0001035267-24-000021 | 10-K | XBRL Viewer

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Commitments and Contingencies (Details)			2 Months Ended	12 Months Ended
Commitments and Contingencies (Details)	Sep. 20, 2023 USD ($)	Oct. 19, 2022 USD ($)	Jul. 08, 2021 classActionComplaint	Dec. 31, 2022 USD ($)	Dec. 31, 2023 USD ($)
Loss Contingencies [Line Items]
Estimated commitments for open purchase orders and contractual obligations					$ 2,370,000,000
Pre-tax litigation charges				$ 28,100,000
Number of class action complaints filed \| classActionComplaint			3
Rex Medical, L.P.
Loss Contingencies [Line Items]
Damages awarded	$ 1	$ 10,000,000

Stockholders' Equity

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Stockholders' Equity

STOCKHOLDERS’ EQUITY

Stock Repurchase Program

Through December 31, 2023, the Board has authorized an aggregate of $10.0 billion of funding for the Company’s common stock Repurchase Program since its establishment in March 2009. The most recent authorization occurred in July 2022 when the Board increased the authorized amount available under the Repurchase Program to $3.5 billion, including amounts remaining under previous authorization. As of December 31, 2023, the remaining amount of share repurchases authorized by the Board under the Repurchase Program was approximately $1.1 billion.

The following table summarizes stock repurchase activities (in millions, except per share amounts):


	Years Ended December 31,
	2023		2022		2021
Shares repurchased	1.7		11.2		—
Average price per share	$	241.38	$	233.70	$	—
Value of shares repurchased	$	416.3	$	2,607.4	$	—

In August 2022, the Company entered into an accelerated share repurchase program (the “August ASR Program”) with Goldman, Sachs & Co. (“Goldman”) to repurchase $1.0 billion of the Company’s common stock. In September 2022, the August ASR Program was completed, and, in total, 4.6 million shares of common stock were received and retired. In total, 4.6 million shares were repurchased at an average price per share of $217.52. The total cost of the August ASR Program was reflected as a reduction to equity in the Consolidated Balance Sheets.

In October 2022, the Company entered into an accelerated share repurchase program (the “October ASR Program”) with Citibank, N.A. (“Citibank”) to repurchase $1.0 billion of the Company’s common stock. In December 2022, the October ASR Program was completed, and, in total, 3.9 million shares were repurchased at an average price per share of $254.48. The total cost of the October ASR Program was reflected as a reduction to equity in the Consolidated Balance Sheets.

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, 2023, 2022, and 2021, the Company reduced common stock and additional paid-in capital by an aggregate of $19 million, $211 million, and zero, respectively, and charged $0.4 billion, $2.4 billion, and zero, respectively, to retained earnings.

As a provision of the Inflation Reduction Act enacted in the U.S. during 2022, the Company is subject to an excise tax on corporate stock repurchases, which is assessed as one percent of the fair market value of net stock repurchases after December 31, 2022. As of December 31, 2023, no excise tax was accrued, as the aggregate fair market value of the Company’s stock issuances exceeded the fair market value of stock repurchases.

Accumulated Other Comprehensive Income (Loss), Net of Tax, Attributable to Intuitive Surgical, Inc.

The components of accumulated other comprehensive income (loss), net of tax, attributable to Intuitive Surgical, Inc. are as follows (in millions):


	Year Ended December 31, 2023
	Gains (Losses) on Hedge Instruments		Unrealized Gains (Losses) on Available-for-Sale Securities		Foreign Currency Translation Gains (Losses)		Employee Benefit Plans		Total
Beginning balance	$	(2.9)	$	(154.2)	$	(6.6)	$	1.2	$	(162.5)
Other comprehensive income (loss) before reclassifications	(6.6)		124.6		26.0		(0.6)		143.4
Amounts reclassified from accumulated other comprehensive income (loss)	7.0		(0.1)		—		—		6.9
Net current-period other comprehensive income (loss)	0.4		124.5		26.0		(0.6)		150.3
Ending balance	$	(2.5)	$	(29.7)	$	19.4	$	0.6	$	(12.2)

	Year Ended December 31, 2022
	Gains (Losses) on Hedge Instruments		Unrealized Gains (Losses) on Available-for-Sale Securities		Foreign Currency Translation Gains (Losses)		Employee Benefit Plans		Total
Beginning balance	$	4.5	$	(16.0)	$	(7.9)	$	(4.8)	$	(24.2)
Other comprehensive income (loss) before reclassifications	(35.0)		(138.2)		1.3		5.8		(166.1)
Amounts reclassified from accumulated other comprehensive income (loss)	27.6		—		—		0.2		27.8
Net current-period other comprehensive income (loss)	(7.4)		(138.2)		1.3		6.0		(138.3)
Ending balance	$	(2.9)	$	(154.2)	$	(6.6)	$	1.2	$	(162.5)

The tax impacts for amounts recognized in other comprehensive income before reclassifications were as follows (in millions):


	Years Ended December 31,
Available-for-sale securities	2023		2022
Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income (loss)	$	(35.7)	$	39.1

The tax impacts for amounts recognized in other comprehensive income (loss) before reclassifications for hedge instruments, foreign currency translation gains (losses), and employee benefit plans in 2023 and 2022 were not material to the Company’s Consolidated Financial Statements. The tax impacts for amounts reclassified from accumulated other comprehensive loss relating to hedge instruments, available-for-sale securities, foreign currency translation gains (losses), and employee benefit plans in 2023 and 2022 were not material to the Company’s Consolidated Financial Statements.

- Definition

The entire disclosure for equity.

+ References

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+ Details

Stockholders' Equity - Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Equity [Abstract]
Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income (loss)	$ (35.7)	$ 39.1

Stockholders' Equity - Components of Accumulated Other Comprehensive Income, Net of Tax (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	$ 11,041.9
Ending balance	13,307.6	$ 11,041.9
Gains (Losses) on Hedge Instruments
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(2.9)	4.5
Other comprehensive income (loss) before reclassifications	(6.6)	(35.0)
Amounts reclassified from accumulated other comprehensive income (loss)	7.0	27.6
Other comprehensive income (loss), net of tax	0.4	(7.4)
Ending balance	(2.5)	(2.9)
Unrealized Gains (Losses) on Available-for-Sale Securities
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(154.2)	(16.0)
Other comprehensive income (loss) before reclassifications	124.6	(138.2)
Amounts reclassified from accumulated other comprehensive income (loss)	(0.1)	0.0
Other comprehensive income (loss), net of tax	124.5	(138.2)
Ending balance	(29.7)	(154.2)
Foreign Currency Translation Gains (Losses)
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(6.6)	(7.9)
Other comprehensive income (loss) before reclassifications	26.0	1.3
Amounts reclassified from accumulated other comprehensive income (loss)	0.0	0.0
Other comprehensive income (loss), net of tax	26.0	1.3
Ending balance	19.4	(6.6)
Employee Benefit Plans
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	1.2	(4.8)
Other comprehensive income (loss) before reclassifications	(0.6)	5.8
Amounts reclassified from accumulated other comprehensive income (loss)	0.0	0.2
Other comprehensive income (loss), net of tax	(0.6)	6.0
Ending balance	0.6	1.2
Total
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(162.5)	(24.2)
Other comprehensive income (loss) before reclassifications	143.4	(166.1)
Amounts reclassified from accumulated other comprehensive income (loss)	6.9	27.8
Other comprehensive income (loss), net of tax	150.3	(138.3)
Ending balance	$ (12.2)	$ (162.5)

Consolidated Financial Statement Details - Accounts Receivable, Net (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Trade accounts receivable, net	$ 1,042.2	$ 864.9
Unbilled accounts receivable and other	105.0	91.7
Sales returns and allowances	(17.0)	(14.5)
Total accounts receivable, net	$ 1,130.2	$ 942.1

Income Taxes - Schedule Of Deferred Tax Assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Deferred tax assets:
Intangible assets	$ 420.9	$ 342.8
Capitalized research and development expenditures	306.4	172.5
Research and development credits	193.2	156.7
Share-based compensation expense	135.1	121.3
Swiss tax credits	122.4	0.0
Expenses deducted in later years for tax purposes	55.9	57.5
Lease liabilities	16.5	16.6
Net operating losses	2.8	6.4
Net unrealized losses on available-for-sale securities and other	9.2	45.5
Gross deferred tax assets	1,262.4	919.3
Valuation allowance	(269.8)	(168.6)
Deferred tax assets	992.6	750.7
Deferred tax liabilities:
Property, plant, and equipment	(60.3)	(64.1)
Right-of-use assets	(11.8)	(11.8)
Intangible assets	(9.8)	(9.3)
Other	(0.2)	(1.0)
Deferred tax liabilities	(82.1)	(86.2)
Net deferred tax assets	$ 910.5	$ 664.5

Income Taxes - Schedule Of Provision For Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Current income taxes, Federal	$ 315.2	$ 350.4	$ 158.8
Current income taxes, State	32.8	49.2	17.3
Current income taxes, Foreign	74.4	48.1	50.1
Current income taxes	422.4	447.7	226.2
Deferred income taxes, Federal	(122.4)	(188.8)	(21.4)
Deferred income taxes, State	(25.1)	(16.4)	0.5
Deferred income taxes, Foreign	(133.3)	19.9	(43.1)
Deferred income taxes	(280.8)	(185.3)	(64.0)
Total income tax expense	$ 141.6	$ 262.4	$ 162.2

Financial Instruments - Schedule Of Available-For-Sale Investments With Unrealized Losses (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months, fair value	$ 132.5	$ 1,510.4
Unrealized losses less than 12 months	(0.1)	(49.1)
Unrealized losses 12 months or greater, fair value	2,595.1	3,538.3
Unrealized losses 12 months or greater	(60.4)	(149.4)
Total Fair Value	2,727.6	5,048.7
Total Unrealized Losses	(60.5)	(198.5)
U.S. treasuries
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months, fair value	48.5	731.7
Unrealized losses less than 12 months	0.0	(26.0)
Unrealized losses 12 months or greater, fair value	1,112.9	1,886.9
Unrealized losses 12 months or greater	(25.4)	(70.6)
Total Fair Value	1,161.4	2,618.6
Total Unrealized Losses	(25.4)	(96.6)
Corporate debt securities
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months, fair value	54.2	631.4
Unrealized losses less than 12 months	(0.1)	(17.6)
Unrealized losses 12 months or greater, fair value	1,219.2	1,221.9
Unrealized losses 12 months or greater	(25.8)	(58.4)
Total Fair Value	1,273.4	1,853.3
Total Unrealized Losses	(25.9)	(76.0)
U.S. government agencies
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months, fair value	29.8	102.7
Unrealized losses less than 12 months	0.0	(4.4)
Unrealized losses 12 months or greater, fair value	185.6	324.6
Unrealized losses 12 months or greater	(7.3)	(15.5)
Total Fair Value	215.4	427.3
Total Unrealized Losses	(7.3)	(19.9)
Municipal securities
Schedule of Available-for-sale Securities [Line Items]
Unrealized losses less than 12 months, fair value	0.0	44.6
Unrealized losses less than 12 months	0.0	(1.1)
Unrealized losses 12 months or greater, fair value	77.4	104.9
Unrealized losses 12 months or greater	(1.9)	(4.9)
Total Fair Value	77.4	149.5
Total Unrealized Losses	$ (1.9)	$ (6.0)

Revenue - Sales-type and Operating Lease Revenue (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Deferred Revenue Arrangement [Line Items]
Sales-Type Lease, Lease Income, Statement of Income or Comprehensive Income [Extensible Enumeration]	Total revenue	Total revenue	Total revenue
Sales-type lease revenue	$ 78.4	$ 156.4	$ 220.3
Operating Lease, Lease Income, Statement of Income or Comprehensive Income [Extensible Enumeration]	Total revenue	Total revenue	Total revenue
Operating lease revenue	$ 500.5	$ 376.5	$ 276.9
Variable Lease Revenue, Usage-Based Arrangements
Deferred Revenue Arrangement [Line Items]
Operating lease revenue	$ 216.5	$ 133.0	$ 78.1

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2023
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/or 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.

