$	63.1
Litigation related accruals	55.0		13.8
Other accrued liabilities	137.7		92.0
Total other accrued liabilities—short-term	$	231.8	$	168.9



	December 31,
	2018		2017
Other long-term liabilities:
Income taxes—long-term	$	270.2	$	286.8
Deferred revenue—long-term	33.0		24.8
Other long-term liabilities	35.4		22.0
Total other long-term liabilities	$	338.6	$	333.6

Supplemental Cash flow Information

The following table provides supplemental cash flow information (in millions):



	Years Ended December 31,
	2018		2017		2016
Income taxes paid	$	179.2	$	147.5	$	138.4
Supplemental non-cash investing activities:
Equipment transfers from inventory to property, plant, and equipment	$	125.7	$	65.8	$	39.3
Deferred payments related to business combinations	$	16.7	$	—	$	—

Leases

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Leases

LEASES

Lease Receivables. Lease receivables relating to sales-type lease arrangements are presented on the Consolidated Balance Sheets as follows (in millions):



	December 31,
	2018			2017
Gross lease receivables	$	150.4		$	128.0
Unearned income	(6.3		)	(5.0		)
Allowance for credit loss	(1.0		)	(0.9		)
Net investment in sales-type leases	$	143.1		$	122.1
Reported as:
Prepaids and other current assets	$	51.2		$	41.9
Intangible and other assets, net	91.9			80.2
Total, net	$	143.1		$	122.1

Contractual maturities of gross lease receivables as of December 31, 2018, are as follows (in millions):



Fiscal Year	Amount
2019	$	50.8
2020	46.5
2021	29.7
2022	14.9
2023	7.5
2024 and thereafter	1.0
Total	$	150.4

Operating Leases. The Company’s operating lease terms are generally less than five years. Future minimum lease payments related to non-cancellable portion of operating leases as of December 31, 2018, are as follows (in millions):



Fiscal Year	Amount
2019	$	88.0
2020	85.8
2021	68.8
2022	51.3
2023	25.4
2024 and thereafter	1.9
Total	$	321.2

Contingent rental revenue relating to operating lease arrangements were not material for the periods presented.

Intangible Assets

12 Months Ended

Dec. 31, 2018

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

GOODWILL AND INTANGIBLE ASSETS

The increases in goodwill and intangible assets from December 31, 2017, to December 31, 2018, primarily relate to three transactions accounted for as business combinations.

During the second quarter of fiscal 2018, the Company terminated its India distribution relationship with Vattikuti Technologies Pvt. Ltd. and acquired certain assets related to that distribution business on May 25, 2018, which collectively met the definition of a business. The transaction enhances the Company’s ability to serve patients, surgeons, and hospitals in India. The purchase consideration consisted of $38.1 million in cash. The Company preliminarily recorded $4.1 million of net tangible assets, $24.2 million of intangible assets, and $9.8 million of residual goodwill. Intangible assets included reacquired distribution rights, customer relationships, and a non-compete agreement, which are being amortized over a weighted average period of 4.3 years.

During the third quarter of fiscal 2018, the Company acquired intellectual property, exclusive field of use rights, and certain key employees from InTouch Technologies, Inc. on August 17, 2018, which collectively met the definition of a business. The transaction enhances the Company’s network capabilities in using real-time data to support surgeons. The total purchase consideration of $38.7 million, as of the acquisition date, consisted of an initial cash payment of $22.0 million and subsequent cash payments totaling approximately $16.7 million. The Company recorded $13.3 million of intangible assets and $25.4 million of residual goodwill. Intangible assets included developed technology and a non-compete agreement, which are being amortized over a weighted average period of 5.7 years. The goodwill will be amortized for income tax purposes.

During the fourth quarter of fiscal 2018, the Company acquired its Taiwan distributor, Unison Surgicals Company, on December 11, 2018, which met the definition of a business. The transaction enhances the Company’s ability to serve patients, surgeons, and hospitals in Taiwan. The purchase consideration consisted of $35.4 million in cash. The Company preliminarily recorded $13.1 million of net tangible assets, which included $7.6 million of cash, $17.3 million of intangible assets, and $5.0 million of residual goodwill. Intangible assets included customer relationships and non-compete agreements, which are being amortized over a weighted average period of 6.6 years.

The Company has included the results of the businesses, since their acquisition dates, in its Consolidated Financial Statements, which have not been material to date. Pro forma results of operations related to the acquisitions have not been presented since the operating results of the acquired businesses are not material to the Consolidated Financial Statements.

The following table summarizes the components of gross intangible asset, accumulated amortization, and net intangible asset balances as of December 31, 2018, and 2017 (in millions):



	December 31, 2018							December 31, 2017
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents and developed technology	$	158.7	$	(144.7	)	$	14.0	$	156.0	$	(140.2	)	$	15.8
Distribution rights and others	40.2		(12.9		)	27.3		9.2		(9.2		)	—
Customer relationships	48.5		(23.1		)	25.4		28.6		(18.4		)	10.2
Total intangible assets	$	247.4	$	(180.7	)	$	66.7	$	193.8	$	(167.8	)	$	26.0

Amortization expense related to intangible assets was $14.2 million, $12.9 million, and $18.2 million for the years ended December 31, 2018, 2017, and 2016, respectively.

The estimated future amortization expense related to intangible assets as of December 31, 2018, is as follows (in millions):



Fiscal Year	Amount
2019	$	15.9
2020	15.8
2021	12.5
2022	10.1
2023	6.2
2024 and thereafter	6.2
Total	$	66.7

- Definition

The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final. May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.

+ References + Details

Commitments And Contingencies

12 Months Ended

Dec. 31, 2018

Commitments and Contingencies Disclosure [Abstract]

Commitments And Contingencies

COMMITMENTS AND CONTINGENCIES

OPERATING LEASES

The Company leases space for operations in United States, Mexico, Japan, South Korea, China, and certain other foreign countries. The Company also leases automobiles for certain sales and field service employees. These leases have varying terms up to fifteen years.

Future minimum lease commitments under the Company’s operating leases as of December 31, 2018, are as follows (in millions):



Fiscal Year	Amount
2019	$	15.1
2020	14.5
2021	12.7
2022	11.2
2023	11.0
2024 and thereafter	30.9
Total	$	95.4

OTHER COMMITMENTS

Other commitments include an estimated amount of approximately $711.2 million relating to the Company’s open purchase orders and contractual obligations that occur in the ordinary course of business, including commitments with suppliers, for which the Company has not received the goods or services. Although open purchase orders are considered enforceable and legally binding, the terms generally allow the Company the option to cancel, reschedule, and adjust its requirements based on its business needs prior to the delivery of goods or performance of services. In addition to the above, the Company has committed to make certain future milestone payments to third parties as part of licensing, collaboration, and development arrangements. Payments under these arrangements generally become due and payable only upon the achievement of certain specified developmental, regulatory, and/or commercial milestones. Because the achievement of these milestones is neither probable nor reasonably estimable, such contingencies are not included in the estimated amount.

CONTINGENCIES

The Company is involved in a variety of claims, lawsuits, investigations and proceedings relating to securities laws, product liability, intellectual property, 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 Company’s 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 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 position, or future results of operations. During the years ended December 31, 2018, 2017, and 2016, the Company recorded pre-tax charges of $45.2 million, $16.3 million, and $8.3 million, respectively, related to the securities class action lawsuits and the tolled product liability claims described below. A total of $53.0 million and $12.8 million associated with these matters were included in other accrued liabilities in the accompanying Consolidated Balance Sheets as of December 31, 2018, and 2017, respectively.

Purported Shareholder Class Action Lawsuits filed April 26, 2013, and May 24, 2013

On April 26, 2013, a purported class action lawsuit entitled Abrams v. Intuitive Surgical, et al., No. 5-13-cv-1920, was filed against a number of the Company’s current and former officers and directors in the U.S. District Court for the Northern District of California.

The case has since been retitled In re Intuitive Surgical Securities Litigation, No. 5:13-cv-1920. The plaintiffs sought damages on behalf of a putative class of persons who purchased or otherwise acquired the Company’s common stock between February 6, 2012, and July 18, 2013. The amended complaint alleged that the defendants violated federal securities laws by allegedly making false and misleading statements and omitting certain material facts in certain public statements and in the Company’s filings with the SEC.

On June 11, 2018, the Company reached an agreement in principle to enter into a settlement agreement which stipulates a payment of $42.5 million by the Company. The court granted preliminary approval on October 4, 2018, and on December 20, 2018, the court granted final approval. During the year ended December 31, 2018, the Company recorded a pre-tax charge of $42.5 million for this matter. In connection with the settlement, the Company deposited $42.5 million into an escrow account established for disbursements, which was recorded in prepaids and other current assets in the accompanying Consolidated Balance Sheets as of December 31, 2018. The appeals period expired on January 21, 2019 and the matter has been concluded.

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.

In addition to the filed cases, the Company previously received a substantial number of claims relating to alleged complications from surgeries performed with certain versions of Monopolar Curved Scissor (“MCS”) instruments which included an MCS tip cover accessory that was the subject of a market withdrawal in 2012 and MCS instruments that were the subject of a recall in 2013. In an effort to avoid the expense and distraction of defending multiple lawsuits, the Company entered into tolling agreements to pause the applicable statutes of limitations for many of these claims and engaged in confidential mediation efforts. As of December 31, 2018, all such “tolling agreements” have expired and the majority of the “tolled claims” have either been resolved or the matters have been filed.

During the years ended December 31, 2018, 2017, and 2016, the Company recorded $2.7 million, $16.3 million, and $8.3 million, respectively, of pre-tax charges to reflect the estimated cost of settling a number of the product liability claims covered by the tolling agreements. As of December 31, 2018, and 2017, a total of $10.5 million and $12.8 million, respectively, were included in other accrued liabilities in the accompanying Consolidated Balance Sheets related to the tolled product liability claims.

The Company’s estimate of the anticipated cost of resolving the pending lawsuits and claims is based on negotiations with attorneys for the plaintiffs/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 position, and 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 the U.S. Patent Nos. 9,585,658, 8,479,969, 9,113,874, 8,998,058, 8,991,677, 9,084,601, and 8,616,431. The parties are currently engaged in fact discovery regarding Ethicon’s allegations. A claim construction hearing occurred on October 1, 2018, and the court issued an order on December 28, 2018. Trial is currently scheduled for October 15, 2019. 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 August 27, 2018, Ethicon LLC, Ethicon Endo-Surgery, Inc., and Ethicon US LLC (collectively, “Ethicon”) filed a second complaint for patent infringement against the Company in the U.S. District Court for the District of Delaware. The complaint alleges that the Company’s SureForm 60 Staplers infringe five of Ethicon’s patents. Ethicon asserts infringement of the U.S. Patent Nos. 9,884,369, 7,490,749, 8,602,288, 8,602,287, and 9,326,770. The Company filed an answer denying all claims. Ethicon has indicated it may seek preliminary injunctive relief, but it has yet to confirm, or to file such a motion. The case is set for a claim construction hearing on September 23, 2019, and trial is set for October 13, 2020. 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.

Stockholders' Equity

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Stockholders' Equity

STOCKHOLDERS’ EQUITY

STOCK REPURCHASE PROGRAM

Through December 31, 2018, the Company’s Board of Directors (the “Board”) had authorized an aggregate of $6.2 billion of funding for the Company’s common stock repurchase program (the “Repurchase Program”) since originally established in March 2009, of which the previous authorization occurred in December 2016 when the Board increased the authorized amount available under the Repurchase Program to $3.0 billion. During the first quarter of 2017, the Company entered into an accelerated share repurchase program (the “ASR Program”) with Goldman Sachs & Co. LLC (“Goldman”) and Goldman delivered to the Company approximately 7.3 million shares of the Company’s common stock, for which the Company made a payment of $2.0 billion to Goldman. During the fourth quarter of 2017, the Company completed the ASR Program by making a final settlement payment of $274.0 million to Goldman. As of December 31, 2018, the remaining amount of share repurchases authorized by the Board under the Repurchase Program was approximately $717.5 million.

The following table provides the stock repurchase activities during the years ended December 31, 2018, 2017, and 2016 (in millions, except per share amounts):



	Years Ended December 31,
	2018		2017		2016
Shares repurchased	—		7.3		0.2
Average price per share	$	—	$	310.32	$	201.70
Value of shares repurchased	$	—	$	2,274.0	$	42.5

The Company uses the par value method of accounting for its stock repurchases. As a result of share repurchase activities during the years ended December 31, 2018, 2017, and 2016, the Company reduced common stock and additional paid-in capital by an aggregate of zero, $152.0 million, and $4.1 million, respectively, and charged zero, $2,122.0 million, $38.4 million, respectively, to retained earnings.

ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS)

The components of accumulated other comprehensive income (loss) net of tax, for the years ended December 31, 2018, and 2017, are as follows (in millions):



	Year Ended December 31, 2018
	Gains (Losses) on Hedge Instruments			Unrealized Gains (Losses) on Available-for-Sale Securities			Foreign Currency Translation Gains (Losses)			Employee Benefit Plans			Total
Beginning balance	$	(2.4	)	$	(11.3	)	$	2.3		$	(4.1	)	$	(15.5	)
Other comprehensive income (loss) before reclassifications	3.6			0.3			(2.6		)	0.4			1.7
Reclassified from accumulated other comprehensive income (loss)	(1.0		)	1.2			—			0.3			0.5
Net current-period other comprehensive income (loss)	2.6			1.5			(2.6		)	0.7			2.2
Ending balance	$	0.2		$	(9.8	)	$	(0.3	)	$	(3.4	)	$	(13.3	)

	Year Ended December 31, 2017
	Gains (Losses) on Hedge Instruments			Unrealized Gains (Losses) on Available-for-Sale Securities			Foreign Currency Translation Gains (Losses)			Employee Benefit Plans			Total
Beginning balance	$	5.0		$	(8.6	)	$	(1.3	)	$	(4.0	)	$	(8.9	)
Other comprehensive income (loss) before reclassifications	(8.6		)	(2.7		)	3.6			(0.3		)	(8.0		)
Reclassified from accumulated other comprehensive income	1.2			—			—			0.2			1.4
Net current-period other comprehensive income (loss)	(7.4		)	(2.7		)	3.6			(0.1		)	(6.6		)
Ending balance	$	(2.4	)	$	(11.3	)	$	2.3		$	(4.1	)	$	(15.5	)

Share-Based Compensation

12 Months Ended

Dec. 31, 2018

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Share-Based Compensation

SHARE-BASED COMPENSATION

Stock Plans

2010 Incentive Award Plan. In April 2010, the Company’s stockholders approved the 2010 Incentive Award Plan (“2010 Plan”). Under this plan, the Company issues nonqualified stock options (“NSOs”) and restricted stock units (“RSUs”) to employees and certain consultants. The 2010 Plan generally permits NSOs to be granted at no less than the fair market value of the common stock on the date of grant, with terms of 10 years from the date of grant. The 2010 Plan expires in 2020. In April 2017, the Company’s stockholders approved an amended and restated 2010 Plan to provide for an increase in the number of shares of common stock reserved for issuance from 21,150,000 to 24,450,000. As of December 31, 2018, approximately 4.1 million shares were reserved for future issuance under the 2010 Plan. A maximum of 1.8 million of these shares can be awarded as RSUs.