Share-Based Compensation - Summary Of Stock Option Activity Under All Stock Plans (Details) shares in Millions	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Number Outstanding
Beginning balance (shares) \| shares	10.8
Options granted (shares) \| shares	1.4
Options exercised (shares) \| shares	(2.3)
Options forfeited/expired (shares) \| shares	(0.1)
Ending balance (shares) \| shares	9.8
Weighted-Average Exercise Price Per Share
Beginning balance (usd per share) \| $ / shares	$ 144.86
Options granted (usd per share) \| $ / shares	267.38
Options exercised (usd per share) \| $ / shares	83.97
Options forfeited/expired (usd per share) \| $ / shares	261.39
Ending balance (usd per share) \| $ / shares	$ 174.90

Description of the Business	12 Months Ended
Description of the Business	Dec. 31, 2023
Accounting Policies [Abstract]
Description of the Business	DESCRIPTION OF THE BUSINESS Intuitive Surgical, Inc. (“Intuitive” or the “Company”) develops, manufactures, and markets da Vinci® surgical systems and the Ion® endoluminal 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, and a high-performance vision system. The Ion endoluminal system consists of a system cart, a controller, a catheter, and a vision probe. Both systems use software, instruments, and accessories.

Consolidated Balance Sheets - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 2,750.1	$ 1,581.2
Short-term investments	2,473.1	2,536.7
Accounts receivable, net of allowances of $27.1 and $22.4 as of December 31, 2023, and 2022, respectively	1,130.2	942.1
Inventory	1,220.6	893.2
Prepaids and other current assets	314.0	299.8
Total current assets	7,888.0	6,253.0
Property, plant, and equipment, net	3,537.6	2,374.2
Long-term investments	2,120.0	2,623.6
Deferred tax assets	910.5	664.6
Intangible and other assets, net	636.7	710.1
Goodwill	348.7	348.5
Total assets	15,441.5	12,974.0
Current liabilities:
Accounts payable	188.7	147.0
Accrued compensation and employee benefits	436.4	401.6
Deferred revenue	446.1	397.3
Other accrued liabilities	587.5	476.2
Total current liabilities	1,658.7	1,422.1
Other long-term liabilities	385.5	439.3
Total liabilities	2,044.2	1,861.4
Commitments and contingencies (Note 8)
Stockholders’ equity:
Preferred stock, 2.5 shares authorized, $0.001 par value, issuable in series; zero shares issued and outstanding as of December 31, 2023, and 2022	0.0	0.0
Common stock, 600.0 shares authorized, $0.001 par value, 352.3 shares and 350.0 shares issued and outstanding as of December 31, 2023, and 2022, respectively	0.4	0.4
Additional paid-in capital	8,576.4	7,703.9
Retained earnings	4,743.0	3,500.1
Accumulated other comprehensive loss	(12.2)	(162.5)
Total Intuitive Surgical, Inc. stockholders’ equity	13,307.6	11,041.9
Noncontrolling interest in joint venture	89.7	70.7
Total stockholders’ equity	13,397.3	11,112.6
Total liabilities and stockholders’ equity	$ 15,441.5	$ 12,974.0

Goodwill and Intangible Assets - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Impairment of goodwill	$ 0.0
Amortization of intangible assets	$ 20.2	$ 27.8	$ 27.4

Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases

LEASES

Lessor Information related to Intuitive System Leasing

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


	December 31,
	2023		2022
Gross lease receivables	$	384.5	$	449.4
Unearned income	(12.9)		(14.4)
Subtotal	371.6		435.0
Allowance for credit loss	(2.7)		(3.0)
Net investment in sales-type leases	$	368.9	$	432.0

Reported as:
Prepaids and other current assets	$	137.3	$	131.2
Intangible and other assets, net	231.6		300.8
Net investment in sales-type leases	$	368.9	$	432.0

Contractual maturities of gross lease receivables as of December 31, 2023, are as follows (in millions):


Fiscal Year	Amount
2024	$	143.3
2025	113.0
2026	74.1
2027	39.8
2028	10.9
2029 and thereafter	3.4
Total	$	384.5

Operating Leases. The Company’s fixed-payment or usage-based operating lease terms are generally less than seven years. Future lease payments (excluding non-lease elements and contingent payments related to usage-based arrangements) related to the non-cancellable portion of operating leases as of December 31, 2023, are as follows (in millions):


Fiscal Year	Amount
2024	$	277.2
2025	232.3
2026	169.4
2027	103.0
2028	43.6
2029 and thereafter	11.2
Total	$	836.7

Lessee Information

The Company enters into operating leases for real estate, automobiles, and certain equipment. Operating lease expense was $26.8 million, $25.7 million, and $20.4 million for the years ended December 31, 2023, 2022, and 2021, respectively. For leases with terms of 12 months or less, the related expense was immaterial for each of the years ended December 31, 2023, 2022, and 2021.

Supplemental cash flow information for the years ended December 31, 2023, 2022, and 2021 related to operating leases was as follows (in millions):


	Years Ended December 31,
	2023		2022		2021
Cash paid for leases that were included within operating cash outflows	$	30.2	$	33.8	$	23.2
Right-of-use assets recognized related to new lease obligations	$	27.8	$	34.0	$	30.6

Supplemental balance sheet information, as of December 31, 2023, and 2022, related to operating leases was as follows (in millions, except lease term and discount rate):


	December 31,
	2023		2022
Intangible and other assets, net (Right-of-use assets)	$	79.3	$	82.2

Other accrued liabilities	$	25.3	$	24.2
Other long-term liabilities	64.5		69.6
Total lease liabilities	$	89.8	$	93.8

Weighted-average remaining lease term	3.7 years		4.5 years
Weighted-average discount rate	3.4%		3.0%

As of December 31, 2023, the future payments related to the Company’s operating lease liabilities are scheduled as follows (in millions):


Fiscal Year	Amount
2024	$	27.4
2025	27.1
2026	22.9
2027	9.7
2028	5.9
2029 and thereafter	3.1
Total lease payments	96.1
Less: imputed interest	(6.3)
Total operating lease liabilities	$	89.8

Leases

LEASES

Lessor Information related to Intuitive System Leasing

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


	December 31,
	2023		2022
Gross lease receivables	$	384.5	$	449.4
Unearned income	(12.9)		(14.4)
Subtotal	371.6		435.0
Allowance for credit loss	(2.7)		(3.0)
Net investment in sales-type leases	$	368.9	$	432.0

Reported as:
Prepaids and other current assets	$	137.3	$	131.2
Intangible and other assets, net	231.6		300.8
Net investment in sales-type leases	$	368.9	$	432.0

Contractual maturities of gross lease receivables as of December 31, 2023, are as follows (in millions):


Fiscal Year	Amount
2024	$	143.3
2025	113.0
2026	74.1
2027	39.8
2028	10.9
2029 and thereafter	3.4
Total	$	384.5


Fiscal Year	Amount
2024	$	277.2
2025	232.3
2026	169.4
2027	103.0
2028	43.6
2029 and thereafter	11.2
Total	$	836.7

Lessee Information

Supplemental cash flow information for the years ended December 31, 2023, 2022, and 2021 related to operating leases was as follows (in millions):


	Years Ended December 31,
	2023		2022		2021
Cash paid for leases that were included within operating cash outflows	$	30.2	$	33.8	$	23.2
Right-of-use assets recognized related to new lease obligations	$	27.8	$	34.0	$	30.6

Supplemental balance sheet information, as of December 31, 2023, and 2022, related to operating leases was as follows (in millions, except lease term and discount rate):


	December 31,
	2023		2022
Intangible and other assets, net (Right-of-use assets)	$	79.3	$	82.2

Other accrued liabilities	$	25.3	$	24.2
Other long-term liabilities	64.5		69.6
Total lease liabilities	$	89.8	$	93.8

Weighted-average remaining lease term	3.7 years		4.5 years
Weighted-average discount rate	3.4%		3.0%

As of December 31, 2023, the future payments related to the Company’s operating lease liabilities are scheduled as follows (in millions):


Fiscal Year	Amount
2024	$	27.4
2025	27.1
2026	22.9
2027	9.7
2028	5.9
2029 and thereafter	3.1
Total lease payments	96.1
Less: imputed interest	(6.3)
Total operating lease liabilities	$	89.8

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Audit Information [Abstract]
Auditor Firm ID	238
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	San Jose, California

Revenue (Tables)

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Revenue Disaggregated by Types and Geography

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


	Years Ended December 31,
U.S.	2023		2022		2021
Instruments and accessories	$	3,059.8	$	2,507.2	$	2,225.1
Systems	865.5		966.0		1,024.8
Services	763.3		684.4		603.3
Total U.S. revenue	$	4,688.6	$	4,157.6	$	3,853.2

OUS
Instruments and accessories	$	1,216.8	$	1,010.7	$	875.4
Systems	814.2		714.1		668.6
Services	404.5		339.8		312.9
Total OUS revenue	$	2,435.5	$	2,064.6	$	1,856.9

Total
Instruments and accessories	$	4,276.6	$	3,517.9	$	3,100.5
Systems	1,679.7		1,680.1		1,693.4
Services	1,167.8		1,024.2		916.2
Total revenue	$	7,124.1	$	6,222.2	$	5,710.1

Summary of Contract Assets and Liabilities

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


	December 31,
	2023		2022
Contract assets	$	20.2	$	45.0
Deferred revenue	$	491.7	$	438.3

Sales-type Lease Receivable

The following table presents product revenue from Intuitive System Leasing arrangements (in millions):


	Years Ended December 31,
	2023		2022		2021
Sales-type lease revenue	$	78.4	$	156.4	$	220.3
Operating lease revenue*	$	500.5	$	376.5	$	276.9

*Variable lease revenue relating to usage-based arrangements included within operating lease revenue	$	216.5	$	133.0	$	78.1

Operating Lease Revenue

The following table presents product revenue from Intuitive System Leasing arrangements (in millions):


	Years Ended December 31,
	2023		2022		2021
Sales-type lease revenue	$	78.4	$	156.4	$	220.3
Operating lease revenue*	$	500.5	$	376.5	$	276.9

*Variable lease revenue relating to usage-based arrangements included within operating lease revenue	$	216.5	$	133.0	$	78.1

Revenue - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue recognized	$ 396	$ 380
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Price allocated to remaining performance obligations	$ 2,290
Remaining performance obligations, percent	45.00%
Remaining performance obligations, expected timing of satisfaction, period	5 years

Consolidated Statements Of Stockholders' Equity - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Additional Paid-In Capital	Retained Earnings	Accumulated Other Comprehensive (Loss)/Income	Total Intuitive Surgical, Inc. Stockholders’ Equity	Noncontrolling Interest in Joint Venture
Beginning balance (shares) at Dec. 31, 2020		353.1
Beginning balance at Dec. 31, 2020	$ 9,759.1	$ 0.4	$ 6,444.9	$ 3,261.3	$ 24.9	$ 9,731.5	$ 27.6
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock through employee stock plans (shares)		5.4
Issuance of common stock through employee stock plans	276.5		276.5			276.5
Shares withheld related to net share settlement of equity awards (shares)		(0.8)
Shares withheld related to net share settlement of equity awards	(211.6)		(6.6)	(205.0)		(211.6)
Share-based compensation expense related to employee stock plans	449.2		449.2			449.2
Net income attributable to Intuitive Surgical, Inc.	1,704.6			1,704.6		1,704.6
Other comprehensive income (loss)	(49.8)				(49.1)	(49.1)	(0.7)
Net income attributable to noncontrolling interest in joint venture	23.5						23.5
Ending balance (shares) at Dec. 31, 2021		357.7
Ending balance at Dec. 31, 2021	11,951.5	$ 0.4	7,164.0	4,760.9	(24.2)	11,901.1	50.4
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock through employee stock plans (shares)		4.2
Issuance of common stock through employee stock plans	233.8		233.8			233.8
Shares withheld related to net share settlement of equity awards (shares)		(0.7)
Shares withheld related to net share settlement of equity awards	(194.2)		(7.4)	(186.8)		(194.2)
Share-based compensation expense related to employee stock plans	524.6		524.6			524.6
Repurchase and retirement of common stock (shares)		(11.2)
Repurchase and retirement of common stock	(2,607.4)		(211.1)	(2,396.3)		(2,607.4)
Net income attributable to Intuitive Surgical, Inc.	1,322.3			1,322.3		1,322.3
Other comprehensive income (loss)	(140.1)				(138.3)	(138.3)	(1.8)
Net income attributable to noncontrolling interest in joint venture	$ 22.1						22.1
Ending balance (shares) at Dec. 31, 2022	350.0	350.0
Ending balance at Dec. 31, 2022	$ 11,112.6	$ 0.4	7,703.9	3,500.1	(162.5)	11,041.9	70.7
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock through employee stock plans (shares)		4.7
Issuance of common stock through employee stock plans	296.3		296.3			296.3
Shares withheld related to net share settlement of equity awards (shares)		(0.7)
Shares withheld related to net share settlement of equity awards	(164.7)		(7.2)	(157.5)		(164.7)
Share-based compensation expense related to employee stock plans	602.1		602.1			602.1
Repurchase and retirement of common stock (shares)		(1.7)
Repurchase and retirement of common stock	(416.3)		(18.7)	(397.6)		(416.3)
Net income attributable to Intuitive Surgical, Inc.	1,798.0			1,798.0		1,798.0
Other comprehensive income (loss)	150.0				150.3	150.3	(0.3)
Net income attributable to noncontrolling interest in joint venture	$ 19.3						19.3
Ending balance (shares) at Dec. 31, 2023	352.3	352.3
Ending balance at Dec. 31, 2023	$ 13,397.3	$ 0.4	$ 8,576.4	$ 4,743.0	$ (12.2)	$ 13,307.6	$ 89.7

Leases (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Lessor, Sales-type Lease, Lease Income

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


	December 31,
	2023		2022
Gross lease receivables	$	384.5	$	449.4
Unearned income	(12.9)		(14.4)
Subtotal	371.6		435.0
Allowance for credit loss	(2.7)		(3.0)
Net investment in sales-type leases	$	368.9	$	432.0

Reported as:
Prepaids and other current assets	$	137.3	$	131.2
Intangible and other assets, net	231.6		300.8
Net investment in sales-type leases	$	368.9	$	432.0

Schedule of Contractual Maturities of Gross Lease Receivables

Contractual maturities of gross lease receivables as of December 31, 2023, are as follows (in millions):


Fiscal Year	Amount
2024	$	143.3
2025	113.0
2026	74.1
2027	39.8
2028	10.9
2029 and thereafter	3.4
Total	$	384.5

Schedule of Operating Lease Payments

Future lease payments (excluding non-lease elements and contingent payments related to usage-based arrangements) related to the non-cancellable portion of operating leases as of December 31, 2023, are as follows (in millions):


Fiscal Year	Amount
2024	$	277.2
2025	232.3
2026	169.4
2027	103.0
2028	43.6
2029 and thereafter	11.2
Total	$	836.7

Supplemental Cash Flow and Balance Sheet Information

Supplemental cash flow information for the years ended December 31, 2023, 2022, and 2021 related to operating leases was as follows (in millions):


	Years Ended December 31,
	2023		2022		2021
Cash paid for leases that were included within operating cash outflows	$	30.2	$	33.8	$	23.2
Right-of-use assets recognized related to new lease obligations	$	27.8	$	34.0	$	30.6

Supplemental Balance Sheet Information

Supplemental balance sheet information, as of December 31, 2023, and 2022, related to operating leases was as follows (in millions, except lease term and discount rate):


	December 31,
	2023		2022
Intangible and other assets, net (Right-of-use assets)	$	79.3	$	82.2

Other accrued liabilities	$	25.3	$	24.2
Other long-term liabilities	64.5		69.6
Total lease liabilities	$	89.8	$	93.8

Weighted-average remaining lease term	3.7 years		4.5 years
Weighted-average discount rate	3.4%		3.0%

Schedule of Maturities of Operating Lease Liabilities

As of December 31, 2023, the future payments related to the Company’s operating lease liabilities are scheduled as follows (in millions):


Fiscal Year	Amount
2024	$	27.4
2025	27.1
2026	22.9
2027	9.7
2028	5.9
2029 and thereafter	3.1
Total lease payments	96.1
Less: imputed interest	(6.3)
Total operating lease liabilities	$	89.8

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Summary of Changes in Goodwill

The following table summarizes the changes in the carrying amount of goodwill (in millions):


	Amount
Balance as of December 31, 2021	$	343.6
Acquisition activity	6.5
Translation and other	(1.6)
Balance as of December 31, 2022	348.5
Acquisition activity	—
Translation and other	0.2
Balance as of December 31, 2023	$	348.7

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, 2023, and 2022 (in millions):


	December 31, 2023						December 31, 2022
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Patents and developed technology	$	206.3	$	(178.4)	$	27.9	$	199.1	$	(167.4)	$	31.7
Distribution rights and others	10.8		(9.2)		1.6		11.0		(7.4)		3.6
Customer relationships	32.5		(22.9)		9.6		32.6		(18.1)		14.5
Total intangible assets	$	249.6	$	(210.5)	$	39.1	$	242.7	$	(192.9)	$	49.8

Schedule Of Estimated Future Amortization Expense Of Intangible Assets

The estimated future amortization expense related to intangible assets as of December 31, 2023, is as follows (in millions):


Fiscal Year	Amount
2024	$	16.9
2025	12.0
2026	5.3
2027	2.9
2028	1.3
2029 and thereafter	0.7
Total	$	39.1

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 24
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482548/350-20-55-24

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (h)
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
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-Paragraph 1
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
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-Paragraph 1
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
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-Paragraph 1
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1A

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-2

+ Details

Summary Of Significant Accounting Policies

12 Months Ended

Dec. 31, 2023

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 (“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 balances of the Company’s majority-owned joint ventures, Intuitive Surgical-Fosun Medical Technology (Shanghai) Co., Ltd. and Intuitive Surgical-Fosun (HongKong) Co., Ltd. (collectively, the “Joint Venture”) with Shanghai Fosun Pharmaceutical (Group) Co., Ltd. (“Fosun Pharma”). 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 and Comprehensive Income for the years ended December 31, 2023, 2022, and 2021.

Common Stock Split

Shares issued pursuant to the three-for-one stock split (the “Stock Split”) of the Company’s issued and outstanding common stock, par value $0.001 per share, were distributed on October 4, 2021, to stockholders of record as of September 27, 2021. All share and per-share information presented in the Consolidated Financial Statements have been retroactively adjusted to reflect the Stock Split.

Use of Estimates

The preparation of financial statements in conformity with 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, complex, and subjective judgments include the valuation and recognition of investments, the standalone selling prices used to allocate the contract consideration to the individual performance obligations, the valuation of inventory, the valuation of and assessment of the recoverability of intangible assets and goodwill, the recognition and measurement of current and deferred income taxes, including the measurement of uncertain tax positions, and the estimates for legal contingencies. 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 primarily derived from billings related to revenue arrangements with 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, 2023, and 2022, 65% and 60%, respectively, of accounts receivable were from domestic customers.

During the years ended December 31, 2023, 2022, and 2021, domestic revenue accounted for 66%, 67%, and 67% of total revenue, respectively, while outside of the U.S. (“OUS”) revenue accounted for 34%, 33%, and 33%, respectively, of total revenue for each of the years then ended.

The Company’s future results of operations and liquidity could be materially adversely affected by macroeconomic and geopolitical factors in the U.S. and globally, including the supply chain environment, inflationary pressure, higher interest rates, instability in the global financial markets, significant disruptions in the commodities’ markets as a result of the conflict between Russia and Ukraine and the conflict between Israel and Hamas, labor shortages, the introduction of or changes in tariffs, trade

barriers, or regulatory requirements, and uncertain or reduced demand, as well as the impact of any initiatives or programs that the Company may undertake to address financial and operational challenges faced by its customers.

Supply chain constraints continued to show improvement through 2023 based on fewer market constraints. Notably, supply of semiconductor materials rebounded while certain residual stresses remain. Additionally, prices of such materials remain elevated due to either market demand or production-related cost inflation. With higher interest rates, access to credit may become more difficult, and any insolvency of certain suppliers, including sole- and single-sourced suppliers, may heighten continuity risks. The Company is actively engaged in activities to seek to mitigate the impact of any supply chain disruptions on the Company’s operations.

Global shortages in important components have resulted in, and will continue to cause, inflationary cost pressure in the Company’s supply chain. To date, these supply chain challenges have not materially impacted the Company’s results of operations or ability to deliver products and services to its customers. However, supply constraints with certain materials, which may be unavoidable, could delay the timing of our product deliveries, which could result in deferred or canceled procedures. Additionally, if inflationary pressures in component costs persist, the Company may not be able to quickly or easily adjust pricing, reduce costs, or implement countermeasures. Also, there is continued uncertainty surrounding the impact of any monetary policy changes taken by the U.S. Federal Reserve and other central banks to address the structural risks associated with inflation.

Fluctuations in labor availability globally, including labor shortages and staff burnout and attrition, could also impact the Company’s ability to hire and retain personnel critical to its manufacturing, logistics, and commercial operations. The Company is also highly dependent on the principal members of its management and scientific staff. The loss of critical members of the Company’s team, or its inability to attract and retain qualified personnel, could significantly harm its operations, business, and ability to compete.

A number of hospitals continue to experience challenges with staffing and cost pressures that could affect their ability to provide patient care; however, the staffing challenges have shown signs of improvement during the second half of 2023, relative to the first half of 2023 and to the prior year. Additionally, hospitals are facing significant financial pressure as supply chain constraints and inflation drive up operating costs, higher interest rates make access to credit more expensive, unrealized losses decrease available cash reserves, and fiscal stimulus programs enacted during the COVID-19 pandemic wind down. Hospitals may also be adversely affected by the liquidity concerns in the broader financial services industry that could result in delayed access or loss of access to uninsured deposits or loss of their ability to draw on existing credit facilities involving a troubled or failed financial institution. To the extent macroeconomic conditions remain challenging, it is likely that hospitals’ spend on capital equipment will be adversely impacted. In addition, as overall competition for medical technologies, including robotic-assisted devices and other treatment options, progresses in various markets, longer selling cycles and pricing pressures are likely to result. As of the date of issuance of these Consolidated Financial Statements, the extent to which these macroeconomic factors may materially adversely affect the Company’s financial condition, liquidity, or results of operations is uncertain.

The Company maintains the majority of its cash and cash equivalents in accounts with major U.S. and multi-national financial institutions, and our deposits exceed insured limits. Market conditions could impact the viability of these institutions. To date, these market conditions and liquidity concerns have not impacted our results of operations. However, in the event of the failure of any of the financial institutions where we maintain our cash and cash equivalents, there can be no assurance that we would be able to access uninsured funds in a timely manner or at all. Any inability to access or delay in accessing these funds could adversely affect our business and financial position.

The Company is also subject to additional risks and uncertainties due to COVID-19. When COVID-19 infection rates have spiked in a particular region in the past, procedure volumes were often negatively impacted and the diagnoses of new conditions and their related treatments were sometimes deferred. The Company’s customers may divert resources to treat COVID-19 patients and defer some elective surgical procedures, both of which may impact the Company’s customers’ ability to meet their obligations, including to the Company. The severity of the impact of COVID-19 on the Company’s business will depend on a number of factors, including, but not limited to, the extent and severity of the impact on the Company’s customers, which is uncertain and cannot be predicted.

Cash and Cash Equivalents

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

Restricted Cash

As of December 31, 2023, and 2022, the Company had $20.0 million and $19.5 million, respectively, of restricted cash primarily associated with its insurance programs. Restricted cash was included in prepaids and other current assets and intangible and other assets, net on the Consolidated Balance Sheets.

Investments

Available-for-sale debt securities. The Company’s investments may consist of money market funds, U.S. treasury and U.S. government agency securities, high-quality corporate notes and bonds, commercial paper, non-U.S. government agency securities, and taxable and tax-exempt municipal notes. The Company has designated all investments as available-for-sale and, therefore, the investments are subject to periodic impairment under the available-for-sale debt security impairment model. Available-for-sale debt securities in an unrealized loss position are written down to fair value through a charge to interest and other income, net, if the Company intends to sell the security or it is more likely than not the Company will be required to sell the security before recovery of its amortized cost basis. The Company evaluates the remaining securities to determine what amount of the excess, if any, is caused by expected credit losses. A decline in fair value attributable to expected credit losses is recorded to interest and other income, net, while any portion of the loss related to non-credit factors is recorded in accumulated other comprehensive income (loss). For securities sold prior to maturity, the cost of the 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 the date of purchase greater than 90 days and remaining maturities as of the reporting period of less than one year are classified as short-term investments. Investments with remaining maturities greater than one year are classified as long-term investments.