2009 Employment Commencement Incentive Plan. In October 2009, the Board adopted the 2009 Employment Commencement Incentive Plan (“New Hire Plan”). The New Hire Plan provides for the shares to be used exclusively for the grant of RSUs and NSOs to new employees (“New Hire Options”), who were not previously employees or non-employee directors of the Company. The Compensation Committee approves all equity awards under the New Hire Plan, which are granted to newly-hired employees once a month on the fifth business day of each month after their hire. Options are granted at an exercise price not less than the fair market value of the stock on the date of grant and have a term not to exceed 10 years.

In April 2015, the Board of Directors amended and restated the New Hire Plan to provide for an increase in the number of shares of common stock authorized for issuance pursuant to awards granted under the New Hire Plan from 3,465,000 to 4,365,000. As of December 31, 2018, approximately 102,000 shares were reserved for future issuance under the New Hire Plan. However, the Company intends to no longer issue grants from the New Hire Plan in the future and plans to instead utilize the 2010 Plan to make grants to new employees.

2000 Equity Incentive Plan. In March 2000, the Board adopted the 2000 Equity Incentive Plan (“2000 Plan”), which took effect upon the closing of the Company’s initial public offering. Under this plan, certain employees, consultants, and non-employee directors could be granted Incentive Stock Options (“ISOs”) and Nonstatutory Stock Options (“NSOs”) to purchase shares of the Company’s common stock. The 2000 Plan permitted ISOs to be granted at an exercise price not less than the fair value on the date of the grant and NSOs at an exercise price not less than 85% of the fair value on the date of grant. Options granted under the 2000 Plan generally expire 10 years from the date of grant and become exercisable upon grant subject to repurchase rights in favor of the Company until vested. The 2000 Plan expired in March 2010. However, options granted prior to the plan’s expiration continue to remain outstanding until their original expiration date.

Employee Option Vesting. The Company makes annual option grants on February 15 (or the next business day if the date is not a business day) and on August 15 (or the next business day if the date is not a business day). The February 15 grants vest 6/48 upon completion of 6 months service and 1/48 per month thereafter. The August 15 stock option grants vest 7/48 at the end of one month and 1/48 per month thereafter through a 3.5-year vesting period.

New Hire Options generally vest 12/48 upon completion of one year service and 1/48 per month thereafter. Option vesting terms are determined by the Board and, in the future, may vary from past practices.

2000 Non-Employee Directors’ Stock Option Plan. In March 2000, the Board of Directors adopted the 2000 Non-Employee Directors’ Stock Option Plan (the “Directors’ Plan”). In October 2009, the automatic evergreen increase provisions were eliminated so that no further automatic increases will be made to the number of shares reserved for issuance under the Directors’ Plan. In addition, the common stock authorized for issuance under the Directors’ Plan was reduced to 450,000. Options are granted at an exercise price not less than the fair market value of the stock on the date of grant and have a term not to exceed 10 years. Prior to 2016, initial stock option grants to new non-employee directors vest over a three-year period with 12/36 of the shares vesting after one year from the date of grant and 1/36 of the shares vesting monthly thereafter. Annual stock option grants vest one year from the date of the grant. Since 2016, new non-employee directors receive pro-rated stock option grants that vest on the same term as the annual stock option grants. As of December 31, 2018, approximately 0.1 million shares were reserved for future issuance under the Directors’ Plan.

2000 Employee Stock Purchase Plan. In March 2000, the Board adopted the 2000 Employee Stock Purchase Plan (the “ESPP”). Employees are generally eligible to participate in the ESPP if they are customarily employed by the Company for more than 20 hours per week and more than 5 months in a calendar year and are not 5% stockholders of the Company. Under the ESPP, eligible employees may select a rate of payroll deduction up to 15% of their eligible compensation subject to certain maximum purchase limitations. The duration for each offering period is 24 months and is divided into four purchase periods of approximately six months in length. Offerings are concurrent. The purchase price of the shares under the offering is the lesser of 85% of the fair market value of the shares on the offering date or 85% of the fair market value of the shares on the purchase date. A two-year look-back feature in the ESPP causes the offering period to reset if the fair value of the Company’s common stock on the first or last day of the purchase period is less than that on the original offering date. ESPP purchases by employees are settled with newly-issued common stock from the ESPP’s previously authorized and available pool of shares. In April 2017, the Company’s stockholders approved an amended and restated ESPP to provide for an increase in the number of shares of common stock reserved for issuance from 6,090,315 to 7,590,315.

The Company issued 0.2 million, 0.2 million, and 0.2 million shares under the ESPP, representing approximately $46.8 million, $38.3 million, and $32.5 million in employee contributions for the years ended December 31, 2018, 2017, and 2016, respectively. As of December 31, 2018, there were approximately 1.4 million shares reserved for future issuance under the ESPP.

Restricted Stock Units. Equity awards granted to employees and non-employee directors include a mix of stock options and RSUs. The RSUs to employees vest in one-fourth increments annually over a four-year period. Prior to 2016, initial RSUs granted to new non-employee directors are vested in one-third increments over a three-year period. Annual RSU grants to non-employee directors vest one year from the date of grant. Since 2016, new non-employee directors receive pro-rated RSU grants that vest on the same term as the annual RSU grants. The number of shares issued on the date the RSUs vest is net of the minimum statutory tax withholdings, which are paid in cash to the appropriate taxing authorities on behalf of the Company’s employees.

Stock Option Information

Option activity during fiscal 2018 under all the stock plans was as follows (in millions, except per share amounts):



	Stock Options Outstanding
	Number Outstanding		Weighted Average Exercise Price Per Share
Balance at December 31, 2017	7.2		$	164.16
Options granted	0.6		$	475.38
Options exercised	(1.5	)	$	126.52
Options forfeited/expired	(0.1	)	$	237.05
Balance at December 31, 2018	6.2		$	200.79

The aggregate intrinsic value of stock options exercised under the Company’s stock plans determined as of the date of option exercise was $526.6 million, $379.9 million, and $273.3 million during the years ended December 31, 2018, 2017, and 2016, respectively. Cash received from option exercises and employee stock purchase plans for the years ended December 31, 2018, 2017, and 2016, was $236.6 million, $415.5 million, and $580.9 million, respectively. The income tax benefit from stock options exercised was $87.0 million for the year ended December 31, 2018.

The following table summarizes significant ranges of outstanding and exercisable options as of December 31, 2018 (number of shares and aggregate intrinsic value in millions):



	Options Outstanding						Options Exercisable
Range of Exercise Prices	Number of Shares	Weighted Average Remaining Contractual Life	Weighted Average Exercise Price Per Share		Aggregate Intrinsic Value (1)		Number of Shares	Weighted Average Remaining Contractual Life	Weighted Average Exercise Price Per Share		Aggregate Intrinsic Value (1)
$31.96 - $127.91	1.4	2.7	$	115.05			1.4		$	115.05
$128.30 - $168.41	1.3	4.6	$	156.67			1.3		$	156.62
$169.42 - $178.39	1.4	5.6	$	174.50			1.2		$	174.17
$178.75 - $283.51	1.2	6.2	$	214.60			0.9		$	207.77
$310.67 - $548.71	0.9	9.1	$	423.33			0.2		$	388.12
Total	6.2	5.4	$	200.79	$	1,727.7	5.0	4.7	$	168.62	$	1,554.5


(1)	The aggregate intrinsic value represents the total pre-tax intrinsic value, based on the Company’s closing stock price of $478.92 at December 31, 2018, which would have been received by the option holders had all in-the-money option holders exercised their options as of that date.

As of December 31, 2018, a total of 6.1 million shares of stock options vested and expected to vest had a weighted average remaining contractual life of 5.3 years, an aggregate intrinsic value of $1,715.2 million, and a weighted average exercise price of $197.45.

Restricted Stock Units Information

RSU activity for the year ended December 31, 2018, was as follows (in millions, except per share amounts):



	Shares		Weighted Average Grant Date Fair Value
Unvested balance at December 31, 2017	2.1		$	209.55
Granted	0.8		$	431.11
Vested	(0.8	)	$	195.67
Forfeited	(0.1	)	$	277.10
Unvested balance at December 31, 2018	2.0		$	295.70

As of December 31, 2018, 1.8 million shares of RSUs were expected to vest with an aggregate intrinsic value of $879.4 million. The aggregate vesting date fair value of RSUs vested was $334.3 million, $144.2 million, and $65.3 million during the years ended December 31, 2018, 2017, and 2016, respectively.

Share-Based Compensation Expense

The following table summarizes share-based compensation expense (in millions):



	Years Ended December 31,
	2018		2017		2016
Cost of sales—products	$	36.4	$	28.1	$	25.2
Cost of sales—services	16.8		14.0		12.4
Total cost of sales	53.2		42.1		37.6
Selling, general and administrative	133.2		111.8		97.4
Research and development	76.2		56.0		43.0
Share-based compensation expense before income taxes	262.6		209.9		178.0
Income tax effect	54.3		49.2		56.1
Share-based compensation expense after income taxes	$	208.3	$	160.7	$	121.9

The Black-Scholes option pricing model is used to estimate the fair value of stock options granted under the Company’s share-based compensation plans and rights to acquire stock granted under the Company’s employee stock purchase plan. The weighted average estimated fair values of stock options, the rights to acquire stock granted, and RSUs, as well as the weighted average assumptions used in calculating the fair values of stock options and rights to acquire stock under the ESPP that were granted during the years ended December 31, 2018, 2017, and 2016, were as follows:



	Years Ended December 31,
STOCK OPTION PLANS	2018			2017			2016
Risk-free interest rate	2.7		%	1.8		%	1.1		%
Expected term (years)	4.3			4.1			4.2
Volatility	33		%	25		%	26		%
Fair value at grant date	$	146.30		$	67.03		$	47.06
EMPLOYEE STOCK PURCHASE PLAN
Risk-free interest rate	2.1		%	1.2		%	0.6		%
Expected term (years)	1.3			1.2			1.2
Volatility	32		%	28		%	30		%
Fair value at grant date	$	135.84		$	79.77		$	57.57
RESTRICTED STOCK UNITS
Fair value at grant date	$	431.11		$	249.34		$	184.59

As share-based compensation expense recognized in the Consolidated Statements of Income during the years ended December 31, 2018, 2017, and 2016, is based on awards ultimately expected to vest, it has been reduced for estimated forfeitures.

As of December 31, 2018, there were a total of $91.6 million, $373.5 million, and $11.6 million of total unrecognized compensation expense related to unvested stock options, restricted stock units, and employee stock purchases, respectively. The unrecognized compensation expense is expected to be recognized over a weighted average period of 2.3 years for unvested stock options, 2.2 years for unvested restricted stock units, and 0.9 years for rights granted to acquire common stock under the ESPP.

Income Taxes

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Income Taxes

INCOME TAXES

Income before provision for income taxes for the years ended December 31, 2018, 2017, and 2016, consisted of the following (in millions):



	Years Ended December 31,
	2018		2017		2016
U.S.	$	852.7	$	774.7	$	657.0
Foreign	426.8		330.1		328.3
Total income before provision for income taxes	$	1,279.5	$	1,104.8	$	985.3

The provision for income taxes for the years ended December 31, 2018, 2017, and 2016, consisted of the following (in millions):



	Years Ended December 31,
	2018			2017			2016
Current
Federal	$	89.5		$	352.1		$	207.0
State	21.1			13.0			13.4
Foreign	9.9			8.7			5.4
	$	120.5		$	373.8		$	225.8
Deferred
Federal	$	(4.1	)	$	62.8		$	20.5
State	(0.3		)	(0.3		)	0.6
Foreign	38.4			(2.4		)	0.1
	$	34.0		$	60.1		$	21.2
Total income tax expense	$	154.5		$	433.9		$	247.0

Income tax expense differs from amounts computed by applying the statutory federal income rate of 21% for the year ended December 31, 2018 and 35% for the years ended December 31, 2017, and 2016, as a result of the following (in millions):



	Years Ended December 31,
	2018			2017			2016
Federal tax at statutory rate	$	268.7		$	386.7		$	344.9
Increase (reduction) in tax resulting from:
State taxes, net of federal benefits	20.8			16.0			14.0
Foreign rate differential	(44.7		)	(115.7		)	(91.2		)
U.S. tax on foreign earnings	43.7			8.4			5.0
Research and development credit	(25.2		)	(15.3		)	(7.8		)
Share-based compensation not benefited	9.9			10.8			3.6
Domestic production activities deduction	—			(7.9		)	(8.0		)
Reversal of unrecognized tax benefits	(5.2		)	(62.4		)	(15.8		)
Tax Cuts and Jobs Act impact	0.5			317.8			—
Excess tax benefits related to share-based compensation arrangements	(116.2		)	(102.8		)	—
Other	2.2			(1.7		)	2.3
Total income tax expense	$	154.5		$	433.9		$	247.0

Deferred income taxes reflect tax carry forwards and the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities are as follows (in millions):



	December 31,
	2018			2017
Deferred tax assets:
Share-based compensation expense	$	87.2		$	79.1
Expenses deducted in later years for tax purposes	29.1			29.7
Intangible assets	351.9			—
Research and other credits	40.1			27.5
Other	9.0			10.5
Gross deferred tax assets	$	517.3		$	146.8
Valuation allowance	(42.3		)	(29.4		)
Deferred tax assets	$	475.0		$	117.4
Deferred tax liabilities:
Fixed assets	$	(42.2	)	$	(26.3	)
Intangible assets	(7.5		)	(3.6		)
Other	(0.1		)	(15.5		)
Deferred tax liabilities	$	(49.8	)	$	(45.4	)
Net deferred tax assets	$	425.2		$	72.0

In December 2017, the 2017 Tax Act was enacted, which includes a number of changes in existing tax law impacting businesses, including a one-time deemed repatriation of cumulative undistributed foreign earnings and a permanent reduction in the U.S. federal statutory rate from 35% to 21%, effective on January 1, 2018.The Securities Exchange Commission (“SEC”) issued guidance for a measurement period of one year from the enactment date to finalize the accounting for effects of the 2017 Tax Act. The Company recorded an income tax expense of $317.8 million in its 2017 income tax provision related to the 2017 Tax Act which included a provisional estimate of $270.2 million related to the one-time deemed repatriation toll charge (“Toll Tax”), and a provisional estimate of $47.6 million income tax expense in 2017 due to the re-measurement of its net deferred tax assets at a reduced U.S. federal statutory rate of 21%.

The Company repatriated $1.6 billion of its cumulative undistributed foreign earnings back to the U.S. in June 2018 without any significant U.S. income tax consequences. The Company intends to repatriate earnings from its Swiss subsidiary as needed since the U.S. and foreign tax implications of such repatriations are not expected to be significant. The Company will continue to indefinitely reinvest earnings from the rest of our foreign subsidiaries, which are not significant.