Equity investments. The Company holds equity investments with readily determinable fair values and equity investments without readily determinable fair values. The Company recognizes equity investments with readily determinable fair values at the quoted market price with changes in value recorded in interest and other income, net. The Company generally recognizes equity investments that do not have readily determinable fair values at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer.

Fair Value Measurements

The Company measures the fair value of money market funds, certain U.S. treasury securities, and equity investments with readily determinable value 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, or have been, primarily comprised of commercial paper, corporate notes and bonds, U.S. and non-U.S. government agencies, municipal notes, and equity investments without readily determinable value. 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 cost 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. Additionally, the cost basis of the Company’s inventory does not include any unallocated fixed overhead costs associated with abnormally low utilization of its factories.

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 to 5 years
Enterprise-wide software			5 to 8 years
Purchased software			Lesser of 3 years or life of license

Depreciation expense for the years ended December 31, 2023, 2022, and 2021, was $382 million, $326 million, and $280 million, respectively.

Capitalized Software Costs for Internal Use

The Company capitalizes direct costs associated with developing or obtaining internal use software, including enterprise-wide business software, which are incurred during the application development stage. These capitalized costs are recorded as capitalized software within property, plant, and equipment. Costs related to preliminary project activities and post-implementation activities are expensed as incurred. Once the software is ready for its intended use, amounts capitalized are amortized over an estimated useful life of up to 8 years on a straight-line basis.

Implementation Costs in a Cloud Computing Arrangement

The Company capitalizes qualified implementation costs incurred in a hosting arrangement that is a service contract for which it is the customer in accordance with the requirements for capitalizing costs incurred to develop internal-use software. These capitalized implementation costs are recorded within intangible and other assets, net, and are generally amortized over the fixed, non-cancellable term of the associated hosting arrangement on a straight-line basis.

During the years ended December 31, 2023, 2022, and 2021, the Company recognized $10.2 million, $6.4 million, and $2.9 million of amortization expense associated with capitalized implementation costs, respectively.

Business Combinations

The Company accounts for business acquisitions in accordance with ASC 805, Business Combinations. This standard requires the acquiring entity in a business combination to recognize the assets acquired, liabilities assumed, and any noncontrolling interest in the acquiree using acquisition-date fair values. Certain provisions of this standard prescribe, among other things, the determination of acquisition-date fair value of consideration paid in a business combination, including contingent consideration. The excess of the acquisition-date fair value of consideration paid 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. The Company includes the results of operations of the businesses that are acquired as of the acquisition date.

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 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.

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 3 to 9 years.

Impairment of Long-lived Assets

The Company evaluates long-lived assets, which include finite-lived 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’s revenue consists of product revenue, resulting from the sale of systems, system components, and 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 the 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 at a point in time. System components, system accessories, instruments, accessories, and service are also sold on a stand-alone basis.

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 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 in the following manner:

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 could occur at the time of delivery, depending on the customer arrangement. The Company generally allows its customers in the normal course of business to return unused products for a limited period of time subsequent to the 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. 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 separate performance obligations in the arrangement for a system sale. The Company generally does not provide specified-price trade-in rights or upgrade rights at the time of a system purchase; however, when they are provided, it is typically a specified trade-in credit that declines over time and requires the customer to enter into a new purchase agreement to exercise the right. The Company accounts for such rights as guarantees and, first, reduces the total consideration by the fair value of the guarantee; the remaining consideration is then allocated to each performance obligation. The liability associated with these guarantees was not material for any of the years presented.

Traded-in systems can generally be reconditioned and resold. The Company accounts for the fair value of the traded-in system in the total consideration in the arrangement for the purchase of the newer generation system. When there is no market for the traded-in units, no value is assigned. The value of the traded-in units is reported as a component of inventory until resold or otherwise disposed.

In addition, customers may also have the opportunity to add additional features to their systems at a price that is separately negotiated, for example, by adding a second surgeon console for use with the da Vinci surgical system. Revenue is recognized when the component level features are provided and all revenue recognition criteria are met.

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 system sales transaction. When determining the economic life of the contract acquisition assets recognized, the Company considers historical contract renewal rates, expectations of future contract renewals, and other factors that could impact the economic benefits that the Company expects to generate from the relationship with its customers. The amounts capitalized as contract acquisition costs, which are included in intangible and other assets, net in the Consolidated Balance Sheets, were $89.3 million and $72.3 million as of December 31, 2023, and 2022, respectively. The Company did not incur any impairment losses during the periods presented.

Intuitive System Leasing

The Company enters into lease arrangements with certain qualified customers. Leases have terms that generally range from 24 to 84 months and are usually collateralized by a security interest in the underlying assets. The Company also leases systems to certain qualified customers under usage-based arrangements that have terms of up to 84 months. For these usage-based lease arrangements, the lease fee is generally billed monthly in arrears based on a contractual per-use fee, and usage is generally defined as the number of procedures performed with the system.

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 system or system component, while non-lease elements generally include service. For some lease arrangements, customers are provided with the right to purchase the leased system at some point during and/or at the end of the lease term. Except for usage-based lease arrangements, lease arrangements generally do not provide rights for the customers to exit or terminate the lease without incurring a penalty. Certain lease arrangements may also include upgrade rights that allow customers to upgrade the leased system to newer technology at some point during the lease term. Generally, these upgrade rights do not specify the terms, including the price or structure of the future upgrade transactions, as those terms are negotiated based on the circumstances at the time of the upgrade, including the then-fair value of the system as well as other factors.

In determining whether a transaction should be classified as a sales-type or operating lease (whether fixed-payment or usage-based), the Company considers the following terms at lease commencement: (1) whether title of the system transfers automatically or for a nominal fee by the end of the lease term; (2) whether the present value of the minimum lease payments equals or exceeds substantially all of the fair value of the leased system; (3) whether the lease term is for the major part of the remaining economic life of the leased system; (4) whether the lease grants the lessee an option to purchase the leased system that the lessee is reasonably certain to exercise; and (5) whether the underlying system is of such a specialized nature that it is expected to have no alternative use to the Company 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 related to lease elements from sales-type leases is presented as product revenue. Revenue related to lease elements from fixed-payment operating lease arrangements is generally recognized on a straight-line basis over the lease term and is presented as product revenue. Revenue related to lease elements from usage-based arrangements is recognized as the customers utilize the systems and is presented as product revenue.

Other Leasing Arrangements

The Company determines if an arrangement contains a lease at inception. For arrangements where the Company is the lessee, operating leases are included in intangible and other assets, net, other accrued liabilities, and other long-term liabilities on the Consolidated Balance Sheet as of December 31, 2023. The Company currently does not have any finance leases.

Operating lease right-of-use (“ROU”) assets and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at the commencement date. ROU assets also include any initial direct costs incurred and any lease payments made at or before the lease commencement date, less lease incentives received. The Company uses its incremental borrowing rate based on the information available at the commencement date in determining the lease liabilities, as the Company does not have insight into the inputs necessary to calculate the implicit rate of the leases. Lease terms may include options to extend or terminate when the Company is reasonably certain the option will be exercised. Lease expense is recognized on a straight-line basis over the lease term.

The Company also has lease arrangements with lease and non-lease components. The Company elected the practical expedient not to separate non-lease components from lease components for the Company’s real estate and automobile leases. Additionally, the Company applied a portfolio approach to effectively account for the operating lease ROU assets and lease liabilities for the Company’s automobile leases. The Company also elected to apply the short-term lease measurement and recognition exemption in which ROU assets and lease liabilities are not recognized for leases with terms of 12 months or less.

Credit Losses

Trade accounts receivable. 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, age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. For the years ended December 31, 2023, and 2022, bad debt expense was not material.

Net investment in sales-type leases. The Company enters into sales-type leases with certain qualified customers to purchase its systems. 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. The allowance for loan loss is based on the Company’s assessment of the current expected lifetime loss on lease receivables. The Company regularly reviews the allowance by considering factors such as historical

experience, credit quality, age of the lease receivable balances, and current economic conditions that may affect a customer’s ability to pay. Lease receivables are considered past due 90 days after invoice.

The Company manages the credit risk of the net investment in sales-type leases using a number of factors relating to our customers, including, but not limited to, the following: size of operations; profitability, liquidity, and debt ratios; payment history; and past due amounts. The Company also uses credit scores obtained from external providers as a key indicator for the purposes of determining credit quality. The following table summarizes the amortized cost basis by year of origination and by credit quality for the net investment in sales-type leases as of December 31, 2023 (in millions):


	2023		2022		2021		2020		2019		Prior		Net Investment
Credit Rating:
High	$	39.6	$	70.2	$	60.3	$	24.4	$	6.5	$	0.2	$	201.2
Moderate	37.6		51.4		43.1		22.2		4.5		1.0		159.8
Low	1.5		4.6		3.5		0.8		—		0.2		10.6
Total	$	78.7	$	126.2	$	106.9	$	47.4	$	11.0	$	1.4	$	371.6

For the year ended December 31, 2023, and 2022, credit losses related to the net investment in sales-type leases were not material.

The Company’s exposure to credit losses may increase if its customers are adversely affected by changes in healthcare laws, procedure coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with COVID-19, or other customer-specific factors. Although the Company has historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of trade and lease receivables as hospital cash flows are impacted by macroeconomic factors, including inflation, high interest rates, and staffing shortages.

Available-for-sale debt securities. The Company regularly reviews the securities in an unrealized loss position and evaluates the current expected credit loss by considering factors such as historical experience, market data, financial condition and near-term prospects of the investee, the extent of the loss related to the credit of the issuer, and the expected cash flows from the security. The Company segments its portfolio based on the underlying risk profiles of the securities and has a zero-loss expectation for U.S. treasury and U.S. government agency securities. The basis for this assumption is that these securities have consistently high credit ratings by rating agencies, have a long history with no credit losses, are explicitly guaranteed by a sovereign entity, which can print its own currency, and are denominated in a currency that is routinely held by central banks, used in international commerce, and commonly viewed as a reserve currency. Additionally, all of the Company’s investments in corporate debt securities are in securities with high-quality credit ratings, which have historically experienced low rates of default. For the years ended December 31, 2023, and 2022, credit losses related to available-for-sale debt securities were not material.

Allowance for Sales Returns

The allowance for sales returns is based on the Company’s estimates of potential future returns of certain products 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.

Share-Based Compensation

The Company grants long-term equity awards under its stock-based compensation plans to certain employees of the Company. These awards include restricted stock units, stock options, and performance stock units. The Company accounts for share-based compensation plans using the fair value recognition and measurement provisions under 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 the estimate, if necessary, in subsequent periods if actual forfeitures differ from those estimated.

Restricted stock units. The fair value of restricted stock units (“RSUs”) is determined based on the closing quoted price of the Company’s common stock on the date of the grant.

Stock options. The Black-Scholes-Merton option-pricing model is used to estimate the fair value of stock options granted and utilizes the following inputs: (1) closing quoted price of the Company’s common stock on the date of grant; (2) expected term; (3) expected volatility; and (4) risk-free interest rate.

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 that 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 actively traded options with expirations greater than one year on the Company’s common stock. The extent to which the Company relies on market-based volatility when valuing options depends, among other things, on the availability of traded options on the Company’s stock and the term of such options. Due to a sufficient volume of 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.

Performance stock units. Performance stock units (“PSUs”) include predefined performance and market conditions. The fair value of performance stock units with performance conditions is based on the closing quoted price of the Company’s common stock on the date of the grant. The Company estimates the number of awards with performance conditions that will ultimately vest based on the probability of achievement each quarter to determine the amount of compensation expense to recognize each reporting period. The fair value of performance stock units that include a market condition is determined using a Monte Carlo valuation model.

Employee stock purchase plan. The fair value of shares to be issued under the Company’s Employee Stock Purchase Plan (the “ESPP”) is computed using the Black-Scholes-Merton model at the commencement of an offering period in February and August of each year utilizing the following inputs: (1) closing quoted price of the Company’s common stock on the initial date of the offering period; (2) expected term; (3) expected volatility; and (4) risk-free interest rate. Share-based compensation for the ESPP is recognized as expense on a straight-line basis over the two-year offering period.

See “Note 10. 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 restricted stock units, stock options, performance stock units, and shares to be purchased by employees under the Company’s employee stock purchase plan.

Employee equity share options, non-vested shares, and similar equity instruments granted by the Company are 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 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 monetary 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 thirteen 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 the 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 hedging or non-hedging 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 that 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 the 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 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 Consolidated 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. The Company includes interest and penalty on unrecognized tax benefits as a component of its income tax expense.

The Company recognizes excess tax benefits and tax deficiencies in the provision for income taxes as discrete items in the period when the awards vest or are settled. The Company accounts for Global Intangible Low-Taxed Income (“GILTI”) as period costs when incurred.

Segments

The Company operates in one segment. The chief operating decision maker regularly reviews the operating results of the Company on a consolidated basis as part of making decisions for allocating resources and evaluating performance. As of both December 31, 2023, and 2022, 84% of long-lived assets were in the United States. Revenue from external customers is attributed to individual countries based on customer location.

Legal Contingencies

From time to time, 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 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 that are 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.

Recently Adopted Accounting Pronouncements

Troubled Debt Restructurings and Vintage Disclosures

In March 2022, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2022-02, Financial Instruments-Credit Losses (Topic 326): Troubled Debt Restructurings and Vintage Disclosures (“ASU 2022-02”), which eliminates the accounting guidance for troubled debt restructurings by creditors while enhancing disclosure requirements for certain loan refinancings and restructurings by creditors when a borrower is experiencing financial difficulty. Additionally, the standard requires disclosure of current-period gross write-offs by year of origination for financing receivables and net investments in leases within the scope of Subtopic ASC 326-20, Financial Instruments-Credit Losses-Measured at Amortized Cost. The Company adopted ASU 2022-02 on January 1, 2023, on a prospective basis. There was no impact of the adoption of ASU 2022-02 on the Company’s Financial Statements for the year ended December 31, 2023.

Recently Issued Accounting Pronouncements

In December 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”), which requires all public entities, including public entities with a single reportable segment, to provide in interim and annual periods one or more measures of segment profit or loss used by the chief operating decision maker to allocate resources and assess performance. Additionally, the standard requires disclosures of significant segment expenses and other segment items as well as incremental qualitative disclosures. The guidance in this update is effective for fiscal years beginning after December 15, 2023, and interim periods after December 15, 2024. The Company is currently in the process of evaluating the effects of this pronouncement on our related disclosures.

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU 2023-09”), which requires enhanced income tax disclosures, including specific categories and disaggregation of information in the effective tax rate reconciliation, disaggregated information related to income taxes paid, income or loss from continuing operations before income tax expense or benefit, and income tax expense or benefit from continuing operations. The requirements of the ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently in the process of evaluating the impact of this pronouncement on our related disclosures.

The Company continues to monitor new accounting pronouncements issued by the FASB and does not believe any accounting pronouncements issued through the date of this report will have a material impact on the Company’s Financial Statements.

Leases - Lease Receivables (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Capital Leased Assets [Line Items]
Gross lease receivables	$ 384.5	$ 449.4
Unearned income	(12.9)	(14.4)
Subtotal	371.6	435.0
Allowance for credit loss	(2.7)	(3.0)
Net investment in sales-type leases	368.9	432.0
Reported as:
Net investment in sales-type leases	368.9	432.0
Prepaids and other current assets
Capital Leased Assets [Line Items]
Net investment in sales-type leases	137.3	131.2
Reported as:
Net investment in sales-type leases	137.3	131.2
Intangible and other assets, net
Capital Leased Assets [Line Items]
Net investment in sales-type leases	231.6	300.8
Reported as:
Net investment in sales-type leases	$ 231.6	$ 300.8

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule Of Income Before Provision For Income Taxes

Income before provision for income taxes for the years ended December 31, 2023, 2022, and 2021, consisted of the following (in millions):


	Years Ended December 31,
	2023		2022		2021
U.S.	$	1,251.1	$	956.7	$	1,298.7
Foreign	707.8		650.1		591.6
Total income before provision for income taxes	$	1,958.9	$	1,606.8	$	1,890.3

Schedule Of Provision For Income Taxes

The provision for income taxes for the years ended December 31, 2023, 2022, and 2021, consisted of the following (in millions):


	Years Ended December 31,
	2023		2022		2021
Current
Federal	$	315.2	$	350.4	$	158.8
State	32.8		49.2		17.3
Foreign	74.4		48.1		50.1
Total current income tax expense	422.4		447.7		226.2
Deferred
Federal	(122.4)		(188.8)		(21.4)
State	(25.1)		(16.4)		0.5
Foreign	(133.3)		19.9		(43.1)
Total deferred income tax expense	(280.8)		(185.3)		(64.0)
Total income tax expense	$	141.6	$	262.4	$	162.2

Schedule Of Income Tax Difference From The Statutory Rate

Income tax expense differs from amounts computed by applying the statutory federal income rate of 21% for the years ended December 31, 2023, 2022, and 2021, as a result of the following (in millions):


	Years Ended December 31,
	2023		2022		2021
Federal tax at statutory rate	$	411.4	$	337.4	$	397.0
Increase (reduction) in tax resulting from:
State taxes, net of federal benefits	35.0		34.9		33.1
Foreign rate differential	(64.4)		(64.2)		(54.3)
U.S. tax on foreign earnings	70.9		75.4		40.1
Research and development credit	(48.6)		(41.7)		(30.7)
Excess tax benefits related to share-based compensation	(107.9)		(98.7)		(185.8)
Share-based compensation not benefited	29.5		24.1		17.8
Unrecognized tax benefits related to share-based compensation	4.4		3.3		13.6
Reversal of unrecognized tax benefits	(20.9)		(11.1)		(3.0)
Swiss tax benefits, net of valuation allowance	(92.3)		—		—
Deferred tax re-measurement	(67.1)		—		(66.4)
Other	(8.4)		3.0		0.8
Total income tax expense	$	141.6	$	262.4	$	162.2

Schedule Of Deferred Tax Assets

Deferred income taxes reflect tax carryforwards 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,
	2023		2022
Deferred tax assets:
Intangible assets	$	420.9	$	342.8
Capitalized research and development expenditures	306.4		172.5
Research and development credits	193.2		156.7
Share-based compensation expense	135.1		121.3
Swiss tax credits	122.4		—
Expenses deducted in later years for tax purposes	55.9		57.5
Lease liabilities	16.5		16.6
Net operating losses	2.8		6.4
Net unrealized losses on available-for-sale securities and other	9.2		45.5
Gross deferred tax assets	1,262.4		919.3
Valuation allowance	(269.8)		(168.6)
Deferred tax assets	992.6		750.7
Deferred tax liabilities:
Property, plant, and equipment	(60.3)		(64.1)
Right-of-use assets	(11.8)		(11.8)
Intangible assets	(9.8)		(9.3)
Other	(0.2)		(1.0)
Deferred tax liabilities	(82.1)		(86.2)
Net deferred tax assets	$	910.5	$	664.5

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, 2023, 2022, and 2021, are as follows (in millions):


	Years Ended December 31,
	2023		2022		2021
Beginning balance	$	252.6	$	222.5	$	176.3
Increases related to tax positions taken during the current year	48.5		49.5		40.6
Increases related to tax positions taken during a prior year	—		4.9		11.2
Decreases related to tax positions taken during a prior year	(18.9)		(16.5)		(1.3)
Decreases related to settlements with tax authorities	(1.0)		(1.2)		(0.2)
Decreases related to expiration of statute of limitations	(20.8)		(6.6)		(4.1)
Ending balance	$	260.4	$	252.6	$	222.5

Insider Trading Arrangements	3 Months Ended	12 Months Ended
Insider Trading Arrangements	Dec. 31, 2023 shares	Dec. 31, 2023 shares
Trading Arrangements, by Individual
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
David J. Rosa [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 8, 2023, David J. Rosa, the Company’s President, adopted a Rule 10b5-1 trading plan. Mr. Rosa’s trading plan provides for the potential exercise and sale of up to 140,850 shares of the Company’s common stock subject to stock options, until February 14, 2025. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Securities Exchange Act of 1934, as amended, and the Company’s policies regarding transactions in the Company’s securities.
Name	David J. Rosa
Title	President
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 8, 2023
Aggregate Available	140,850	140,850
Marshall L. Mohr [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 15, 2023, Marshall L. Mohr, the Company’s Executive Vice President, Global Business Services, adopted a Rule 10b5-1 trading plan. Mr. Mohr’s trading plan provides for the potential exercise and sale of up to 129,810 shares of the Company’s common stock subject to stock options, until November 15, 2024. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Securities Exchange Act of 1934, as amended, and the Company’s policies regarding transactions in the Company’s securities.
Name	Marshall L. Mohr
Title	Executive Vice President, Global Business Services
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 15, 2023
Aggregate Available	129,810	129,810
Bob DeSantis [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On December 8, 2023, Bob DeSantis, the Company’s Executive Vice President and Chief Strategy and Corporate Operations Officer, adopted a Rule 10b5-1 trading plan. Mr. DeSantis’s trading plan provides for the potential sale of up to 29,868 shares of the Company’s common stock, including the potential exercise and sale of up to 24,106 shares of the Company’s common stock subject to stock options, until December 9, 2024. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Securities Exchange Act of 1934, as amended, and the Company’s policies regarding transactions in the Company’s securities.
Name	Bob DeSantis
Title	Executive Vice President and Chief Strategy and Corporate Operations Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	December 8, 2023
Frederik C. Widman [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On December 15, 2023, Frederik C. Widman, the Company’s Vice President, Corporate Controller, and Principal Accounting Officer, adopted a Rule 10b5-1 trading plan. Mr. Widman’s trading plan provides for the potential sale of up to 7,593 shares of the Company’s common stock, including the potential exercise and sale of up to 1,224 shares of the Company’s common stock subject to stock options, until March 7, 2025. This trading plan was entered into during an open insider trading window and is intended to satisfy the affirmative defense of Rule 10b5-1(c) under the Securities Exchange Act of 1934, as amended, and the Company’s policies regarding transactions in the Company’s securities.
Name	Frederik C. Widman
Title	Vice President, Corporate Controller, and Principal Accounting Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	December 15, 2023
Bob DeSantis Trading Arrangement, Common Stock [Member] \| Bob DeSantis [Member]
Trading Arrangements, by Individual
Aggregate Available	29,868	29,868
Bob DeSantis Trading Arrangement, Stock Options [Member] \| Bob DeSantis [Member]
Trading Arrangements, by Individual
Aggregate Available	24,106	24,106
Frederik C. Widman Trading Arrangement, Common Stock [Member] \| Frederik C. Widman [Member]
Trading Arrangements, by Individual
Aggregate Available	7,593	7,593
Frederik C. Widman Trading Arrangement, Stock Options [Member] \| Frederik C. Widman [Member]
Trading Arrangements, by Individual
Aggregate Available	1,224	1,224

Financial Instruments - Summary of Equity Investment Activity (Details) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Level 1:
Fair Value, Level 1
Beginning balance, carrying value	$ 4.3
Changes in fair value	(0.4)
Purchases / Sales / Other	(3.9)
Ending balance, carrying value	0.0
Fair Value, Inputs, Level 2
Fair Value, Level 2
Beginning balance, carrying value	59.1
Changes in fair value	(5.9)
Purchases / Sales / Other	21.3
Ending balance, carrying value	74.5
Prepaids and other current assets \| Level 1:
Fair Value, Level 1
Ending balance, carrying value	0.0
Prepaids and other current assets \| Fair Value, Inputs, Level 2
Fair Value, Level 2
Ending balance, carrying value	0.0
Intangible and other assets, net \| Level 1:
Fair Value, Level 1
Ending balance, carrying value	0.0
Intangible and other assets, net \| Fair Value, Inputs, Level 2
Fair Value, Level 2
Ending balance, carrying value	$ 74.5

Goodwill and Intangible Assets - Schedule of Summary of Changes in Goodwill (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Beginning balance	$ 348.5	$ 343.6
Acquisition activity	0.0	6.5
Translation and other	0.2	(1.6)
Ending balance	$ 348.7	$ 348.5

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Financial Instruments - Summary Of Contractual Maturities Of Cash Equivalents And Available-For-Sale Investments (Details) $ in Millions	Dec. 31, 2023 USD ($)
Amortized Cost
Mature in less than one year	$ 2,512.5
Mature in one to five years	2,120.1
Total	4,632.6
Fair Value
Mature in less than one year	2,473.1
Mature in one to five years	2,120.0
Total	$ 4,593.1

Revenue

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Revenue

REVENUE

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


	Years Ended December 31,
U.S.	2023		2022		2021
Instruments and accessories	$	3,059.8	$	2,507.2	$	2,225.1
Systems	865.5		966.0		1,024.8
Services	763.3		684.4		603.3
Total U.S. revenue	$	4,688.6	$	4,157.6	$	3,853.2

OUS
Instruments and accessories	$	1,216.8	$	1,010.7	$	875.4
Systems	814.2		714.1		668.6
Services	404.5		339.8		312.9
Total OUS revenue	$	2,435.5	$	2,064.6	$	1,856.9

Total
Instruments and accessories	$	4,276.6	$	3,517.9	$	3,100.5
Systems	1,679.7		1,680.1		1,693.4
Services	1,167.8		1,024.2		916.2
Total revenue	$	7,124.1	$	6,222.2	$	5,710.1

Remaining Performance Obligations

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 these performance obligations relate to service obligations in the Company’s system sale and lease arrangements that will be satisfied and recognized as revenue in future periods. The transaction price allocated to the remaining performance obligations was $2.29 billion as of December 31, 2023. The remaining performance obligations are expected to be satisfied over the term of the system sale, lease, and service arrangements. Approximately 45% of the remaining performance obligations are expected to be recognized in the next 12 months with the remainder recognized thereafter over the term of the system sale, lease, and service arrangements, which are generally up to 5 years.