In December 2018, the Company completed its accounting for the effect of the 2017 Tax Act within the measurement period under the SEC guidance, and reflected a net $0.5 million increase in the 2018 income tax expense. The Company has adopted the approach of recording the consequences of the GILTI provision of the 2017 Tax Act as period costs when incurred.

The Company’s tax holiday obtained in 2007 for business operations in Switzerland ended on December 31, 2017. The Company received a new tax ruling in Switzerland for new business operations. The new ruling is effective for years 2018 through 2022, which will be extended for the next five years thereafter, to the extent certain terms and conditions continue to be met. The new ruling allows for a reduced cantonal tax rate based on various thresholds of investment, including the ownership, development, and use of the non-U.S. intellectual property rights and employment in such jurisdiction. The tax benefits from Swiss tax holidays for the year ended December 31, 2018 were insignificant, while for the years ended December 31, 2017 and 2016 were approximately $10.9 million, or $0.09 per diluted share, and $10.0 million, or $0.08 per diluted share, respectively.

As of December 31, 2018, and 2017, the Company had valuation allowances of $42.3 million and $29.4 million, respectively, primarily related to California deferred tax assets generated by California R&D credit forwards which have no expiration period. The Company recorded a valuation allowance against its California deferred tax assets as it is more likely than not these deferred tax assets will not be realized as a result of the computation of California taxes under the single sales factor.

The Company recorded a net increase of its gross unrecognized tax benefits of approximately $13.4 million during the year ended December 31, 2018. The net increase was primarily due to increases related to 2018 uncertain tax positions, partially offset by the reversal of gross unrecognized tax benefits in connection with the expiration of certain statutes of limitation in various jurisdictions. The Company had gross unrecognized tax benefits of approximately $78.8 million, $65.4 million, and $106.0 million as of December 31, 2018, 2017, and 2016, respectively, which if recognized, would result in a reduction of the Company’s effective tax rate. The Company included interest expense accrued on unrecognized tax benefits as a component of its income tax expense. As of December 31, 2018, 2017, and 2016, gross interest related to unrecognized tax benefits accrued was approximately $2.6 million, $1.8 million, and $3.7 million, respectively. A majority of the Company’s net unrecognized tax benefits and related interest is presented in other accrued liabilities on the Consolidated Balance Sheets.

A reconciliation of the beginning and ending amounts of gross unrecognized income tax benefits for the years ended December 31, 2018, 2017, and 2016, are as follows (in millions):



	Years Ended December 31,
	2018			2017			2016
Beginning balance	$	65.4		$	106.0		$	92.4
Increases related to tax positions taken during the current year	22.5			21.1			29.9
Decreases related to tax positions taken during a prior year	(0.9		)	(46.5		)	(0.5		)
Decreases related to settlements with tax authorities	—			(0.5		)	—
Decreases related to expiration of statute of limitations	(8.2		)	(14.7		)	(15.8		)
Ending balance	$	78.8		$	65.4		$	106.0

The Company files federal, state and foreign income tax returns in many U.S. and OUS jurisdictions. Years before 2015 are closed for the significant jurisdictions. Certain of the Company’s unrecognized tax benefits could change due to activities of various tax authorities, including 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 change 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

12 Months Ended

Dec. 31, 2018

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):



	Years Ended December 31,
	2018		2017		2016
Numerator:
Net income attributable to Intuitive Surgical, Inc.	$	1,127.9	$	670.9	$	738.3
Denominator:
Weighted average shares outstanding used in basic calculation	113.7		111.7		114.9
Add: dilutive effect of potential common shares	5.1		4.6		3.0
Weighted average shares outstanding used in diluted calculation	118.8		116.3		117.9
Net income per share attributable to Intuitive Surgical, Inc.:
Basic	$	9.92	$	6.01	$	6.43
Diluted	$	9.49	$	5.77	$	6.26

Share-based compensation awards of approximately 0.4 million, 0.2 million, and 0.6 million shares for the years ended December 31, 2018, 2017, and 2016, 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.

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2018
Retirement Benefits [Abstract]
Employee Benefit Plans	EMPLOYEE BENEFIT PLANS The Company sponsors various retirement plans for its eligible U.S. and non-U.S. employees. For employees in the U.S., the Company maintains the Intuitive Surgical, Inc. 401(k) Plan (the “Plan”). As allowed under Section 401(k) of the Internal Revenue Code, the Plan provides tax-deferred salary contributions for eligible U.S. employees. The Plan allows employees to contribute up to 100% of their annual compensation to the Plan on a pre-tax and after-tax basis. Employee contributions are limited to a maximum annual amount as set periodically by the Internal Revenue Code. The Company matches 200% of employee contributions up to $1,500 per calendar year per person. All matching employer contributions vest immediately.

Subsequent Event	12 Months Ended
Subsequent Event	Dec. 31, 2018
Subsequent Events [Abstract]
Subsequent Event	SUBSEQUENT EVENTS Acquisition of Certain Assets from Chindex In January 2019, the Joint Venture acquired certain assets from Chindex and its affiliates, a subsidiary of Fosun Pharma, including distribution rights, customer relationships, and certain personnel for estimated cash payments of approximately $80 to $90 million that are contingent on achieving certain commercial milestones in 2019 and 2020. Chindex was the Company’s distributor of da Vinci products and services in China. Subsequent to the acquisition of the above mentioned assets, the Company’s Joint Venture began direct operations for da Vinci products and services in China. The Company is currently completing its accounting assessment of this transaction. Increase Authorization of Common Stock Repurchase Program On January 31, 2019, the Board increased the authorized amount available under the Repurchase Program to an aggregate of $2.0 billion, including amounts remaining under previous authorization. The Repurchase Program does not have an expiration date.

Selected Quarterly Data

12 Months Ended

Dec. 31, 2018

Selected Quarterly Financial Information [Abstract]

Selected Quarterly Data



	Three Months Ended
	December 31, 2018			September 30, 2018			June 30, 2018			March 31, 2018
Revenue	$	1,046.5		$	920.9		$	909.3		$	847.5
Gross profit	$	735.7		$	642.3		$	632.3		$	593.8
Net income attributable to Intuitive Surgical, Inc. ^(1)(2)(3)	$	292.5		$	292.5		$	255.3		$	287.6
Net income attributable to Intuitive Surgical, Inc. per share:
Basic	$	2.56		$	2.57		$	2.25		$	2.55
Diluted	$	2.45		$	2.45		$	2.15		$	2.44

(1) Includes discrete tax benefits as follows:
Excess tax benefits related to share-based compensation arrangements	$	15.8		$	24.1		$	21.6		$	54.7
Certain one-time tax benefits	$	2.5		$	4.6		$	—		$	—
(2) Includes pre-tax litigation benefits (charges)	$	—		$	1.8		$	(42.5	)	$	(4.5	)
(3) Includes charitable foundation contribution expense	$	(25.2	)	$	—		$	—		$	—

	Three Months Ended
	December 31, 2017			September 30, 2017			June 30, 2017			March 31, 2017
Revenue	$	892.0		$	807.8		$	758.8		$	679.6
Gross profit	$	634.0		$	568.1		$	530.1		$	469.8
Net income (loss) attributable to Intuitive Surgical, Inc. ⁽¹⁾⁽²⁾	$	(31.5	)	$	298.6		$	223.0		$	180.8
Net income (loss) attributable to Intuitive Surgical, Inc. per share:
Basic	$	(0.28	)	$	2.67		$	2.01		$	1.62
Diluted	$	(0.28	)	$	2.56		$	1.94		$	1.57

(1) Includes discrete tax benefits (expense) as follows:
Income expense related to the 2017 Tax Act	$	(317.8	)	$	—		$	—		$	—
Excess tax benefits related to share-based compensation arrangements	$	19.9		$	19.7		$	30.6		$	32.6
Certain one-time tax benefits	$	—		$	68.4		$	—		$	—
(2) Includes pre-tax litigation benefits (charges)	$	1.2		$	(9.7	)	$	4.5		$	(21.3	)

Valuation And Qualifying Accounts

12 Months Ended

Dec. 31, 2018

Valuation and Qualifying Accounts [Abstract]

Valuation And Qualifying Accounts



	Balance at Beginning of Year		Additions		Deductions ⁽¹⁾			Balance at End of Year
Allowance for doubtful accounts, loan credit losses, and sales returns
Year ended December 31, 2018	$	14.6	$	46.0	$	(40.2	)	$	20.4
Year ended December 31, 2017	$	10.8	$	36.1	$	(32.3	)	$	14.6
Year ended December 31, 2016	$	9.4	$	24.6	$	(23.2	)	$	10.8


(1)	Primarily represents products returned.

Summary Of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Basis of Presentation

Use of Estimates

Concentrations of Credit Risk and Other Risks and Uncertainties

Cash and Cash Equivalents

The Company considers all highly liquid investments with an original maturity from date of purchase of 90 days or less to be cash equivalents.

Investments

Fair Value Measurements

Inventory

Property, Plant, and Equipment



	Useful Lives
Building	Up to 30 years
Building improvements	Up to 15 years
Leasehold improvements	Lesser of useful life or term of lease
Equipment and furniture	5 years
Operating lease assets	Greater of lease term or 1 to 5 years
Computer and office equipment	3 years
Enterprise-wide software	5 years
Purchased software	Lesser of 3 years or life of license

Capitalized Software Costs for Internal Use

Business Combinations

Goodwill and Intangible Assets

Impairment of Long-lived Assets

Revenue Recognition

The following table presents revenue disaggregated by types and geography (in millions):



	Years Ended December 31,
U.S.	2018		2017		2016
Instruments and accessories	$	1,485.2	$	1,263.1	$	1,077.3
Systems	692.2		603.5		501.3
Services	456.1		419.2		377.8
Total U.S. revenue	$	2,633.5	$	2,285.8	$	1,956.4

Outside of U.S. (“OUS”)
Instruments and accessories	$	476.8	$	373.8	$	318.5
Systems	434.9		324.9		298.7
Services	179.0		153.7		132.9
Total OUS revenue	$	1,090.7	$	852.4	$	750.1

Total
Instruments and accessories	$	1,962.0	$	1,636.9	$	1,395.8
Systems	1,127.1		928.4		800.0
Services	635.1		572.9		510.7
Total revenue	$	3,724.2	$	3,138.2	$	2,706.5

The following information summarizes the Company’s contract assets and liabilities (in millions):



	As of
	December 31, 2018		December 31, 2017
Contract assets	$	12.4	$	8.3
Deferred revenue	$	327.3	$	268.6

Assets Recognized from the Costs to Obtain a Contract with a Customer

Leases

Allowance for Sales Returns and Doubtful Accounts

Share-Based Compensation

Risk-Free Interest Rate: The risk-free interest rate is based on the U.S. treasury yield curve in effect at the time of grant for the expected term of the stock option.

Computation of Net Income per Share

Research and Development Expenses

Foreign Currency and Other Hedging Instruments

Derivatives that are not designated as hedging instruments and the ineffective portions of cash flow hedges are adjusted to fair value through earnings in interest and other income, net.

Income Taxes

Segments

Legal Contingencies

Recent Accounting Pronouncements

Adopted Accounting Pronouncements

Revenue from Contracts with Customers



	Fiscal 2017							Fiscal 2016
	As Previously Reported		Adjustments			As Restated		As Previously Reported		Adjustments			As Restated
Revenue:
Product	$	2,547.1	$	18.2		$	2,565.3	$	2,187.4	$	8.4		$	2,195.8
Service	581.8		(8.9		)	572.9		517.0		(6.3		)	510.7
Total revenue	3,128.9		9.3			3,138.2		2,704.4		2.1			2,706.5
Cost of revenue:
Product	754.9		1.4			756.3		663.3		(0.7		)	662.6
Service	179.9		—			179.9		151.0		—			151.0
Total cost of revenue	934.8		1.4			936.2		814.3		(0.7		)	813.6
Gross profit	2,194.1		7.9			2,202.0		1,890.1		2.8			1,892.9
Operating expenses:
Selling, general and administrative	810.9		(0.4		)	810.5		705.3		(1.7		)	703.6
Research and development	328.6		—			328.6		239.6		—			239.6
Total operating expenses	1,139.5		(0.4		)	1,139.1		944.9		(1.7		)	943.2
Income from operations	1,054.6		8.3			1,062.9		945.2		4.5			949.7
Interest and other income, net	41.9		—			41.9		35.6		—			35.6
Income before taxes	1,096.5		8.3			1,104.8		980.8		4.5			985.3
Income tax expense	436.5		(2.6		)	433.9		244.9		2.1			247.0
Net income attributable to Intuitive Surgical, Inc.	$	660.0	$	10.9		$	670.9	$	735.9	$	2.4		$	738.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic	$	5.91	$	0.10		$	6.01	$	6.40	$	0.03		$	6.43
Diluted	$	5.67	$	0.10		$	5.77	$	6.24	$	0.02		$	6.26
Total comprehensive income attributable to Intuitive Surgical, Inc.	$	653.4	$	10.9		$	664.3	$	736.5	$	2.4		$	738.9

The adjustments to the Consolidated Statement of Financial Position are as follows (in millions):



	December 31, 2017
	As Previously Reported		Adjustments			As Restated
ASSETS
Accounts receivable, net	$	511.9	$	(4.0	)	$	507.9
Prepaids and other current assets	$	97.2	$	2.0		$	99.2
Deferred tax assets	$	87.3	$	(15.3	)	$	72.0
Intangible and other assets, net	$	159.7	$	36.1		$	195.8

LIABILITIES AND STOCKHOLDERS’ EQUITY
Deferred revenue	$	284.5	$	(40.7	)	$	243.8
Other accrued liabilities	$	169.5	$	(0.6	)	$	168.9
Other long-term liabilities	$	327.1	$	6.5		$	333.6
Retained earnings	$	61.4	$	53.6		$	115.0

Intra-Entity Transfer of Assets Other than Inventory

Business Combinations: Clarifying the Definition of a Business

Statement of Cash Flows: Restricted Cash

Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income

Disclosure Framework for Fair Value Measurement

Improvements to Employee Share-based Payment Accounting

Recent Accounting Pronouncements Not Yet Adopted

Leases (Topic 842)

Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract

Summary Of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Estimated Useful Lives Of The Assets



	Useful Lives
Building	Up to 30 years
Building improvements	Up to 15 years
Leasehold improvements	Lesser of useful life or term of lease
Equipment and furniture	5 years
Operating lease assets	Greater of lease term or 1 to 5 years
Computer and office equipment	3 years
Enterprise-wide software	5 years
Purchased software	Lesser of 3 years or life of license



	December 31,
	2018			2017
Property, plant, and equipment, net:
Land	$	184.6		$	174.8
Building and building/leasehold improvements	266.2			230.5
Machinery and equipment	280.1			224.8
Operating lease assets	150.2			66.1
Computer and office equipment	52.6			44.8
Capitalized software	157.8			135.6
Construction-in-process	156.7			83.5
Gross property, plant, and equipment	1,248.2			960.1
Less: Accumulated depreciation*	(436.2		)	(347.0		)
Total property, plant, and equipment, net	$	812.0		$	613.1

*Accumulated depreciation associated with operating lease assets	$	(32.1	)	$	(13.8	)

Revenue Disaggregated by Types and Geography

The following table presents revenue disaggregated by types and geography (in millions):



	Years Ended December 31,
U.S.	2018		2017		2016
Instruments and accessories	$	1,485.2	$	1,263.1	$	1,077.3
Systems	692.2		603.5		501.3
Services	456.1		419.2		377.8
Total U.S. revenue	$	2,633.5	$	2,285.8	$	1,956.4

Outside of U.S. (“OUS”)
Instruments and accessories	$	476.8	$	373.8	$	318.5
Systems	434.9		324.9		298.7
Services	179.0		153.7		132.9
Total OUS revenue	$	1,090.7	$	852.4	$	750.1

Total
Instruments and accessories	$	1,962.0	$	1,636.9	$	1,395.8
Systems	1,127.1		928.4		800.0
Services	635.1		572.9		510.7
Total revenue	$	3,724.2	$	3,138.2	$	2,706.5

Summary of Contract Assets and Liabilities

The following information summarizes the Company’s contract assets and liabilities (in millions):



	As of
	December 31, 2018		December 31, 2017
Contract assets	$	12.4	$	8.3
Deferred revenue	$	327.3	$	268.6

Schedule of Impact of Adopting New Standard



	Fiscal 2017							Fiscal 2016
	As Previously Reported		Adjustments			As Restated		As Previously Reported		Adjustments			As Restated
Revenue:
Product	$	2,547.1	$	18.2		$	2,565.3	$	2,187.4	$	8.4		$	2,195.8
Service	581.8		(8.9		)	572.9		517.0		(6.3		)	510.7
Total revenue	3,128.9		9.3			3,138.2		2,704.4		2.1			2,706.5
Cost of revenue:
Product	754.9		1.4			756.3		663.3		(0.7		)	662.6
Service	179.9		—			179.9		151.0		—			151.0
Total cost of revenue	934.8		1.4			936.2		814.3		(0.7		)	813.6
Gross profit	2,194.1		7.9			2,202.0		1,890.1		2.8			1,892.9
Operating expenses:
Selling, general and administrative	810.9		(0.4		)	810.5		705.3		(1.7		)	703.6
Research and development	328.6		—			328.6		239.6		—			239.6
Total operating expenses	1,139.5		(0.4		)	1,139.1		944.9		(1.7		)	943.2
Income from operations	1,054.6		8.3			1,062.9		945.2		4.5			949.7
Interest and other income, net	41.9		—			41.9		35.6		—			35.6
Income before taxes	1,096.5		8.3			1,104.8		980.8		4.5			985.3
Income tax expense	436.5		(2.6		)	433.9		244.9		2.1			247.0
Net income attributable to Intuitive Surgical, Inc.	$	660.0	$	10.9		$	670.9	$	735.9	$	2.4		$	738.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic	$	5.91	$	0.10		$	6.01	$	6.40	$	0.03		$	6.43
Diluted	$	5.67	$	0.10		$	5.77	$	6.24	$	0.02		$	6.26
Total comprehensive income attributable to Intuitive Surgical, Inc.	$	653.4	$	10.9		$	664.3	$	736.5	$	2.4		$	738.9

The adjustments to the Consolidated Statement of Financial Position are as follows (in millions):



	December 31, 2017
	As Previously Reported		Adjustments			As Restated
ASSETS
Accounts receivable, net	$	511.9	$	(4.0	)	$	507.9
Prepaids and other current assets	$	97.2	$	2.0		$	99.2
Deferred tax assets	$	87.3	$	(15.3	)	$	72.0
Intangible and other assets, net	$	159.7	$	36.1		$	195.8

LIABILITIES AND STOCKHOLDERS’ EQUITY
Deferred revenue	$	284.5	$	(40.7	)	$	243.8
Other accrued liabilities	$	169.5	$	(0.6	)	$	168.9
Other long-term liabilities	$	327.1	$	6.5		$	333.6
Retained earnings	$	61.4	$	53.6		$	115.0

Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2018

Fair Value Disclosures [Abstract]

Summary of Cash and Available-For-Sale Securities



										Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses			Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2018
Cash	$	269.4	$	—	$	—		$	269.4	$	269.4	$	—	$	—
Level 1:
Money market funds	569.1		—		—			569.1		569.1		—		—
U.S. treasuries	1,477.8		1.7		(5.3		)	1,474.2		10.0		897.8		566.4
Subtotal	2,046.9		1.7		(5.3		)	2,043.3		579.1		897.8		566.4
Level 2:
Commercial paper	110.7		—		—			110.7		1.4		109.3		—
Corporate securities	1,607.8		1.3		(4.8		)	1,604.3		8.0		724.5		871.8
U.S. government agencies	791.8		0.3		(3.8		)	788.3		—		468.9		319.4
Municipal securities	18.4		—		—			18.4		—		4.7		13.7
Subtotal	2,528.7		1.6		(8.6		)	2,521.7		9.4		1,307.4		1,204.9
Total assets measured at fair value	$	4,845.0	$	3.3	$	(13.9	)	$	4,834.4	$	857.9	$	2,205.2	$	1,771.3



										Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses			Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2017
Cash	$	197.7	$	—	$	—		$	197.7	$	197.7	$	—	$	—
Level 1:
Money market funds	445.0		—		—			445.0		445.0		—		—
U.S. treasuries	1,029.1		—		(4.7		)	1,024.4		5.5		396.2		622.7
Subtotal	1,474.1		—		(4.7		)	1,469.4		450.5		396.2		622.7
Level 2:
Commercial paper	38.4		—		—			38.4		—		38.4		—
Corporate securities	946.6		0.2		(4.4		)	942.4		—		403.9		538.5
U.S. government agencies	901.3		—		(4.4		)	896.9		—		311.7		585.2
Non-U.S. government securities	2.5		—		—			2.5		—		2.5		—
Municipal securities	301.1		—		(1.9		)	299.2		—		159.7		139.5
Subtotal	2,189.9		0.2		(10.7		)	2,179.4		—		916.2		1,263.2
Total assets measured at fair value	$	3,861.7	$	0.2	$	(15.4	)	$	3,846.5	$	648.2	$	1,312.4	$	1,885.9

Summary Of Contractual Maturities Of Cash Equivalents And Available-For-Sale Investments



	Amortized Cost		Fair Value
Mature in less than one year	$	2,230.2	$	2,224.6
Mature in one to five years	1,776.3		1,771.3
Total	$	4,006.5	$	3,995.9

Schedule Of Available-For-Sale Investments With Unrealized Losses

The following tables present the breakdown of the available-for-sale investments with unrealized losses at December 31, 2018, and 2017 (in millions):



	Unrealized losses less than 12 months					Unrealized losses 12 months or greater					Total
December 31, 2018	Fair Value		Unrealized Losses			Fair Value		Unrealized Losses			Fair Value		Unrealized Losses
Corporate securities	$	727.4	$	(1.7	)	$	409.6	$	(3.1	)	$	1,137.0	$	(4.8	)
U.S. treasuries	478.7		(0.9		)	592.8		(4.4		)	1,071.5		(5.3		)
U.S. government agencies	228.0		(0.2		)	425.2		(3.6		)	653.2		(3.8		)
	$	1,434.1	$	(2.8	)	$	1,427.6	$	(11.1	)	$	2,861.7	$	(13.9	)
December 31, 2017
Corporate securities	$	567.6	$	(2.1	)	$	277.0	$	(2.3	)	$	844.6	$	(4.4	)
U.S. treasuries	763.5		(2.5		)	206.2		(2.2		)	969.7		(4.7		)
U.S. government agencies	428.9		(1.3		)	345.5		(3.1		)	774.4		(4.4		)
Municipal securities	236.3		(1.3		)	51.7		(0.6		)	288.0		(1.9		)
	$	1,996.3	$	(7.2	)	$	880.4	$	(8.2	)	$	2,876.7	$	(15.4	)

Derivative Instruments Used to Hedge against Balance Sheet Foreign Currency Exposures

These derivative instruments are used to hedge against balance sheet foreign currency exposures. The related gains and losses were as follows (in millions):



	Years Ended December 31,
	2018			2017			2016
Recognized gains (losses) in interest and other income, net	$	8.7		$	(9.2	)	$	6.4
Foreign exchange gains (losses) related to balance sheet re-measurement	$	(2.6	)	$	9.7		$	(5.6	)

Gross Notional Amounts for Outstanding Derivatives

Total gross notional amounts (in USD) for derivatives and aggregate gross fair value outstanding at the end of each period were as follows (in millions):



	Derivatives Designated as Hedging Instruments				Derivatives Not Designated as Hedging Instruments
	December 31, 2018		December 31, 2017		December 31, 2018		December 31, 2017
Notional amounts:
Forward contracts	$	183.0	$	128.5	$	182.7	$	168.4
Gross fair value recorded in:
Prepaid and other current assets	$	3.1	$	0.9	$	4.1	$	1.2
Other accrued liabilities	$	0.9	$	2.9	$	1.1	$	4.6

- Definition

Tabular disclosure of available-for-sale securities which includes, but is not limited to, changes in the cost basis and fair value, fair value and gross unrealized gain (loss), fair values by type of security, contractual maturity and classification, amortized cost basis, contracts to acquire securities to be accounted for as available-for-sale, debt maturities, transfers to trading, change in net unrealized holding gain (loss) net of tax, continuous unrealized loss position fair value, aggregate losses qualitative disclosures, other than temporary impairment (OTTI) losses or other disclosures related to available for sale securities.

+ References + Details

Consolidated Financial Statement Details (Tables)

12 Months Ended

Dec. 31, 2018

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Details of the Inventory Balance Sheet Item



	December 31,
	2018		2017
Inventory:
Raw materials	$	164.1	$	80.9
Work-in-process	40.0		19.7
Finished goods	204.9		140.6
Total inventory	$	409.0	$	241.2

Details of the Property, Plant and Equipment, Net Balance Sheet Item



	Useful Lives
Building	Up to 30 years
Building improvements	Up to 15 years
Leasehold improvements	Lesser of useful life or term of lease
Equipment and furniture	5 years
Operating lease assets	Greater of lease term or 1 to 5 years
Computer and office equipment	3 years
Enterprise-wide software	5 years
Purchased software	Lesser of 3 years or life of license



	December 31,
	2018			2017
Property, plant, and equipment, net:
Land	$	184.6		$	174.8
Building and building/leasehold improvements	266.2			230.5
Machinery and equipment	280.1			224.8
Operating lease assets	150.2			66.1
Computer and office equipment	52.6			44.8
Capitalized software	157.8			135.6
Construction-in-process	156.7			83.5
Gross property, plant, and equipment	1,248.2			960.1
Less: Accumulated depreciation*	(436.2		)	(347.0		)
Total property, plant, and equipment, net	$	812.0		$	613.1

*Accumulated depreciation associated with operating lease assets	$	(32.1	)	$	(13.8	)

Details of the Other Accrued Liabilities—Short Term Balance Sheet Item



	December 31,
	2018		2017
Other accrued liabilities—short-term:
Taxes payable	$	39.1	$	63.1
Litigation related accruals	55.0		13.8
Other accrued liabilities	137.7		92.0
Total other accrued liabilities—short-term	$	231.8	$	168.9

Details of the Other Long-Term Liabilities Balance Sheet Item



	December 31,
	2018		2017
Other long-term liabilities:
Income taxes—long-term	$	270.2	$	286.8
Deferred revenue—long-term	33.0		24.8
Other long-term liabilities	35.4		22.0
Total other long-term liabilities	$	338.6	$	333.6

Supplemental Cash Flow Information

The following table provides supplemental cash flow information (in millions):



	Years Ended December 31,
	2018		2017		2016
Income taxes paid	$	179.2	$	147.5	$	138.4
Supplemental non-cash investing activities:
Equipment transfers from inventory to property, plant, and equipment	$	125.7	$	65.8	$	39.3
Deferred payments related to business combinations	$	16.7	$	—	$	—

Leases (Tables)

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Lease Receivables Relating to Sales-type Lease Arrangements

Lease receivables relating to sales-type lease arrangements are presented on the Consolidated Balance Sheets as follows (in millions):



	December 31,
	2018			2017
Gross lease receivables	$	150.4		$	128.0
Unearned income	(6.3		)	(5.0		)
Allowance for credit loss	(1.0		)	(0.9		)
Net investment in sales-type leases	$	143.1		$	122.1
Reported as:
Prepaids and other current assets	$	51.2		$	41.9
Intangible and other assets, net	91.9			80.2
Total, net	$	143.1		$	122.1

Contractual Maturities of Gross Lease Receivables

Contractual maturities of gross lease receivables as of December 31, 2018, are as follows (in millions):



Fiscal Year	Amount
2019	$	50.8
2020	46.5
2021	29.7
2022	14.9
2023	7.5
2024 and thereafter	1.0
Total	$	150.4

Schedule Of Future Minimum Lease Receivables Under Operating Leases

The Company’s operating lease terms are generally less than five years. Future minimum lease payments related to non-cancellable portion of operating leases as of December 31, 2018, are as follows (in millions):



Fiscal Year	Amount
2019	$	88.0
2020	85.8
2021	68.8
2022	51.3
2023	25.4
2024 and thereafter	1.9
Total	$	321.2

Future minimum lease commitments under the Company’s operating leases as of December 31, 2018, are as follows (in millions):



Fiscal Year	Amount
2019	$	15.1
2020	14.5
2021	12.7
2022	11.2
2023	11.0
2024 and thereafter	30.9
Total	$	95.4

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2018

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Intangible Assets

The following table summarizes the components of gross intangible asset, accumulated amortization, and net intangible asset balances as of December 31, 2018, and 2017 (in millions):



	December 31, 2018							December 31, 2017
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents and developed technology	$	158.7	$	(144.7	)	$	14.0	$	156.0	$	(140.2	)	$	15.8
Distribution rights and others	40.2		(12.9		)	27.3		9.2		(9.2		)	—
Customer relationships	48.5		(23.1		)	25.4		28.6		(18.4		)	10.2
Total intangible assets	$	247.4	$	(180.7	)	$	66.7	$	193.8	$	(167.8	)	$	26.0

Schedule Of Estimated Future Amortization Expense Of Intangible Assets

The estimated future amortization expense related to intangible assets as of December 31, 2018, is as follows (in millions):



Fiscal Year	Amount
2019	$	15.9
2020	15.8
2021	12.5
2022	10.1
2023	6.2
2024 and thereafter	6.2
Total	$	66.7

Commitments And Contingencies (Tables)

12 Months Ended

Dec. 31, 2018

Commitments and Contingencies Disclosure [Abstract]

Schedule Of Future Minimum Lease Commitments Under Operating Leases



Fiscal Year	Amount
2019	$	88.0
2020	85.8
2021	68.8
2022	51.3
2023	25.4
2024 and thereafter	1.9
Total	$	321.2

Future minimum lease commitments under the Company’s operating leases as of December 31, 2018, are as follows (in millions):



Fiscal Year	Amount
2019	$	15.1
2020	14.5
2021	12.7
2022	11.2
2023	11.0
2024 and thereafter	30.9
Total	$	95.4