Contract Assets and Liabilities

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


	December 31,
	2023		2022
Contract assets	$	20.2	$	45.0
Deferred revenue	$	491.7	$	438.3

The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 to 60 days from the 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, 2023, the Company recognized $396 million of revenue that was included in the deferred revenue balance as of December 31, 2022. During the year ended December 31, 2022, the Company recognized $380 million of revenue that was included in the deferred revenue balance as of December 31, 2021.

Intuitive System Leasing

The following table presents product revenue from Intuitive System Leasing arrangements (in millions):


	Years Ended December 31,
	2023		2022		2021
Sales-type lease revenue	$	78.4	$	156.4	$	220.3
Operating lease revenue*	$	500.5	$	376.5	$	276.9

*Variable lease revenue relating to usage-based arrangements included within operating lease revenue	$	216.5	$	133.0	$	78.1

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

Goodwill and Intangible Assets - Schedule Of Estimated Future Amortization Expense Of Intangible Assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 16.9
2025	12.0
2026	5.3
2027	2.9
2028	1.3
2029 and thereafter	0.7
Net Carrying Amount	$ 39.1	$ 49.8

Financial Instruments - Derivative Instruments Used to Hedge against Balance Sheet Foreign Currency Exposures (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Interest and other income, net	Interest and other income, net	Interest and other income, net
Foreign exchange losses related to balance sheet re-measurement	$ (8.5)	$ (54.2)	$ (16.4)
Foreign Exchange Forward \| Derivatives Not Designated as Hedging Instruments
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Recognized gains in interest and other income, net	$ 4.8	$ 26.9	$ 15.5

Leases - Schedule of Contractual Maturities of Gross Lease Receivables (Details) $ in Millions	Dec. 31, 2023 USD ($)
Leases [Abstract]
2024	$ 143.3
2025	113.0
2026	74.1
2027	39.8
2028	10.9
2029 and thereafter	3.4
Total	$ 384.5

Consolidated Financial Statement Details - Property, Plant, and Equipment, Net (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Land	$ 457.3	$ 388.6
Building and building/leasehold improvements	1,002.1	866.5
Machinery and equipment	724.2	566.4
Operating lease assets – Intuitive System Leasing	1,149.7	806.4
Computer and office equipment	153.8	134.7
Capitalized software	257.8	240.9
Construction-in-process	1,354.7	608.6
Gross property, plant, and equipment	5,099.6	3,612.1
Less: Accumulated depreciation	(1,562.0)	(1,237.9)
Total property, plant, and equipment, net	3,537.6	2,374.2
Accumulated depreciation associated with operating lease assets - Intuitive System Leasing	$ (434.3)	$ (285.8)

Consolidated Statements Of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities:
Net income	$ 1,817.3	$ 1,344.4	$ 1,728.1
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and loss on disposal of property, plant, and equipment, net	401.6	338.0	282.8
Amortization of intangible assets	20.2	27.8	27.4
Gain on sale of business	0.0	(3.8)	0.0
Loss on investments, accretion of discounts, and amortization of premiums on investments, net	7.3	49.0	10.6
Deferred income taxes	(280.8)	(185.3)	(62.6)
Share-based compensation expense	592.8	513.2	449.2
Amortization of contract acquisition assets	33.0	26.6	22.0
Changes in operating assets and liabilities, net of effects of acquisitions:
Accounts receivable	(186.3)	(159.3)	(142.3)
Inventory	(712.5)	(546.6)	(256.0)
Prepaids and other assets	24.2	(129.2)	(204.9)
Accounts payable	41.7	21.3	36.0
Accrued compensation and employee benefits	34.8	51.5	115.1
Deferred revenue	53.4	21.5	32.6
Other liabilities	(32.9)	121.7	51.4
Net cash provided by operating activities	1,813.8	1,490.8	2,089.4
Investing activities:
Purchase of investments	(2,207.4)	(1,399.5)	(6,452.0)
Proceeds from sales of investments	230.3	61.1	84.9
Proceeds from maturities of investments	2,690.1	3,254.4	4,267.8
Purchase of property, plant, and equipment	(1,064.2)	(532.4)	(339.5)
Acquisition of businesses, net of cash, and intellectual property and other investing activities	8.9	12.8	22.7
Net cash provided by (used in) investing activities	(360.1)	1,370.8	(2,461.5)
Financing activities:
Proceeds from issuance of common stock relating to employee stock plans	296.3	233.8	276.5
Taxes paid related to net share settlement of equity awards	(164.7)	(194.2)	(211.6)
Repurchase of common stock	(416.3)	(2,607.4)	0.0
Payment of deferred purchase consideration	(2.9)	(4.5)	(21.9)
Net cash provided by (used in) financing activities	(287.6)	(2,572.3)	43.0
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	3.3	5.4	(3.4)
Net increase (decrease) in cash, cash equivalents, and restricted cash	1,169.4	294.7	(332.5)
Cash, cash equivalents, and restricted cash, beginning of year	1,600.7	1,306.0	1,638.5
Cash, cash equivalents, and restricted cash, end of year	$ 2,770.1	$ 1,600.7	$ 1,306.0

Consolidated Financial Statement Details - Inventory (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 454.7	$ 382.9
Work-in-process	159.9	159.9
Finished goods	606.0	350.4
Total inventory	$ 1,220.6	$ 893.2

Share-Based Compensation - Summary of RSU and PSU Activity (Details) - $ / shares shares in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Restricted Stock Units (RSUs)
Shares
Unvested beginning balance (shares)	4.6
Granted (shares)	2.5
Vested (shares)	(1.8)
Forfeited (shares)	(0.3)
Unvested ending balance (shares)	5.0	4.6
Weighted-Average Grant Date Fair Value Per Share
Unvested beginning balance (usd per share)	$ 241.47
Granted (usd per share)	237.37	$ 272.97	$ 256.52
Vested (usd per share)	223.52
Forfeited (usd per share)	247.21
Unvested ending balance (usd per share)	$ 245.75	$ 241.47
PSUs
Shares
Unvested beginning balance (shares)	0.1
Granted (shares)	0.1
Vested (shares)	0.0
Performance change (shares)	0.0
Forfeited (shares)	0.0
Unvested ending balance (shares)	0.2	0.1
Weighted-Average Grant Date Fair Value Per Share
Unvested beginning balance (usd per share)	$ 299.32
Granted (usd per share)	240.45	$ 299.32	$ 0
Vested (usd per share)	0
Performance change (usd per share)	0
Forfeited (usd per share)	235.84
Unvested ending balance (usd per share)	$ 259.60	$ 299.32

Stockholders' Equity - Schedule Of Stock Repurchase Activities (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Equity, Class of Treasury Stock [Line Items]
Value of shares repurchased (in dollars per share)	$ 416.3	$ 2,607.4
Common Stock
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)	1,700	11,200
Common Stock Repurchase Program \| Common Stock
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)	1,700	11,200	0
Average price per share (in dollars per share)	$ 241.38	$ 233.70	$ 0
Value of shares repurchased (in dollars per share)	$ 416.3	$ 2,607.4	$ 0.0

Revenue - Revenue Disaggregated by Types and Geography (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Total revenue	$ 7,124.1	$ 6,222.2	$ 5,710.1
Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	4,276.6	3,517.9	3,100.5
Systems
Disaggregation of Revenue [Line Items]
Total revenue	1,679.7	1,680.1	1,693.4
Services
Disaggregation of Revenue [Line Items]
Total revenue	1,167.8	1,024.2	916.2
U.S.
Disaggregation of Revenue [Line Items]
Total revenue	4,688.6	4,157.6	3,853.2
U.S. \| Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	3,059.8	2,507.2	2,225.1
U.S. \| Systems
Disaggregation of Revenue [Line Items]
Total revenue	865.5	966.0	1,024.8
U.S. \| Services
Disaggregation of Revenue [Line Items]
Total revenue	763.3	684.4	603.3
OUS
Disaggregation of Revenue [Line Items]
Total revenue	2,435.5	2,064.6	1,856.9
OUS \| Instruments and accessories
Disaggregation of Revenue [Line Items]
Total revenue	1,216.8	1,010.7	875.4
OUS \| Systems
Disaggregation of Revenue [Line Items]
Total revenue	814.2	714.1	668.6
OUS \| Services
Disaggregation of Revenue [Line Items]
Total revenue	$ 404.5	$ 339.8	$ 312.9

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 924
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479941/924-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 30
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-30

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-42

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-40

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-4

+ Details

Share-Based Compensation - Additional Information (Details) $ / shares in Units, $ in Millions		1 Months Ended		12 Months Ended				141 Months Ended	190 Months Ended
	Dec. 31, 2022	Feb. 28, 2022	Jan. 31, 2022	Dec. 31, 2023 USD ($) quantitativeGoal period $ / shares shares	Dec. 31, 2022 USD ($) shares	Dec. 31, 2021 USD ($) shares	Dec. 31, 2020	Dec. 31, 2021	Dec. 31, 2015	Apr. 30, 2022 shares	Mar. 31, 2022 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				$ 476.0	$ 315.0	$ 613.0
Cash received from option exercises and employee stock purchase plans				192.0	146.0	201.0
Employee service share-based compensation, tax benefit from exercise of stock options				$ 109.0
Number of options vested and expected to vest \| shares				9,600,000
Weighted average remaining contractual life of shares vested and expected to vest, years				4 years 7 months 6 days
Aggregate intrinsic value of shares vested and expected to vest				$ 1,580.0
Options vested and expected to vest, weighted-average exercise price per share \| $ / shares				$ 173.14
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected to vest (in shares) \| shares				4,500,000
Aggregate intrinsic value				$ 1,520.0
Vested in period, aggregate fair value				454.0	$ 536.0	$ 578.0
Total unrecognized compensation expense				$ 761.0
Weighted average period unrecognized compensation expenses are expected to be recognized, years				2 years 4 months 24 days
Restricted Stock Units (RSUs) \| Employees
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage				25.00%
Award vesting period				4 years
Restricted Stock Units (RSUs) \| Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period				1 year
Annual Grant Options \| February Grant \| Share-Based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage				12.50%
Award vesting period	6 months
Annual Grant Options \| February Grant \| Share-Based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage				2.08%
Annual Grant Options \| August Grant \| Share-Based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage				14.58%
Award vesting period				1 month
Annual Grant Options \| August Grant \| Share-Based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage				2.08%
New Hire Options \| Share-Based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage				25.00%
New Hire Options \| Share-Based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage				2.08%
New Hire Options \| Employees \| Share-Based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period				1 year
New Hire Options \| Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period				1 year
PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period		3 years		3 years	3 years
Number of equally-weighted, quantitative goals \| quantitativeGoal				3
Expected to vest (in shares) \| shares				200,000
Aggregate intrinsic value				$ 70.0
Total unrecognized compensation expense				$ 38.0
Weighted average period unrecognized compensation expenses are expected to be recognized, years				1 year 9 months 18 days
PSUs \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of awards vested					0.00%
PSUs \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of awards vested					125.00%
Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares were reserved for future issuance (shares) \| shares				1,800,000
Employee stock purchase plan, shares issued \| shares				500,000	400,000	500,000
Employee stock purchase plan, value of shares issued				$ 104.5	$ 87.9	$ 75.9
Total unrecognized compensation expense				$ 22.0
Weighted average period unrecognized compensation expenses are expected to be recognized, years				7 months 6 days
Nonvested Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation expense				$ 134.0
Weighted average period unrecognized compensation expenses are expected to be recognized, years				2 years 6 months
2010 Incentive Award Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, options, expiration term (in years)			7 years					10 years
Number of shares of common stock reserved for issuance (shares) \| shares										110,350,000	103,350,000
Shares were reserved for future issuance (shares) \| shares				20,600,000
2010 Incentive Award Plan \| Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares were reserved for future issuance (shares) \| shares				8,900,000
2010 Incentive Award Plan \| Annual Grant Options \| August Grant
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period				3 years 6 months
2009 Employment Commencement Incentive 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) \| shares				0										13,095,000	10,395,000
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) \| shares				0												1,350,000
2000 Non-Employee Directors' Stock Option Plan \| Annual Grant Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award 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]
Stock options granted initial vesting period, years							3 years
2000 Non-Employee Directors' Stock Option Plan \| Initial Grant Options \| Share-Based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage									33.33%
2000 Non-Employee Directors' Stock Option Plan \| Initial Grant Options \| Share-Based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage									2.78%
2000 Non-Employee Directors' Stock Option Plan \| Initial Grant Options \| Director \| Share-Based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period							1 year
2000 Employee Stock Purchase Plan \| Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
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 \| shares												22,770,945	18,270,945