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Schedule Of Stock Repurchase Activities

The following table provides the stock repurchase activities during the years ended December 31, 2018, 2017, and 2016 (in millions, except per share amounts):



	Years Ended December 31,
	2018		2017		2016
Shares repurchased	—		7.3		0.2
Average price per share	$	—	$	310.32	$	201.70
Value of shares repurchased	$	—	$	2,274.0	$	42.5

Components of Accumulated Other Comprehensive Income (Loss), Net of Tax

The components of accumulated other comprehensive income (loss) net of tax, for the years ended December 31, 2018, and 2017, are as follows (in millions):



	Year Ended December 31, 2018
	Gains (Losses) on Hedge Instruments			Unrealized Gains (Losses) on Available-for-Sale Securities			Foreign Currency Translation Gains (Losses)			Employee Benefit Plans			Total
Beginning balance	$	(2.4	)	$	(11.3	)	$	2.3		$	(4.1	)	$	(15.5	)
Other comprehensive income (loss) before reclassifications	3.6			0.3			(2.6		)	0.4			1.7
Reclassified from accumulated other comprehensive income (loss)	(1.0		)	1.2			—			0.3			0.5
Net current-period other comprehensive income (loss)	2.6			1.5			(2.6		)	0.7			2.2
Ending balance	$	0.2		$	(9.8	)	$	(0.3	)	$	(3.4	)	$	(13.3	)

	Year Ended December 31, 2017
	Gains (Losses) on Hedge Instruments			Unrealized Gains (Losses) on Available-for-Sale Securities			Foreign Currency Translation Gains (Losses)			Employee Benefit Plans			Total
Beginning balance	$	5.0		$	(8.6	)	$	(1.3	)	$	(4.0	)	$	(8.9	)
Other comprehensive income (loss) before reclassifications	(8.6		)	(2.7		)	3.6			(0.3		)	(8.0		)
Reclassified from accumulated other comprehensive income	1.2			—			—			0.2			1.4
Net current-period other comprehensive income (loss)	(7.4		)	(2.7		)	3.6			(0.1		)	(6.6		)
Ending balance	$	(2.4	)	$	(11.3	)	$	2.3		$	(4.1	)	$	(15.5	)

Share-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2018

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Summary Of Stock Option Activity Under All Stock Plans

Option activity during fiscal 2018 under all the stock plans was as follows (in millions, except per share amounts):



	Stock Options Outstanding
	Number Outstanding		Weighted Average Exercise Price Per Share
Balance at December 31, 2017	7.2		$	164.16
Options granted	0.6		$	475.38
Options exercised	(1.5	)	$	126.52
Options forfeited/expired	(0.1	)	$	237.05
Balance at December 31, 2018	6.2		$	200.79

Summary Of Significant Ranges Of Outstanding And Exercisable Options

The following table summarizes significant ranges of outstanding and exercisable options as of December 31, 2018 (number of shares and aggregate intrinsic value in millions):



	Options Outstanding						Options Exercisable
Range of Exercise Prices	Number of Shares	Weighted Average Remaining Contractual Life	Weighted Average Exercise Price Per Share		Aggregate Intrinsic Value (1)		Number of Shares	Weighted Average Remaining Contractual Life	Weighted Average Exercise Price Per Share		Aggregate Intrinsic Value (1)
$31.96 - $127.91	1.4	2.7	$	115.05			1.4		$	115.05
$128.30 - $168.41	1.3	4.6	$	156.67			1.3		$	156.62
$169.42 - $178.39	1.4	5.6	$	174.50			1.2		$	174.17
$178.75 - $283.51	1.2	6.2	$	214.60			0.9		$	207.77
$310.67 - $548.71	0.9	9.1	$	423.33			0.2		$	388.12
Total	6.2	5.4	$	200.79	$	1,727.7	5.0	4.7	$	168.62	$	1,554.5


(1)	The aggregate intrinsic value represents the total pre-tax intrinsic value, based on the Company’s closing stock price of $478.92 at December 31, 2018, which would have been received by the option holders had all in-the-money option holders exercised their options as of that date.

Summary of RSU Activity

RSU activity for the year ended December 31, 2018, was as follows (in millions, except per share amounts):



	Shares		Weighted Average Grant Date Fair Value
Unvested balance at December 31, 2017	2.1		$	209.55
Granted	0.8		$	431.11
Vested	(0.8	)	$	195.67
Forfeited	(0.1	)	$	277.10
Unvested balance at December 31, 2018	2.0		$	295.70

Summary Of Share-Based Compensation Expense

The following table summarizes share-based compensation expense (in millions):



	Years Ended December 31,
	2018		2017		2016
Cost of sales—products	$	36.4	$	28.1	$	25.2
Cost of sales—services	16.8		14.0		12.4
Total cost of sales	53.2		42.1		37.6
Selling, general and administrative	133.2		111.8		97.4
Research and development	76.2		56.0		43.0
Share-based compensation expense before income taxes	262.6		209.9		178.0
Income tax effect	54.3		49.2		56.1
Share-based compensation expense after income taxes	$	208.3	$	160.7	$	121.9

Schedule Of Estimated Fair Values Of The Option Using Black-Scholes Option Pricing Model, Weighted Average Assumptions and Fair Value of RSUs

The weighted average estimated fair values of stock options, the rights to acquire stock granted, and RSUs, as well as the weighted average assumptions used in calculating the fair values of stock options and rights to acquire stock under the ESPP that were granted during the years ended December 31, 2018, 2017, and 2016, were as follows:



	Years Ended December 31,
STOCK OPTION PLANS	2018			2017			2016
Risk-free interest rate	2.7		%	1.8		%	1.1		%
Expected term (years)	4.3			4.1			4.2
Volatility	33		%	25		%	26		%
Fair value at grant date	$	146.30		$	67.03		$	47.06
EMPLOYEE STOCK PURCHASE PLAN
Risk-free interest rate	2.1		%	1.2		%	0.6		%
Expected term (years)	1.3			1.2			1.2
Volatility	32		%	28		%	30		%
Fair value at grant date	$	135.84		$	79.77		$	57.57
RESTRICTED STOCK UNITS
Fair value at grant date	$	431.11		$	249.34		$	184.59

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Schedule Of Income Before Provision For Income Taxes

Income before provision for income taxes for the years ended December 31, 2018, 2017, and 2016, consisted of the following (in millions):



	Years Ended December 31,
	2018		2017		2016
U.S.	$	852.7	$	774.7	$	657.0
Foreign	426.8		330.1		328.3
Total income before provision for income taxes	$	1,279.5	$	1,104.8	$	985.3

Schedule Of Provision For Income Taxes

The provision for income taxes for the years ended December 31, 2018, 2017, and 2016, consisted of the following (in millions):



	Years Ended December 31,
	2018			2017			2016
Current
Federal	$	89.5		$	352.1		$	207.0
State	21.1			13.0			13.4
Foreign	9.9			8.7			5.4
	$	120.5		$	373.8		$	225.8
Deferred
Federal	$	(4.1	)	$	62.8		$	20.5
State	(0.3		)	(0.3		)	0.6
Foreign	38.4			(2.4		)	0.1
	$	34.0		$	60.1		$	21.2
Total income tax expense	$	154.5		$	433.9		$	247.0

Schedule Of Income Tax Difference From The Statutory Rate



	Years Ended December 31,
	2018			2017			2016
Federal tax at statutory rate	$	268.7		$	386.7		$	344.9
Increase (reduction) in tax resulting from:
State taxes, net of federal benefits	20.8			16.0			14.0
Foreign rate differential	(44.7		)	(115.7		)	(91.2		)
U.S. tax on foreign earnings	43.7			8.4			5.0
Research and development credit	(25.2		)	(15.3		)	(7.8		)
Share-based compensation not benefited	9.9			10.8			3.6
Domestic production activities deduction	—			(7.9		)	(8.0		)
Reversal of unrecognized tax benefits	(5.2		)	(62.4		)	(15.8		)
Tax Cuts and Jobs Act impact	0.5			317.8			—
Excess tax benefits related to share-based compensation arrangements	(116.2		)	(102.8		)	—
Other	2.2			(1.7		)	2.3
Total income tax expense	$	154.5		$	433.9		$	247.0

Schedule Of Deferred Tax Assets



	December 31,
	2018			2017
Deferred tax assets:
Share-based compensation expense	$	87.2		$	79.1
Expenses deducted in later years for tax purposes	29.1			29.7
Intangible assets	351.9			—
Research and other credits	40.1			27.5
Other	9.0			10.5
Gross deferred tax assets	$	517.3		$	146.8
Valuation allowance	(42.3		)	(29.4		)
Deferred tax assets	$	475.0		$	117.4
Deferred tax liabilities:
Fixed assets	$	(42.2	)	$	(26.3	)
Intangible assets	(7.5		)	(3.6		)
Other	(0.1		)	(15.5		)
Deferred tax liabilities	$	(49.8	)	$	(45.4	)
Net deferred tax assets	$	425.2		$	72.0

Schedule Of Gross Unrecognized Income Tax Benefits

A reconciliation of the beginning and ending amounts of gross unrecognized income tax benefits for the years ended December 31, 2018, 2017, and 2016, are as follows (in millions):



	Years Ended December 31,
	2018			2017			2016
Beginning balance	$	65.4		$	106.0		$	92.4
Increases related to tax positions taken during the current year	22.5			21.1			29.9
Decreases related to tax positions taken during a prior year	(0.9		)	(46.5		)	(0.5		)
Decreases related to settlements with tax authorities	—			(0.5		)	—
Decreases related to expiration of statute of limitations	(8.2		)	(14.7		)	(15.8		)
Ending balance	$	78.8		$	65.4		$	106.0

Net Income Per Share (Tables)

12 Months Ended

Dec. 31, 2018

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):



	Years Ended December 31,
	2018		2017		2016
Numerator:
Net income attributable to Intuitive Surgical, Inc.	$	1,127.9	$	670.9	$	738.3
Denominator:
Weighted average shares outstanding used in basic calculation	113.7		111.7		114.9
Add: dilutive effect of potential common shares	5.1		4.6		3.0
Weighted average shares outstanding used in diluted calculation	118.8		116.3		117.9
Net income per share attributable to Intuitive Surgical, Inc.:
Basic	$	9.92	$	6.01	$	6.43
Diluted	$	9.49	$	5.77	$	6.26

Selected Quarterly Data (Tables)

12 Months Ended

Dec. 31, 2018

Selected Quarterly Financial Information [Abstract]

Schedule Of Selected Quarterly Data



	Three Months Ended
	December 31, 2018			September 30, 2018			June 30, 2018			March 31, 2018
Revenue	$	1,046.5		$	920.9		$	909.3		$	847.5
Gross profit	$	735.7		$	642.3		$	632.3		$	593.8
Net income attributable to Intuitive Surgical, Inc. ^(1)(2)(3)	$	292.5		$	292.5		$	255.3		$	287.6
Net income attributable to Intuitive Surgical, Inc. per share:
Basic	$	2.56		$	2.57		$	2.25		$	2.55
Diluted	$	2.45		$	2.45		$	2.15		$	2.44

(1) Includes discrete tax benefits as follows:
Excess tax benefits related to share-based compensation arrangements	$	15.8		$	24.1		$	21.6		$	54.7
Certain one-time tax benefits	$	2.5		$	4.6		$	—		$	—
(2) Includes pre-tax litigation benefits (charges)	$	—		$	1.8		$	(42.5	)	$	(4.5	)
(3) Includes charitable foundation contribution expense	$	(25.2	)	$	—		$	—		$	—

	Three Months Ended
	December 31, 2017			September 30, 2017			June 30, 2017			March 31, 2017
Revenue	$	892.0		$	807.8		$	758.8		$	679.6
Gross profit	$	634.0		$	568.1		$	530.1		$	469.8
Net income (loss) attributable to Intuitive Surgical, Inc. ⁽¹⁾⁽²⁾	$	(31.5	)	$	298.6		$	223.0		$	180.8
Net income (loss) attributable to Intuitive Surgical, Inc. per share:
Basic	$	(0.28	)	$	2.67		$	2.01		$	1.62
Diluted	$	(0.28	)	$	2.56		$	1.94		$	1.57

(1) Includes discrete tax benefits (expense) as follows:
Income expense related to the 2017 Tax Act	$	(317.8	)	$	—		$	—		$	—
Excess tax benefits related to share-based compensation arrangements	$	19.9		$	19.7		$	30.6		$	32.6
Certain one-time tax benefits	$	—		$	68.4		$	—		$	—
(2) Includes pre-tax litigation benefits (charges)	$	1.2		$	(9.7	)	$	4.5		$	(21.3	)

Summary Of Significant Accounting Policies - Additional Information (Details)	12 Months Ended
	Dec. 31, 2018 USD ($) customer segment	Dec. 31, 2017 USD ($) customer	Dec. 31, 2016 USD ($) customer	Jan. 01, 2018 USD ($)	Dec. 31, 2015 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Effective Income Tax Rate Reconciliation, Share-based Compensation, Excess Tax Benefit, Percent	9.10%	9.30%
Other-than-temporary impairment losses	$ 0	$ 0	$ 0
Performance obligation period	The Company’s system sale arrangements generally include a five-year period of service. The first year of service is generally free and included in the system sale arrangement and the remaining four years are generally included at a stated service price.
Restricted cash	$ 51,500,000	15,000,000	15,000,000
Depreciation expense	$ 105,900,000	82,100,000	70,700,000
Number of operating segments \| segment	1
Impairment of goodwill	$ 0
System sales arrangement, warranty period	1 year
Transaction price allocated to remaining performance obligations	$ 1,448,700,000
Revenue recognized	268,900,000	225,500,000
Operating lease revenue	$ 51,400,000	25,900,000	16,600,000
Market-based implied volatility (period)	1 year
Market-based implied volatility (percent)	100.00%
Cash flow hedges de-designated (period)	2 months
Likelihood of tax benefits being realized upon ultimate settlement	50.00%
Operating expenses	$ 1,404,700,000	1,139,100,000	943,200,000
Retained earnings	1,521,700,000	115,000,000
Net cash provided by operating activities	1,169,600,000	1,143,900,000	1,087,000,000
Capitalized contract costs	34,200,000	31,400,000
Net Cash Provided by (Used in) Financing Activities	126,300,000	(1,913,100,000)	514,400,000
Undiscounted future minimum operating lease commitments	$ 95,400,000
ASU No. 2014-09
Summary Of Significant Accounting Policies [Line Items]
Operating expenses		1,139,100,000	943,200,000
Retained earnings		115,000,000
ASU No. 2014-09 \| Difference between evenue guidance in effect before and after Topic 606
Summary Of Significant Accounting Policies [Line Items]
Retained earnings					$ 40,300,000
ASU 2016-16
Summary Of Significant Accounting Policies [Line Items]
Catch-up adjustment to retained earnings				$ 390,800,000
ASU 2016-16 \| Retained Earnings
Summary Of Significant Accounting Policies [Line Items]
Catch-up adjustment to retained earnings				$ 390,800,000
ASU No. 2016-09
Summary Of Significant Accounting Policies [Line Items]
Net cash provided by operating activities			44,100,000
Net Cash Provided by (Used in) Financing Activities			44,100,000
Enterprise-wide software
Summary Of Significant Accounting Policies [Line Items]
Property, plant and equipment, estimated useful lives	5 years
Internal use software
Summary Of Significant Accounting Policies [Line Items]
Capitalized computer software, gross	$ 17,400,000	$ 22,400,000	$ 11,800,000
Minimum
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life, intangible asset	1 year
Sales-type leases term	24 months
Maximum
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life, intangible asset	9 years
Sales-type leases term	84 months
Derivative, term of contract	12 months
Maximum \| Internal use software
Summary Of Significant Accounting Policies [Line Items]
Property, plant and equipment, estimated useful lives	5 years
United States
Summary Of Significant Accounting Policies [Line Items]
Long-lived assets, percent	88.00%	88.00%
Accounts Receivable \| United States
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	71.00%	69.00%
Total Revenue
Summary Of Significant Accounting Policies [Line Items]
Number of customers representing more than 10% of total revenue \| customer	0	0	0
Total Revenue \| United States
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	71.00%	73.00%	72.00%
Total Revenue \| International
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	29.00%	27.00%	28.00%
Early adoption \| ASU 2018-02
Summary Of Significant Accounting Policies [Line Items]
Reclassification from AOCI to retained earnings	$ 1,300,000

Summary Of Significant Accounting Policies - Estimated Useful Lives Of Assets (Details)	12 Months Ended
	Dec. 31, 2018
Building
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	Up to 30 years
Property, plant and equipment, estimated useful lives	30 years
Building improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	Up to 15 years
Property, plant and equipment, estimated useful lives	15 years
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	Lesser of useful life or term of lease
Equipment and furniture
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	5 years
Operating lease assets
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	Greater of lease term or 1 to 5 years
Operating lease assets \| Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	5 years
Operating lease assets \| Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	1 year
Computer and office equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	3 years
Enterprise-wide software
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	5 years
Purchased software
Property, Plant and Equipment [Line Items]
Property, plant and equipment, estimated useful lives	Lesser of 3 years or life of license
Property, plant and equipment, estimated useful lives	3 years

Summary Of Significant Accounting Policies - Revenue Disaggregated by Types and Geography (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation of Revenue [Line Items]
Total revenue	$ 1,046.5	$ 920.9	$ 909.3	$ 847.5	$ 892.0	$ 807.8	$ 758.8	$ 679.6	$ 3,724.2	$ 3,138.2	$ 2,706.5
Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue									1,962.0	1,636.9	1,395.8
Systems
Disaggregation of Revenue [Line Items]
Total revenue									1,127.1	928.4	800.0
Services
Disaggregation of Revenue [Line Items]
Total revenue									635.1	572.9	510.7
U.S.
Disaggregation of Revenue [Line Items]
Total revenue									2,633.5	2,285.8	1,956.4
U.S. \| Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue									1,485.2	1,263.1	1,077.3
U.S. \| Systems
Disaggregation of Revenue [Line Items]
Total revenue									692.2	603.5	501.3
U.S. \| Services
Disaggregation of Revenue [Line Items]
Total revenue									456.1	419.2	377.8
Outside of U.S. (“OUS”)
Disaggregation of Revenue [Line Items]
Total revenue									1,090.7	852.4	750.1
Outside of U.S. (“OUS”) \| Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue									476.8	373.8	318.5
Outside of U.S. (“OUS”) \| Systems
Disaggregation of Revenue [Line Items]
Total revenue									434.9	324.9	298.7
Outside of U.S. (“OUS”) \| Services
Disaggregation of Revenue [Line Items]
Total revenue									$ 179.0	$ 153.7	$ 132.9

Summary Of Significant Accounting Policies - Summary of Contract Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Contract assets	$ 12.4	$ 8.3
Deferred revenue	$ 327.3	$ 268.6

Summary Of Significant Accounting Policies - Schedule of Impact of Adopting New Standard (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue:
Total revenue	$ 1,046.5	$ 920.9	$ 909.3	$ 847.5	$ 892.0	$ 807.8	$ 758.8	$ 679.6	$ 3,724.2	$ 3,138.2	$ 2,706.5
Cost of revenue:
Total cost of revenue									1,120.1	936.2	813.6
Gross profit	735.7	642.3	632.3	593.8	634.0	568.1	530.1	469.8	2,604.1	2,202.0	1,892.9
Operating expenses:
Selling, general and administrative									986.6	810.5	703.6
Research and development									418.1	328.6	239.6
Total operating expenses									1,404.7	1,139.1	943.2
Income from operations									1,199.4	1,062.9	949.7
Interest and other income, net									80.1	41.9	35.6
Income before taxes									1,279.5	1,104.8	985.3
Income tax expense									154.5	433.9	247.0
Net income attributable to Intuitive Surgical, Inc.	$ 292.5	$ 292.5	$ 255.3	$ 287.6	$ (31.5)	$ 298.6	$ 223.0	$ 180.8	$ 1,127.9	$ 670.9	$ 738.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (usd per share)	$ 2.56	$ 2.57	$ 2.25	$ 2.55	$ (0.28)	$ 2.67	$ 2.01	$ 1.62	$ 9.92	$ 6.01	$ 6.43
Diluted (usd per share)	$ 2.45	$ 2.45	$ 2.15	$ 2.44	$ (0.28)	$ 2.56	$ 1.94	$ 1.57	$ 9.49	$ 5.77	$ 6.26
Total comprehensive income attributable to Intuitive Surgical, Inc.									$ 1,130.1	$ 664.3	$ 738.9
ASSETS
Accounts receivable, net	$ 682.3				$ 507.9				682.3	507.9
Prepaids and other current assets	178.8				99.2				178.8	99.2
Deferred tax assets	428.6				72.0				428.6	72.0
Intangible and other assets, net	261.0				195.8				261.0	195.8
LIABILITIES AND STOCKHOLDERS’ EQUITY
Deferred revenue	294.3				243.8				294.3	243.8
Other accrued liabilities	231.8				168.9				231.8	168.9
Retained earnings	$ 1,521.7				115.0				1,521.7	115.0
Product
Revenue:
Total revenue									3,089.1	2,565.3	2,195.8
Cost of revenue:
Total cost of revenue									906.2	756.3	662.6
Service
Revenue:
Total revenue									635.1	572.9	510.7
Cost of revenue:
Total cost of revenue									$ 213.9	179.9	151.0
ASC 606
Revenue:
Total revenue										3,138.2	2,706.5
Cost of revenue:
Total cost of revenue										936.2	813.6
Gross profit										2,202.0	1,892.9
Operating expenses:
Selling, general and administrative										810.5	703.6
Research and development										328.6	239.6
Total operating expenses										1,139.1	943.2
Income from operations										1,062.9	949.7
Interest and other income, net										41.9	35.6
Income before taxes										1,104.8	985.3
Income tax expense										433.9	247.0
Net income attributable to Intuitive Surgical, Inc.										$ 670.9	$ 738.3
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (usd per share)										$ 6.01	$ 6.43
Diluted (usd per share)										$ 5.77	$ 6.26
Total comprehensive income attributable to Intuitive Surgical, Inc.										$ 664.3	$ 738.9
ASSETS
Accounts receivable, net					507.9					507.9
Prepaids and other current assets					99.2					99.2
Deferred tax assets					72.0					72.0
Intangible and other assets, net					195.8					195.8
LIABILITIES AND STOCKHOLDERS’ EQUITY
Deferred revenue					243.8					243.8
Other accrued liabilities					168.9					168.9
Other Liabilities, Noncurrent					333.6					333.6
Retained earnings					115.0					115.0
ASC 606 \| Product
Revenue:
Total revenue										2,565.3	2,195.8
Cost of revenue:
Total cost of revenue										756.3	662.6
ASC 606 \| Service
Revenue:
Total revenue										572.9	510.7
Cost of revenue:
Total cost of revenue										179.9	151.0
As Previously Reported \| ASC 606
Revenue:
Total revenue										3,128.9	2,704.4
Cost of revenue:
Total cost of revenue										934.8	814.3
Gross profit										2,194.1	1,890.1
Operating expenses:
Selling, general and administrative										810.9	705.3
Research and development										328.6	239.6
Total operating expenses										1,139.5	944.9
Income from operations										1,054.6	945.2
Interest and other income, net										41.9	35.6
Income before taxes										1,096.5	980.8
Income tax expense										436.5	244.9
Net income attributable to Intuitive Surgical, Inc.										$ 660.0	$ 735.9
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (usd per share)										$ 5.91	$ 6.40
Diluted (usd per share)										$ 5.67	$ 6.24
Total comprehensive income attributable to Intuitive Surgical, Inc.										$ 653.4	$ 736.5
ASSETS
Accounts receivable, net					511.9					511.9
Prepaids and other current assets					97.2					97.2
Deferred tax assets					87.3					87.3
Intangible and other assets, net					159.7					159.7
LIABILITIES AND STOCKHOLDERS’ EQUITY
Deferred revenue					284.5					284.5
Other accrued liabilities					169.5					169.5
Other Liabilities, Noncurrent					327.1					327.1
Retained earnings					61.4					61.4
As Previously Reported \| ASC 606 \| Product
Revenue:
Total revenue										2,547.1	2,187.4
Cost of revenue:
Total cost of revenue										754.9	663.3
As Previously Reported \| ASC 606 \| Service
Revenue:
Total revenue										581.8	517.0
Cost of revenue:
Total cost of revenue										179.9	151.0
Adjustments \| ASC 606
Revenue:
Total revenue										9.3	2.1
Cost of revenue:
Total cost of revenue										1.4	(0.7)
Gross profit										7.9	2.8
Operating expenses:
Selling, general and administrative										(0.4)	(1.7)
Research and development										0.0	0.0
Total operating expenses										(0.4)	(1.7)
Income from operations										8.3	4.5
Interest and other income, net										0.0	0.0
Income before taxes										8.3	4.5
Income tax expense										(2.6)	2.1
Net income attributable to Intuitive Surgical, Inc.										$ 10.9	$ 2.4
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (usd per share)										$ 0.10	$ 0.03
Diluted (usd per share)										$ 0.10	$ 0.02
Total comprehensive income attributable to Intuitive Surgical, Inc.										$ 10.9	$ 2.4
ASSETS
Accounts receivable, net					(4.0)					(4.0)
Prepaids and other current assets					2.0					2.0
Deferred tax assets					(15.3)					(15.3)
Intangible and other assets, net					36.1					36.1
LIABILITIES AND STOCKHOLDERS’ EQUITY
Deferred revenue					(40.7)					(40.7)
Other accrued liabilities					(0.6)					(0.6)
Other Liabilities, Noncurrent					6.5					6.5
Retained earnings					$ 53.6					53.6
Adjustments \| ASC 606 \| Product
Revenue:
Total revenue										18.2	8.4
Cost of revenue:
Total cost of revenue										1.4	(0.7)
Adjustments \| ASC 606 \| Service
Revenue:
Total revenue										(8.9)	(6.3)
Cost of revenue:
Total cost of revenue										$ 0.0	$ 0.0

Financial Instruments - Summary Of Cash And Available-For-Sale Securities (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	$ 857.9	$ 648.2
Total	4,006.5
Total assets measured at fair value, Amortized Cost	4,845.0	3,861.7
Gross Unrealized Gains	3.3	0.2
Gross Unrealized Losses	13.9	15.4
Fair Value	3,995.9
Total assets measured at fair value, Fair Value	4,834.4	3,846.5
Short-term Investments	2,205.2	1,312.4
Long-term Investments	1,771.3	1,885.9
Cash
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	269.4	197.7
Fair Value	269.4	197.7
Level 1
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	579.1	450.5
Total	2,046.9	1,474.1
Gross Unrealized Gains	1.7	0.0
Gross Unrealized Losses	5.3	4.7
Fair Value	2,043.3	1,469.4
Short-term Investments	897.8	396.2
Long-term Investments	566.4	622.7
Level 1 \| Money market funds
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	569.1	445.0
Fair Value	569.1	445.0
Short-term Investments	0.0	0.0
Long-term Investments	0.0	0.0
Level 1 \| U.S. treasuries
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	10.0	5.5
Total	1,477.8	1,029.1
Gross Unrealized Gains	1.7	0.0
Gross Unrealized Losses	5.3	4.7
Fair Value	1,474.2	1,024.4
Short-term Investments	897.8	396.2
Long-term Investments	566.4	622.7
Level 2
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	9.4	0.0
Total	2,528.7	2,189.9
Gross Unrealized Gains	1.6	0.2
Gross Unrealized Losses	8.6	10.7
Fair Value	2,521.7	2,179.4
Short-term Investments	1,307.4	916.2
Long-term Investments	1,204.9	1,263.2
Level 2 \| Commercial paper
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	1.4	0.0
Total	110.7	38.4
Gross Unrealized Gains	0.0	0.0
Gross Unrealized Losses	0.0	0.0
Fair Value	110.7	38.4
Short-term Investments	109.3	38.4
Long-term Investments	0.0	0.0
Level 2 \| Corporate securities
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	8.0	0.0
Total	1,607.8	946.6
Gross Unrealized Gains	1.3	0.2
Gross Unrealized Losses	4.8	4.4
Fair Value	1,604.3	942.4
Short-term Investments	724.5	403.9
Long-term Investments	871.8	538.5
Level 2 \| U.S. government agencies
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	0.0	0.0
Total	791.8	901.3
Gross Unrealized Gains	0.3	0.0
Gross Unrealized Losses	3.8	4.4
Fair Value	788.3	896.9
Short-term Investments	468.9	311.7
Long-term Investments	319.4	585.2
Level 2 \| Non-U.S. government securities
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents		0.0
Total		2.5
Gross Unrealized Gains		0.0
Gross Unrealized Losses		0.0
Fair Value		2.5
Short-term Investments		2.5
Long-term Investments		0.0
Level 2 \| Municipal securities
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	0.0	0.0
Total	18.4	301.1
Gross Unrealized Gains	0.0	0.0
Gross Unrealized Losses	0.0	1.9
Fair Value	18.4	299.2
Short-term Investments	4.7	159.7
Long-term Investments	$ 13.7	$ 139.5

Financial Instruments - Summary Of Contractual Maturities Of Cash Equivalents And Available-For-Sale Investments (Details) $ in Millions	Dec. 31, 2018 USD ($)
Amortized Cost
Mature in less than one year	$ 2,230.2
Mature in one to five years	1,776.3
Total	4,006.5
Fair Value
Mature in less than one year	2,224.6
Mature in one to five years	1,771.3
Total	$ 3,995.9

Financial Instruments - Additional Information (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Net unrealized losses on investments	$ (9.8)	$ (11.3)
Prepaid and other current assets
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Restricted Cash and Cash Equivalents	$ 36.5