Income Taxes - Schedule Of Income Before Provision For Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S.	$ 1,251.1	$ 956.7	$ 1,298.7
Foreign	707.8	650.1	591.6
Income before taxes	$ 1,958.9	$ 1,606.8	$ 1,890.3

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(11))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483586/944-220-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 30
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-30

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-31

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 235
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479557/942-235-S99-1

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section 25
-Paragraph 1
-SubTopic 20
-Topic 940
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481913/940-20-25-1

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(10))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483621/220-10-S99-2

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 942
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(15))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483589/942-220-S99-1

+ Details

Financial Instruments - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Net unrealized losses on available-for-sale debt securities, net of tax	$ 29.7	$ 154.2
Maximum
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Derivative contract term	13 months
Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Net decrease in fair value	$ 5.9

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

INCOME TAXES

Income before provision for income taxes for the years ended December 31, 2023, 2022, and 2021, consisted of the following (in millions):


	Years Ended December 31,
	2023		2022		2021
U.S.	$	1,251.1	$	956.7	$	1,298.7
Foreign	707.8		650.1		591.6
Total income before provision for income taxes	$	1,958.9	$	1,606.8	$	1,890.3

The provision for income taxes for the years ended December 31, 2023, 2022, and 2021, consisted of the following (in millions):


	Years Ended December 31,
	2023		2022		2021
Current
Federal	$	315.2	$	350.4	$	158.8
State	32.8		49.2		17.3
Foreign	74.4		48.1		50.1
Total current income tax expense	422.4		447.7		226.2
Deferred
Federal	(122.4)		(188.8)		(21.4)
State	(25.1)		(16.4)		0.5
Foreign	(133.3)		19.9		(43.1)
Total deferred income tax expense	(280.8)		(185.3)		(64.0)
Total income tax expense	$	141.6	$	262.4	$	162.2

The provision for income taxes for the years ended December 31, 2023, and 2022, reflected the impact of a change in U.S. tax law effective January 1, 2022, which requires the capitalization and amortization of research and development expenditures incurred after December 31, 2021.

The Company’s provision for income taxes for 2023 reflected Swiss tax benefits of $92.3 million, net of a $67.3 million valuation allowance, related to certain tax assets recorded by our Swiss entity. In addition, a one-time net benefit of $67.1 million was recorded from the re-measurement of the Company’s Swiss deferred tax assets resulting from the Swiss cantonal tax rate increase enacted in December 2023 for years after 2024 as well as a Swiss cantonal tax rate increase from the discontinuation of the Company’s 2017 Swiss tax ruling, which was deemed effective as of January 1, 2023. The Company’s provision for income taxes for 2021 also included a one-time benefit of $66.4 million from the re-measurement of its Swiss deferred tax assets resulting from the extension of the economic useful life of certain intangible assets.

In August 2022, the Inflation Reduction Act of 2022 (the “IRA”) was enacted in the United States. The IRA introduces a 15% alternative minimum tax based on the financial statement income of certain large corporations, effective for tax years beginning after December 31, 2022. The Company considered the applicable tax law changes, and there is no impact to the Company’s tax provision for the twelve months ended December 31, 2023.


	Years Ended December 31,
	2023		2022		2021
Federal tax at statutory rate	$	411.4	$	337.4	$	397.0
Increase (reduction) in tax resulting from:
State taxes, net of federal benefits	35.0		34.9		33.1
Foreign rate differential	(64.4)		(64.2)		(54.3)
U.S. tax on foreign earnings	70.9		75.4		40.1
Research and development credit	(48.6)		(41.7)		(30.7)
Excess tax benefits related to share-based compensation	(107.9)		(98.7)		(185.8)
Share-based compensation not benefited	29.5		24.1		17.8
Unrecognized tax benefits related to share-based compensation	4.4		3.3		13.6
Reversal of unrecognized tax benefits	(20.9)		(11.1)		(3.0)
Swiss tax benefits, net of valuation allowance	(92.3)		—		—
Deferred tax re-measurement	(67.1)		—		(66.4)
Other	(8.4)		3.0		0.8
Total income tax expense	$	141.6	$	262.4	$	162.2


	December 31,
	2023		2022
Deferred tax assets:
Intangible assets	$	420.9	$	342.8
Capitalized research and development expenditures	306.4		172.5
Research and development credits	193.2		156.7
Share-based compensation expense	135.1		121.3
Swiss tax credits	122.4		—
Expenses deducted in later years for tax purposes	55.9		57.5
Lease liabilities	16.5		16.6
Net operating losses	2.8		6.4
Net unrealized losses on available-for-sale securities and other	9.2		45.5
Gross deferred tax assets	1,262.4		919.3
Valuation allowance	(269.8)		(168.6)
Deferred tax assets	992.6		750.7
Deferred tax liabilities:
Property, plant, and equipment	(60.3)		(64.1)
Right-of-use assets	(11.8)		(11.8)
Intangible assets	(9.8)		(9.3)
Other	(0.2)		(1.0)
Deferred tax liabilities	(82.1)		(86.2)
Net deferred tax assets	$	910.5	$	664.5

As of December 31, 2023, the Company had $38.2 million of federal, state, and foreign net operating loss carryforwards, certain of which will expire starting in 2025 if not utilized. Utilization of these net operating loss carryforwards may be subject to certain limitations. The Company does not expect the limitations to result in any permanent loss of these tax benefits. As of

December 31, 2023, the Company had $122.4 million of Swiss tax credit carryforwards, which will expire in 2028. As of December 31, 2023, the Company had $267.7 million of California research and development credit carryforwards, which do not expire, and $5.2 million of other state research and development credit carryforwards, which begin to expire in 2029.

As of December 31, 2023, the Company had a valuation allowance of $269.8 million, primarily related to California deferred tax assets and certain Swiss deferred tax assets, for which the Company does not believe a tax benefit is more likely than not to be realized. As of December 31, 2022, the Company had a valuation allowance of $168.6 million, primarily related to California deferred tax assets, for which the Company does not believe a tax benefit is more likely than not to be realized. The increase in the valuation allowance during 2023 is primarily related to certain Swiss tax assets and California research and development credits. These valuation allowances would result in a reduction to the income tax provision in the consolidated statements of income if they are ultimately not necessary.

The Company intends to repatriate earnings from its Swiss subsidiary and joint venture in Hong Kong, as needed, and 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 its foreign subsidiaries and does not expect the tax implications of repatriating these earnings to be significant.

A reconciliation of the beginning and ending amounts of gross unrecognized income tax benefits for the years ended December 31, 2023, 2022, and 2021, are as follows (in millions):


	Years Ended December 31,
	2023		2022		2021
Beginning balance	$	252.6	$	222.5	$	176.3
Increases related to tax positions taken during the current year	48.5		49.5		40.6
Increases related to tax positions taken during a prior year	—		4.9		11.2
Decreases related to tax positions taken during a prior year	(18.9)		(16.5)		(1.3)
Decreases related to settlements with tax authorities	(1.0)		(1.2)		(0.2)
Decreases related to expiration of statute of limitations	(20.8)		(6.6)		(4.1)
Ending balance	$	260.4	$	252.6	$	222.5

As of December 31, 2023, 2022, and 2021, gross interest related to unrecognized tax benefits accrued was $31.2 million, $21.0 million, and $14.9 million, respectively. The Company’s net unrecognized tax benefits and related interest are presented in other long-term liabilities and long-term deferred tax assets on the Consolidated Balance Sheets.

Total gross unrecognized tax benefits as of December 31, 2023, were $260.4 million, of which $181.8 million, if recognized, would have an impact on the Company’s effective tax rate.

A charge of $13.6 million was recorded to income tax expense in 2021, after additional IRS guidance was issued in July 2021 related to a Ninth Circuit Court of Appeals opinion involving an independent third party related to charging foreign subsidiaries for share-based compensation. The Company will continue to monitor future IRS actions or other developments regarding this matter and will assess the impact of any such developments on its income tax provision in the quarter that they occur.

The Company files federal, state, and foreign income tax returns in many U.S. and OUS jurisdictions. Years before 2016 are closed for the significant jurisdictions. Certain of the Company’s unrecognized tax benefits could change due to activities of various tax authorities, including evolving interpretations of existing tax laws in the jurisdictions in which the Company operates, 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 changes 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.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Share-Based Compensation

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [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 can issue RSUs, nonqualified stock options (“NSOs”), and PSUs to employees, non-employee directors, and consultants. Equity awards granted to employees and non-employee directors include a mix of RSUs, stock options, and, as applicable, PSUs. 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. Prior to 2022, NSOs were granted with terms of 10 years from the date of the grant. In January 2022, the Company changed the term of its new NSO grants to 7 years from the date of the grant. The 2010 Plan expires in 2032. In April 2022, the Company’s shareholders approved an amended and restated 2010 Plan to provide for an increase in the number of shares of common stock reserved for issuance thereunder from 103,350,000 to 110,350,000. As of December 31, 2023, approximately 20.6 million shares were reserved for future issuance under the 2010 Plan. A maximum of approximately 8.9 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 10,395,000 to 13,095,000. The New Hire Plan expired in October 2019 and, therefore, there are no shares reserved for future grants under the New Hire Plan. However, awards granted prior to the plan’s expiration continue to remain outstanding until their original expiration date.

Restricted Stock Units. The RSUs granted to employees vest in one-fourth increments annually over a four-year period. The RSUs granted to existing non-employee directors vest one year from the date of grant or at the next Annual Shareholders Meeting, whichever comes first. 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.

Nonqualified Stock Options. Prior to 2020, annual NSO grants were made to employees 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). In 2020, the Company changed the timing of its annual NSO grants to the last trading day of February and on the same date in August or, if that date is not a trading day, the next trading day. Beginning in 2023, the Company changed the timing of its annual NSO grants to the last trading day of February and August 10 or, if that date is not a trading day, the next trading day. Prior to 2023, the February NSO grants vest 1/8 upon completion of 6 months of service and 1/48 per month thereafter. Beginning in 2023, the February NSO grants vest 1/8 on August 10 and 1/48 per month thereafter. The August NSO grants vest 7/48 at the end of one month and 1/48 per month thereafter through a 3.5-year vesting period. NSOs granted to new hires generally vest 1/4 upon completion of one year of service and 1/48 per month thereafter. NSOs granted to existing non-employee directors vest one year from the date of grant or at the next Annual Shareholders Meeting, whichever comes first. New non-employee directors receive pro-rated NSO grants that vest on the same term as the annual NSO grants. Option vesting terms are determined by the Board and, in the future, may vary from past practices.