Financial Instruments - Schedule Of Available-For-Sale Investments With Unrealized Losses (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months Fair Value	$ 1,434.1	$ 1,996.3
Unrealized losses less than 12 months	(2.8)	(7.2)
Unrealized losses 12 months or greater Fair Value	1,427.6	880.4
Unrealized losses 12 months or greater	(11.1)	(8.2)
Total Fair Value	2,861.7	2,876.7
Total Unrealized Losses	(13.9)	(15.4)
Corporate securities
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months Fair Value	727.4	567.6
Unrealized losses less than 12 months	(1.7)	(2.1)
Unrealized losses 12 months or greater Fair Value	409.6	277.0
Unrealized losses 12 months or greater	(3.1)	(2.3)
Total Fair Value	1,137.0	844.6
Total Unrealized Losses	(4.8)	(4.4)
U.S. treasuries
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months Fair Value	478.7	763.5
Unrealized losses less than 12 months	(0.9)	(2.5)
Unrealized losses 12 months or greater Fair Value	592.8	206.2
Unrealized losses 12 months or greater	(4.4)	(2.2)
Total Fair Value	1,071.5	969.7
Total Unrealized Losses	(5.3)	(4.7)
U.S. government agencies
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months Fair Value	228.0	428.9
Unrealized losses less than 12 months	(0.2)	(1.3)
Unrealized losses 12 months or greater Fair Value	425.2	345.5
Unrealized losses 12 months or greater	(3.6)	(3.1)
Total Fair Value	653.2	774.4
Total Unrealized Losses	$ (3.8)	(4.4)
Municipal securities
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months Fair Value		236.3
Unrealized losses less than 12 months		(1.3)
Unrealized losses 12 months or greater Fair Value		51.7
Unrealized losses 12 months or greater		(0.6)
Total Fair Value		288.0
Total Unrealized Losses		$ (1.9)

Financial Instruments - Derivative Instruments Used to Hedge against Balance Sheet Foreign Currency Exposures (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign exchange gains (losses) related to balance sheet re-measurement	$ (2.6)	$ 9.7	$ (5.6)
Foreign Exchange Forward \| Other income \| 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	$ 8.7	$ (9.2)	$ 6.4

Financial Instruments - Gross Notional Amounts for Outstanding Derivatives (Details) - Forward contracts - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
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	$ 183.0	$ 128.5
Derivatives Designated as Hedging Instruments \| Prepaid and other current assets
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	3.1	0.9
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	0.9	2.9
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	182.7	168.4
Derivatives Not Designated as Hedging Instruments \| Prepaid and other current assets
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	4.1	1.2
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	$ 1.1	$ 4.6

Consolidated Financial Statement Details - Inventory (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Inventory:
Raw materials	$ 164.1	$ 80.9
Work-in-process	40.0	19.7
Finished goods	204.9	140.6
Total inventory	$ 409.0	$ 241.2

Consolidated Financial Statement Details - Property, Plant and Equipment, Net (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Property, plant, and equipment, net:
Land	$ 184.6	$ 174.8
Building and building/leasehold improvements	266.2	230.5
Machinery and equipment	280.1	224.8
Operating lease assets	150.2	66.1
Computer and office equipment	52.6	44.8
Capitalized software	157.8	135.6
Construction-in-process	156.7	83.5
Gross property, plant, and equipment	1,248.2	960.1
Less: Accumulated depreciation	(436.2)	(347.0)
Total property, plant, and equipment, net	812.0	613.1
Accumulated depreciation associated with operating lease assets	$ (32.1)	$ (13.8)

Consolidated Financial Statement Details - Other Accrued Liabilities—Short Term (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Taxes payable	$ 39.1	$ 63.1
Litigation related accruals	55.0	13.8
Other accrued liabilities	137.7	92.0
Other Liabilities, Current	$ 231.8	$ 168.9

Consolidated Financial Statement Details - Other Long-Term Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income taxes—long-term	$ 270.2	$ 286.8
Deferred revenue—long-term	33.0	24.8
Other long-term liabilities	35.4	22.0
Liabilities, Other than Long-term Debt, Noncurrent	$ 338.6	$ 333.6

- Definition

The noncurrent portion of deferred revenue amount as of balance sheet date. Deferred revenue is a liability related to a revenue producing activity for which revenue has not yet been recognized, and is not expected to be recognized in the next twelve months. Generally, an entity records deferred revenue when it receives consideration from a customer before achieving certain criteria that must be met for revenue to be recognized in conformity with GAAP.

+ References + Details

Consolidated Financial Statement Details - Supplemental Cash Flow Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Supplemental Cash Flow Elements [Abstract]
Income taxes paid	$ 179.2	$ 147.5	$ 138.4
Supplemental non-cash investing activities:
Equipment transfers from inventory to property, plant, and equipment	125.7	65.8	39.3
Deferred payments related to business combinations	$ 16.7	$ 0.0	$ 0.0

Leases - Lease Receivables (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Leases [Abstract]
Gross lease receivables	$ 150.4	$ 128.0
Unearned income	(6.3)	(5.0)
Allowance for credit loss	(1.0)	(0.9)
Accounts, Notes, Loans and Financing Receivable [Line Items]
Net investment in sales-type leases	143.1	122.1
Capital Leases, Future Minimum Payments Receivable, Fiscal Year Maturity [Abstract]
2019	50.8
2020	46.5
2021	29.7
2022	14.9
2023	7.5
2024 and thereafter	1.0
Total	150.4
Prepaid and other current assets
Accounts, Notes, Loans and Financing Receivable [Line Items]
Net investment in sales-type leases	51.2	41.9
Intangible and other assets, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Net investment in sales-type leases	$ 91.9	$ 80.2

Leases - Operating Leases (Details) $ in Millions	Dec. 31, 2018 USD ($)
Leases [Abstract]
2019	$ 88.0
2020	85.8
2021	68.8
2022	51.3
2023	25.4
2024 and thereafter	1.9
Total	$ 321.2

Goodwill and Intangible Assets - Additional Information (Details) - USD ($) $ in Millions				12 Months Ended
	Dec. 11, 2018	Aug. 17, 2018	May 25, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill				$ 240.6	$ 201.1
Deferred payments related to business combinations				16.7	0.0	$ 0.0
Amortization expense related to intangible assets				$ 14.2	$ 12.9	$ 18.2
Vattikuti Technologies Pvt. Ltd.
Business Acquisition [Line Items]
Cash payments			$ 38.1
Net tangible assets acquired			4.1
Intangible assets acquired			24.2
Goodwill			$ 9.8
Weighted average useful life			4 years 3 months 18 days
InTouch
Business Acquisition [Line Items]
Cash payments		$ 22.0
Intangible assets acquired		13.3
Goodwill		$ 25.4
Weighted average useful life		5 years 8 months 12 days
Total purchase consideration		$ 38.7
Deferred payments related to business combinations		$ 16.7
Unison Surgicals Company
Business Acquisition [Line Items]
Cash payments	$ 35.4
Net tangible assets acquired	13.1
Intangible assets acquired	17.3
Goodwill	$ 5.0
Weighted average useful life	6 years 7 months 6 days
Cash acquired	$ 7.6

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 247.4	$ 193.8
Accumulated Amortization	(180.7)	(167.8)
Net Carrying Amount	66.7	26.0
Patents and developed technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	158.7	156.0
Accumulated Amortization	(144.7)	(140.2)
Net Carrying Amount	14.0	15.8
Distribution rights and others
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	40.2	9.2
Accumulated Amortization	(12.9)	(9.2)
Net Carrying Amount	27.3	0.0
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	48.5	28.6
Accumulated Amortization	(23.1)	(18.4)
Net Carrying Amount	$ 25.4	$ 10.2

Goodwill and Intangible Assets - Schedule Of Estimated Future Amortization Expense Of Intangible Assets (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
2019	$ 15.9
2020	15.8
2021	12.5
2022	10.1
2023	6.2
2024 and thereafter	6.2
Net Carrying Amount	$ 66.7	$ 26.0

Commitments And Contingencies - Schedule Of Future Minimum Lease Commitments Under Operating Leases (Details) $ in Millions	Dec. 31, 2018 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2019	$ 15.1
2020	14.5
2021	12.7
2022	11.2
2023	11.0
2024	30.9
Total	$ 95.4

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions			12 Months Ended
	Dec. 31, 2018	Jun. 11, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Operating lease maximum term (in years)			15 years
Other commitments	$ 711.2		$ 711.2
Commitments And Contingencies [Line Items]
Pre-tax settlement charges			45.2
Accrued liabilities, product liability claims	53.0		53.0	$ 12.8
Settlement agreement payment		$ 42.5
Pre-tax loss			42.5
Prepaid and other current assets
Commitments And Contingencies [Line Items]
Settlement agreement payment	42.5
da Vinci Surgical System Product Liability Matters
Commitments And Contingencies [Line Items]
Pre-tax settlement charges			2.7	16.3	$ 8.3
Accrued liabilities, product liability claims	$ 10.5		$ 10.5	$ 12.8

Stockholders' Equity - Additional Information (Details) - USD ($) shares in Millions	3 Months Ended		12 Months Ended
	Dec. 31, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (shares)			0.0	7.3	0.2
Repurchase of common stock			$ 0	$ 2,274,000,000	$ 42,500,000
Stock repurchase program, remaining authorized amount			717,500,000
Aggregate reduction in common stock and additional paid-in capital during stock repurchases			0	152,000,000	4,100,000
Amount charged to retained earnings during stock repurchases			0	$ 2,122,000,000	38,400,000
Goldman \| ASR Program
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (shares)		7.3
Repurchase of common stock	$ 274,000,000	$ 2,000,000,000
Common stock
Equity, Class of Treasury Stock [Line Items]
Stock repurchase program, authorized amount			$ 6,200,000,000.0
Stock Repurchase Program, increased to authorized amount					$ 3,000,000,000

Stockholders' Equity - Schedule Of Stock Repurchase Activities (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Equity [Abstract]
Shares repurchased (shares)	0.0	7.3	0.2
Average price per share (usd per share)	$ 0.00	$ 310.32	$ 201.70
Value of shares repurchased	$ 0.0	$ 2,274.0	$ 42.5

Stockholders' Equity - Components of Accumulated Other Comprehensive Income, Net of Tax (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	$ 4,778.8
Other comprehensive income (loss) before reclassifications	1.7	$ (8.0)
Reclassified from accumulated other comprehensive income (loss)	0.5	1.4
Other comprehensive gains (losses)	2.2	(6.6)	$ 0.6
Ending balance	6,678.8	4,778.8
Gains (Losses) on Hedge Instruments
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(2.4)	5.0
Other comprehensive income (loss) before reclassifications	3.6	(8.6)
Reclassified from accumulated other comprehensive income (loss)	(1.0)	1.2
Other comprehensive gains (losses)	2.6	(7.4)
Ending balance	0.2	(2.4)	5.0
Unrealized Gains (Losses) on Available-for-Sale Securities
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(11.3)	(8.6)
Other comprehensive income (loss) before reclassifications	0.3	(2.7)
Reclassified from accumulated other comprehensive income (loss)	1.2	0.0
Other comprehensive gains (losses)	1.5	(2.7)
Ending balance	(9.8)	(11.3)	(8.6)
Foreign Currency Translation Gains (Losses)
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	2.3	(1.3)
Other comprehensive income (loss) before reclassifications	(2.6)	3.6
Reclassified from accumulated other comprehensive income (loss)	0.0	0.0
Other comprehensive gains (losses)	(2.6)	3.6
Ending balance	(0.3)	2.3	(1.3)
Employee Benefit Plans
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(4.1)	(4.0)
Other comprehensive income (loss) before reclassifications	0.4	(0.3)
Reclassified from accumulated other comprehensive income (loss)	0.3	0.2
Other comprehensive gains (losses)	0.7	(0.1)
Ending balance	(3.4)	(4.1)	(4.0)
Total
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(15.5)	(8.9)
Other comprehensive gains (losses)		(6.6)	0.6
Ending balance	$ (13.3)	$ (15.5)	$ (8.9)

Share-Based Compensation - Additional Information (Details) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($) period $ / shares shares	Dec. 31, 2017 USD ($) shares	Dec. 31, 2016 USD ($) shares	Apr. 30, 2017 shares	Mar. 31, 2017 shares	Apr. 30, 2015 shares	Mar. 31, 2015 shares	Oct. 31, 2009 shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value of options exercised under stock option plans \| $	$ 526.6	$ 379.9	$ 273.3
Cash received from option exercises and employee stock purchase plans \| $	$ 236.6	415.5	580.9
Number of options vested and expected to vest	6,100,000
Weighted average remaining contractual life of shares vested and expected to vest, years	5 years 4 months
Aggregate intrinsic value of shares vested and expected to vest \| $	$ 1,715.2
Options vested and expected to vest, weighted-average exercise price per share \| $ / shares	$ 197.45
Share-based compensation charges, income tax effect \| $	$ 54.3	49.2	56.1
Employee Service Share-based Compensation, Tax Benefit from Exercise of Stock Options \| $	87.0
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation expense \| $	$ 373.5
Weighted average period unrecognized compensation expenses are expected to be recognized, years	2 years 2 months
Expected to vest (in shares)	1,800,000
Aggregate intrinsic value \| $	$ 879.4
Canceled (shares)	100,000
Vested in period, aggregate fair value \| $	$ 334.3	$ 144.2	$ 65.3
Restricted Stock Units (RSUs) \| Employees
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage	25.00%
Share based vesting period	4 years
Restricted Stock Units (RSUs) \| Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based vesting period	1 year
Annual Grant Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage vesting upon six months of service	12.50%
Percentage vesting per month after six months of service	2.0833%
Annual Grant Options \| February Grant
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage vesting upon six months of service	12.50%
Percentage vesting per month after six months of service	2.0833%
Annual Grant Options \| August Grant
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage vesting at the end of one month	14.5833%
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage	2.0833%
New Hire Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage vesting upon one year of service	25.00%
Percentage vesting per month after one year	2.0833%
Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares were reserved for future issuance (shares)	1,400,000
Minimum hours employed per week	20 hours
Minimum months employed per year	5 months
Maximum percentage of employees on stockholders to participate in ESPP	5.00%
Percentage of employee payroll deduction under the stock plan, maximum	15.00%
Duration for each offering period	24 months
Number of shorter purchase periods that each offering period is divided into \| period	4
Duration of each shorter offering period	6 months
Discount on fair market value on the offering date	85.00%
Discount on fair market value on the purchase date	85.00%
Period of look-back that could cause offering period to reset	2 years
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant				7,590,315	6,090,315
Employee stock purchase plan, shares issued	200,000	200,000	200,000
Employee stock purchase plan, value of shares issued \| $	$ 46.8	$ 38.3	$ 32.5
Total unrecognized compensation expense \| $	$ 11.6
Weighted average period unrecognized compensation expenses are expected to be recognized, years	11 months
Nonvested Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation expense \| $	$ 91.6
Weighted average period unrecognized compensation expenses are expected to be recognized, years	2 years 3 months 18 days
Initial RSU grants \| Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage		33.3333%
Share based vesting period		3 years
2010 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, options, expiration term (in years)	10 years
Number of shares of common stock reserved for issuance (shares)				24,450,000	21,150,000
Shares were reserved for future issuance (shares)	4,100,000
2010 Plan \| Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares were reserved for future issuance (shares)	1,800,000
2010 Plan \| Annual Grant Options \| February Grant
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based vesting period	4 years
2010 Plan \| Annual Grant Options \| August Grant
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based vesting period	3 years 6 months
2009 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, options, expiration term (in years)	10 years
Number of shares of common stock reserved for issuance (shares)						4,365,000	3,465,000
Shares were reserved for future issuance (shares)	102,000
2000 Equity Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, options, expiration term (in years)	10 years
Minimum exercise price of NSOs, percentage of fair value	85.00%
2000 Non-Employee Directors' Stock Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, options, expiration term (in years)	10 years
Number of shares of common stock reserved for issuance (shares)								450,000
Shares were reserved for future issuance (shares)	100,000
2000 Non-Employee Directors' Stock Option Plan \| Annual Grant Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based vesting period	1 year
2000 Non-Employee Directors' Stock Option Plan \| Initial Grant Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage vesting upon one year of service		33.3333%
Percentage vesting per month after one year		2.7778%
Stock options granted initial vesting period, years		3 years

Share-Based Compensation - Summary Of Stock Option Activity Under All Stock Plans (Details) shares in Millions	12 Months Ended
	Dec. 31, 2018 $ / shares shares
Number Outstanding
Beginning balance (shares) \| shares	7.2
Options granted (shares) \| shares	0.6
Options exercised (shares) \| shares	(1.5)
Options forfeited/expired (shares) \| shares	(0.1)
Ending balance (shares) \| shares	6.2
Weighted Average Exercise Price Per Share
Beginning balance (usd per share) \| $ / shares	$ 164.16
Options granted (usd per share) \| $ / shares	475.38
Options exercised (usd per share) \| $ / shares	126.52
Options forfeited/expired (usd per share) \| $ / shares	237.05
Ending balance (usd per share) \| $ / shares	$ 200.79

Share-Based Compensation - Outstanding and Exercisable Options Ranges (Details) $ / shares in Units, shares in Millions	12 Months Ended
	Dec. 31, 2018 USD ($) $ / shares shares
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Options Outstanding, Number of Shares \| shares	6.2
Options Outstanding, Weighted Average Remaining Contractual Life	5 years 5 months
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 200.79
Options Outstanding, Aggregate Intrinsic Value \| $	$ 1,727,700,000
Options Exercisable, Number of Shares \| shares	5.0
Options Exercisable, Weighted Average Remaining Contractual Life	4 years 8 months
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 168.62
Options Exercisable, Aggregate Intrinsic Value \| $	$ 1,554,500,000
Closing stock price (usd per share) \| $	$ 478.92
Exercise Price Range 1
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	$ 31.96
Range of Exercise Prices, maximum (usd per share)	$ 127.91
Options Outstanding, Number of Shares \| shares	1.4
Options Outstanding, Weighted Average Remaining Contractual Life	2 years 8 months
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 115.05
Options Exercisable, Number of Shares \| shares	1.4
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 115.05
Exercise Price Range 2
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	128.30
Range of Exercise Prices, maximum (usd per share)	$ 168.41
Options Outstanding, Number of Shares \| shares	1.3
Options Outstanding, Weighted Average Remaining Contractual Life	4 years 7 months
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 156.67
Options Exercisable, Number of Shares \| shares	1.3
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 156.62
Exercise Price Range 3
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	169.42
Range of Exercise Prices, maximum (usd per share)	$ 178.39
Options Outstanding, Number of Shares \| shares	1.4
Options Outstanding, Weighted Average Remaining Contractual Life	5 years 7 months
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 174.50
Options Exercisable, Number of Shares \| shares	1.2
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 174.17
Exercise Price Range 4
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	178.75
Range of Exercise Prices, maximum (usd per share)	$ 283.51
Options Outstanding, Number of Shares \| shares	1.2
Options Outstanding, Weighted Average Remaining Contractual Life	6 years 2 months
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 214.60
Options Exercisable, Number of Shares \| shares	0.9
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 207.77
Exercise Price Range 5
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	310.67
Range of Exercise Prices, maximum (usd per share)	$ 548.71
Options Outstanding, Number of Shares \| shares	0.9
Options Outstanding, Weighted Average Remaining Contractual Life	9 years 1 month
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 423.33
Options Exercisable, Number of Shares \| shares	0.2
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 388.12

Share-Based Compensation - Summary of RSU Activity (Details) - Restricted Stock Units (RSUs) - $ / shares shares in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Shares
Unvested beginning balance (shares)	2.1
Granted (shares)	0.8
Vested (shares)	(0.8)
Canceled (shares)	(0.1)
Unvested ending balance (shares)	2.0	2.1
Weighted Average Grant Date Fair Value
Unvested beginning balance (usd per share)	$ 209.55
Fair value at grant date (usd per share)	431.11	$ 249.34	$ 184.59
Vested (usd per share)	195.67
Canceled (usd per share)	277.10
Unvested ending balance (usd per share)	$ 295.70	$ 209.55

Share-Based Compensation - Share-Based Compensation Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 262.6	$ 209.9	$ 178.0
Income tax effect	54.3	49.2	56.1
Share-based compensation expense after income taxes	208.3	160.7	121.9
Total cost of sales
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	53.2	42.1	37.6
Total cost of sales \| Cost of sales—products
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	36.4	28.1	25.2
Total cost of sales \| Cost of sales—services
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	16.8	14.0	12.4
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	133.2	111.8	97.4
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 76.2	$ 56.0	$ 43.0

Share-Based Compensation - Schedule Of Estimated Fair Value Of Option Using Black-Scholes Option Pricing Model, Weighted Average Assumptions (Details) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
STOCK OPTION PLANS
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	2.70%	1.80%	1.10%
Expected term (years)	4 years 3 months 6 days	4 years 1 month 6 days	4 years 2 months
Volatility (percent)	33.00%	25.00%	26.00%
Weighted average fair value at grant date (usd per share)	$ 146.30	$ 67.03	$ 47.06
EMPLOYEE STOCK PURCHASE PLAN
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	2.10%	1.20%	0.60%
Expected term (years)	1 year 3 months 18 days	1 year 2 months 12 days	1 year 2 months 12 days
Volatility (percent)	32.00%	28.00%	30.00%
Weighted average fair value at grant date (usd per share)	$ 135.84	$ 79.77	$ 57.57
RESTRICTED STOCK UNITS
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value at grant date (usd per share)	$ 431.11	$ 249.34	$ 184.59

Income Taxes - Schedule Of Income Before Provision For Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Income before provision for income taxes, U.S.	$ 852.7	$ 774.7	$ 657.0
Income before provision for income taxes, Foreign	426.8	330.1	328.3
Income before taxes	$ 1,279.5	$ 1,104.8	$ 985.3

Income Taxes - Schedule Of Provision For Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Current income taxes, Federal	$ 89.5	$ 352.1	$ 207.0
Current income taxes, State	21.1	13.0	13.4
Current income taxes, Foreign	9.9	8.7	5.4
Current income taxes	120.5	373.8	225.8
Deferred income taxes, Federal	(4.1)	62.8	20.5
Deferred income taxes, State	(0.3)	(0.3)	0.6
Deferred income taxes, Foreign	38.4	(2.4)	0.1
Deferred income taxes	34.0	60.1	21.2
Total income tax expense	$ 154.5	$ 433.9	$ 247.0

Income Taxes - Schedule Of Income Tax Difference From Statutory Rate (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Federal tax at statutory rate									$ 268.7	$ 386.7	$ 344.9
State taxes, net of federal benefits									20.8	16.0	14.0
Foreign rate differential									(44.7)	(115.7)	(91.2)
U.S. tax on foreign earnings									43.7	8.4	5.0
Research and development credit									(25.2)	(15.3)	(7.8)
Share-based compensation not benefited									9.9	10.8	3.6
Domestic production activities deduction									0.0	(7.9)	(8.0)
Reversal of unrecognized tax benefits									(5.2)	(62.4)	(15.8)
Tax Cuts and Jobs Act impact									0.5	317.8	0.0
Excess tax benefits related to share-based compensation arrangements	$ (15.8)	$ (24.1)	$ (21.6)	$ (54.7)	$ (19.9)	$ (19.7)	$ (30.6)	$ (32.6)	(116.2)	(102.8)	0.0
Other									2.2	(1.7)	2.3
Total income tax expense									$ 154.5	$ 433.9	$ 247.0

Income Taxes - Schedule Of Deferred Tax Assets (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Deferred tax assets:
Share-based compensation expense	$ 87.2	$ 79.1
Expenses deducted in later years for tax purposes	29.1	29.7
Intangible assets	351.9	0.0
Research and other credits	40.1	27.5
Other	9.0	10.5
Gross deferred tax assets	517.3	146.8
Valuation allowance	(42.3)	(29.4)
Deferred tax assets	475.0	117.4
Deferred tax liabilities:
Fixed assets	(42.2)	(26.3)
Intangible assets	(7.5)	(3.6)
Other	(0.1)	(15.5)
Deferred tax liabilities	(49.8)	(45.4)
Net deferred tax assets	$ 425.2	$ 72.0

Income Taxes - Schedule Of Gross Unrecognized Income Tax Benefits (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Reconciliation of Unrecognized Tax Benefits [Roll Forward]
Beginning balance	$ 65.4	$ 106.0	$ 92.4
Increases related to tax positions taken during the current year	22.5	21.1	29.9
Decreases related to tax positions taken during a prior year	(0.9)	(46.5)	(0.5)
Decreases related to settlements with tax authorities	0.0	(0.5)	0.0
Decreases related to expiration of statute of limitations	(8.2)	(14.7)	(15.8)
Ending balance	$ 78.8	$ 65.4	$ 106.0

Income Taxes - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Holiday [Line Items]
Provisional income tax expense									$ 0.5	$ 317.8	$ 0.0
Estimated cumulative undistributed foreign earnings										1,600.0
U.S. tax on foreign earnings									43.7	8.4	5.0
Excess tax benefits associated with employee equity plans	$ 15.8	$ 24.1	$ 21.6	$ 54.7	$ 19.9	$ 19.7	$ 30.6	$ 32.6	116.2	102.8	0.0
Tax Cuts and Jobs Act of 2017, Change in Tax Rate, Income Tax Expense (Benefit)										47.6
Valuation allowance	42.3				29.4				42.3	29.4
Unrecognized tax benefits, period increase (decrease)									13.4
Total gross unrecognized tax benefits	78.8				65.4				78.8	65.4	106.0	$ 92.4
Interest and penalties related to unrecognized tax benefits accrued	$ 2.6				$ 1.8				$ 2.6	1.8	3.7
Swiss Federal Tax Administration (FTA)
Income Tax Holiday [Line Items]
Tax benefit from tax holiday										$ 10.9	$ 10.0
Tax benefit from tax holiday (in dollars per share)										$ 0.09	$ 0.08
Pro forma
Income Tax Holiday [Line Items]
U.S. tax on foreign earnings										$ 270.2

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								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Earnings Per Share [Abstract]
Net income attributable to Intuitive Surgical, Inc.	$ 292.5	$ 292.5	$ 255.3	$ 287.6	$ (31.5)	$ 298.6	$ 223.0	$ 180.8	$ 1,127.9	$ 670.9	$ 738.3
Weighted-average shares outstanding basic (shares)									113.7	111.7	114.9
Add: Dilutive potential shares									5.1	4.6	3.0
Weighted-average shares used in computing diluted net income per share (shares)									118.8	116.3	117.9
Basic net income per share (usd per share)	$ 2.56	$ 2.57	$ 2.25	$ 2.55	$ (0.28)	$ 2.67	$ 2.01	$ 1.62	$ 9.92	$ 6.01	$ 6.43
Diluted net income per share (usd per share)	$ 2.45	$ 2.45	$ 2.15	$ 2.44	$ (0.28)	$ 2.56	$ 1.94	$ 1.57	$ 9.49	$ 5.77	$ 6.26

Net Income Per Share - Additional Information (Details) - shares shares in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Earnings Per Share [Abstract]
Employee stock options excluded from computation of diluted net income per share	0.4	0.2	0.6

Employee Benefit Plans - Additional Information (Details)	12 Months Ended
	Dec. 31, 2018 USD ($)
Retirement Benefits [Abstract]
Maximum rate of employees' contribution to 401(k) plan	100.00%
Employer match percentage	200.00%
Employer matching contributions	$ 1,500

Subsequent Event (Details) - USD ($) $ in Millions	1 Months Ended
Subsequent Event (Details) - USD ($) $ in Millions	Jan. 31, 2019	Dec. 31, 2016
Subsequent event \| Minimum
Subsequent Event [Line Items]
Estimated cash payments	$ 80
Subsequent event \| Maximum
Subsequent Event [Line Items]
Estimated cash payments	90
Common stock
Subsequent Event [Line Items]
Stock Repurchase Program, increased to authorized amount		$ 3,000
Common stock \| Subsequent event
Subsequent Event [Line Items]
Stock Repurchase Program, increased to authorized amount	$ 2,000

Selected Quarterly Data - Schedule Of Selected Quarterly Data (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Selected Quarterly Financial Information [Abstract]
Total revenue	$ 1,046.5	$ 920.9	$ 909.3	$ 847.5	$ 892.0	$ 807.8	$ 758.8	$ 679.6	$ 3,724.2	$ 3,138.2	$ 2,706.5
Gross profit	735.7	642.3	632.3	593.8	634.0	568.1	530.1	469.8	2,604.1	2,202.0	1,892.9
Net income	$ 292.5	$ 292.5	$ 255.3	$ 287.6	$ (31.5)	$ 298.6	$ 223.0	$ 180.8	$ 1,127.9	$ 670.9	$ 738.3
Basic net income per share (usd per share)	$ 2.56	$ 2.57	$ 2.25	$ 2.55	$ (0.28)	$ 2.67	$ 2.01	$ 1.62	$ 9.92	$ 6.01	$ 6.43
Diluted net income per share (usd per share)	$ 2.45	$ 2.45	$ 2.15	$ 2.44	$ (0.28)	$ 2.56	$ 1.94	$ 1.57	$ 9.49	$ 5.77	$ 6.26
Income tax (expense) related to the 2017 Tax Act					$ (317.8)	$ 0.0	$ 0.0	$ 0.0
Excess tax benefits related to share-based compensation arrangements	$ 15.8	$ 24.1	$ 21.6	$ 54.7	19.9	19.7	30.6	32.6	$ 116.2	$ 102.8	$ 0.0
Certain one-time tax benefits	2.5	4.6	0.0	0.0	0.0	68.4	0.0	0.0
Includes pre-tax litigation (charges)	0.0	1.8	(42.5)	(4.5)	$ 1.2	$ (9.7)	$ 4.5	$ (21.3)
Includes charitable foundation contribution expense	$ (25.2)	$ 0.0	$ 0.0	$ 0.0

Valuation And Qualifying Accounts (Details) - Allowance for doubtful accounts, loan credit losses, and sales returns - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	$ 14.6	$ 10.8	$ 9.4
Additions	46.0	36.1	24.6
Deductions	(40.2)	(32.3)	(23.2)
Balance at End of Year	$ 20.4	$ 14.6	$ 10.8