Performance Stock Units. In February 2022, the Company began granting PSUs to officers and other key employees, subject to three-year cliff vesting and pre-established, quantitative goals. Whether any PSUs vest, and the amount that do vest, is tied to completion of service over three years and the achievement of three equally-weighted, quantitative goals that directly align with or help drive the Company’s strategy and long-term total shareholder return.

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 would 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 1,350,000. 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 vested over a three-year period with 1/3 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 vested one year from the date of the grant. Since 2016, new non-employee directors received pro-rated stock option grants that vest on the same term as the annual stock option grants. The Directors’ Plan was terminated in November 2020 and, therefore, there are no shares reserved for future grants under the Directors’ Plan. However, options granted prior to the plan’s termination continue to remain outstanding until their original expiration date.

2000 Employee Stock Purchase Plan. In March 2000, the Board adopted 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 18,270,945 to 22,770,945. As of December 31, 2023, there were approximately 1.8 million shares reserved for future issuance under the ESPP.

Restricted Stock Units

RSU activity for the year ended December 31, 2023, was as follows (in millions, except per share amounts):


	Shares	Weighted-Average Grant Date Fair Value Per Share
Unvested balance as of December 31, 2022	4.6	$	241.47
Granted	2.5	$	237.37
Vested	(1.8)	$	223.52
Forfeited	(0.3)	$	247.21
Unvested balance as of December 31, 2023	5.0	$	245.75

As of December 31, 2023, 4.5 million shares of RSUs were expected to vest with an aggregate intrinsic value of $1.52 billion. The aggregate vesting date fair value of RSUs vested was $454 million, $536 million, and $578 million during the years ended December 31, 2023, 2022, and 2021, respectively.

Stock Options

NSO activity for the year ended December 31, 2023, was as follows (in millions, except per share amounts):


	Stock Options Outstanding
	Number Outstanding	Weighted-Average Exercise Price Per Share
Balance as of December 31, 2022	10.8	$	144.86
Options granted	1.4	$	267.38
Options exercised	(2.3)	$	83.97
Options forfeited/expired	(0.1)	$	261.39
Balance as of December 31, 2023	9.8	$	174.90

The aggregate intrinsic value of stock options exercised under the Company’s stock plans determined as of the date of option exercise was $476 million, $315 million, and $613 million during the years ended December 31, 2023, 2022, and 2021, respectively. Cash received from stock option exercises for the years ended December 31, 2023, 2022, and 2021, was $192 million, $146 million, and $201 million, respectively. The income tax benefit from stock options exercised was $109 million for the year ended December 31, 2023.

The following table summarizes significant ranges of outstanding and exercisable options as of December 31, 2023 (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)
$39.22-$57.11	1.1	0.8	$	53.14			1.1		$	53.14
$57.85-$77.00	1.3	2.2	$	65.86			1.3		$	65.86
$77.04-$139.52	1.3	3.6	$	108.66			1.3		$	108.66
$143.49-$174.26	1.1	5.1	$	169.00			1.1		$	169.01
$175.53-$182.83	1.0	5.6	$	179.98			1.0		$	180.02
$182.90-$229.39	1.3	5.9	$	216.85			0.5		$	209.47
$235.20-$262.70	1.0	6.8	$	244.47			0.7		$	244.09
$271.22-$304.67	1.2	6.0	$	297.47			0.4		$	294.41
$313.64-$341.16	0.0	6.6	$	323.28			0.0		$	334.66
$347.42-$347.42	0.5	7.6	$	347.42			0.3		$	347.42





Total	9.8	4.6	$	174.89	$	1,589	7.7	4.2	$	151.68	$	1,441

(1)The aggregate intrinsic value represents the total pre-tax intrinsic value, based on the Company’s closing stock price of $337.36 as of December 31, 2023, 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, 2023, a total of 9.6 million shares of stock options vested and expected to vest had a weighted-average remaining contractual life of 4.6 years, an aggregate intrinsic value of $1.58 billion, and a weighted-average exercise price of $173.14.

Performance Stock Units

The 2022 PSU grant metrics are focused on relative total shareholder return (“TSR”), year-over-year da Vinci procedure growth for 2023, and two-year compound annual da Vinci procedure growth for 2024. The 2023 PSU grant metrics are focused on relative TSR, da Vinci and Ion procedure growth in 2024 compared to 2022, and da Vinci and Ion procedure growth in 2025 compared to 2022. The TSR metric is considered a market condition, and the expense is determined at the grant date. The procedure growth metrics are considered performance conditions, and the expense is recorded based on the forecasted performance, which is reassessed each reporting period based on the probability of achieving the performance conditions. The number of shares earned at the end of the three-year period will vary, based on actual performance, from 0% to 125% of the target number of PSUs granted. PSUs are subject to forfeiture if employment terminates prior to the vesting date. PSUs are not considered issued or outstanding shares of the Company.

The Company calculates the fair value for each component of the PSUs individually. The fair value for the component with the TSR metric was determined using Monte Carlo simulation. The fair value per share for the components with the procedure growth metrics is equal to the closing stock price on the grant date.

PSU activity for the year ended December 31, 2023, was as follows (in millions, except per share amounts):


	Shares	Weighted-Average Grant Date Fair Value Per Share
Unvested balance as of December 31, 2022	0.1	$	299.32
Granted	0.1	$	240.45
Vested	—	$	—
Performance change	—	$	—
Forfeited	—	$	235.84
Unvested balance as of December 31, 2023	0.2	$	259.60

As of December 31, 2023, 0.2 million shares of PSUs were expected to vest with an aggregate intrinsic value of $70 million.

Employee Stock Purchase Plan

Under the ESPP, employees purchased approximately 0.5 million, 0.4 million, and 0.5 million shares, representing approximately $104.5 million, $87.9 million, and $75.9 million in employee contributions for the years ended December 31, 2023, 2022, and 2021, respectively.

Share-Based Compensation Expense

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


	Years Ended December 31,
	2023		2022		2021
Cost of sales – products (before capitalization)	$	92.7	$	79.0	$	68.9
Amounts capitalized into inventory (1)	(84.3)		(17.2)		—
Amounts recognized in income for amounts previously capitalized in inventory	75.0		5.8		—
Cost of revenue—product	83.4		67.6		68.9
Cost of revenue—service	28.2		23.6		22.2
Total cost of revenue	111.6		91.2		91.1
Selling, general and administrative	274.8		261.1		231.6
Research and development	211.8		164.2		134.1
Share-based compensation expense before income taxes	598.2		516.5		456.8
Income tax benefit	117.4		101.7		93.7
Share-based compensation expense after income taxes	$	480.8	$	414.8	$	363.1

(1)Share-based compensation expense subject to capitalization into inventory was not material during 2021 and the first three quarters of 2022, and, therefore, not recorded. The Company commenced capitalization of share-based compensation expense into inventory during the quarter ended December 31, 2022, on a prospective basis.

The Black-Scholes-Merton option pricing model is used to estimate the fair value of stock options granted under the Company’s share-based compensation plans and the rights to acquire stock granted under the ESPP. The weighted-average estimated fair values of stock options and the rights to acquire stock under the ESPP, as well as the weighted-average assumptions used in calculating the fair values of stock options and the rights to acquire stock under the ESPP that were granted during the years ended December 31, 2023, 2022, and 2021, were as follows:


	Years Ended December 31,
	2023	2022	2021
RSUs
Fair value at grant date	$237.37	$272.97	$256.52
STOCK OPTIONS
Risk-free interest rate	4.6%	2.6%	0.8%
Expected term (in years)	3.2	3.2	4.1
Expected volatility	33%	38%	32%
Fair value at grant date	$77.45	$73.65	$78.23
PSUs
Fair value at grant date	$240.45	$299.32	$—
ESPP
Risk-free interest rate	5.0%	2.1%	0.1%
Expected term (in years)	1.2	1.2	1.2
Expected volatility	33%	39%	29%
Fair value at grant date	$89.42	$80.61	$89.98

As share-based compensation expense recognized in the Consolidated Statements of Income during the years ended December 31, 2023, 2022, and 2021, is based on awards ultimately expected to vest, it has been reduced for estimated forfeitures.

As of December 31, 2023, there was $761 million, $134 million, $38 million, and $22 million of total unrecognized compensation expense related to unvested restricted stock units, unvested stock options, unvested performance stock units, and rights granted to acquire common stock under the ESPP, respectively. The unrecognized compensation expense is expected to be recognized over a weighted-average period of 2.4 years for unvested restricted stock units, 2.5 years for unvested stock options, 1.8 years for unvested performance stock units, and 0.6 years for rights granted to acquire common stock under the ESPP.

Consolidated Financial Statement Details (Tables)

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Accounts Receivable, Net

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


	December 31,
Accounts receivable, net	2023		2022
Trade accounts receivable, net	$	1,042.2	$	864.9


Unbilled accounts receivable and other	105.0		91.7
Sales returns and allowances	(17.0)		(14.5)
Total accounts receivable, net	$	1,130.2	$	942.1

Schedule of Inventory


	December 31,
Inventory	2023		2022
Raw materials	$	454.7	$	382.9
Work-in-process	159.9		159.9
Finished goods	606.0		350.4
Total inventory	$	1,220.6	$	893.2

Schedule of Prepaids and Other Current Assets


	December 31,
Prepaids and other current assets	2023		2022
Net investment in sales-type leases – short-term	137.3		131.2




Other prepaids and other current assets	176.7		168.6
Total prepaids and other current assets	$	314.0	$	299.8

Schedule of Property, Plant, and Equipment, Net


			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 to 5 years
Enterprise-wide software			5 to 8 years
Purchased software			Lesser of 3 years or life of license


	December 31,
Property, plant, and equipment, net	2023		2022
Land	$	457.3	$	388.6
Building and building/leasehold improvements	1,002.1		866.5
Machinery and equipment	724.2		566.4
Operating lease assets – Intuitive System Leasing	1,149.7		806.4
Computer and office equipment	153.8		134.7
Capitalized software	257.8		240.9
Construction-in-process	1,354.7		608.6
Gross property, plant, and equipment	5,099.6		3,612.1
Less: Accumulated depreciation*	(1,562.0)		(1,237.9)
Total property, plant, and equipment, net	$	3,537.6	$	2,374.2
*Accumulated depreciation associated with operating lease assets – Intuitive System Leasing	$	(434.3)	$	(285.8)

Schedule of Capitalized Implementation Costs in Cloud Computing Arrangements


	December 31,
Implementation costs in cloud computing arrangements	2023		2022
Capitalized implementation costs	$	50.7	$	36.0
Less: Accumulated depreciation	(20.5)		(10.3)
Total capitalized implementation costs in intangible and other assets, net	$	30.2	$	25.7

Schedule of Other Accrued Liabilities - Short-Term


	December 31,
Other accrued liabilities – short-term	2023		2022
Income and other taxes payable	$	111.4	$	96.1
Accrued construction-related capital expenditures	143.3		50.3




Other accrued liabilities	332.8		329.8
Total other accrued liabilities – short-term	$	587.5	$	476.2

Schedule of Other Long-Term Liabilities


	December 31,
Other long-term liabilities	2023		2022
Income taxes – long-term	$	233.8	$	288.0
Deferred revenue – long-term	45.6		41.0
Other long-term liabilities	106.1		110.3
Total other long-term liabilities	$	385.5	$	439.3

Schedule of Supplemental Cash Flow Information

The following table provides supplemental non-cash investing and financing activities (in millions):


	Years Ended December 31,
	2023		2022		2021
Income taxes paid	$	447.8	$	444.2	$	180.0
Supplemental non-cash investing and financing activities:
Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment	$	422.4	$	279.2	$	302.4
Acquisition of property, plant, and equipment in accounts payable and accrued liabilities	$	153.7	$	73.4	$	32.1

Share-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Summary of RSU Activity

RSU activity for the year ended December 31, 2023, was as follows (in millions, except per share amounts):


	Shares	Weighted-Average Grant Date Fair Value Per Share
Unvested balance as of December 31, 2022	4.6	$	241.47
Granted	2.5	$	237.37
Vested	(1.8)	$	223.52
Forfeited	(0.3)	$	247.21
Unvested balance as of December 31, 2023	5.0	$	245.75

Summary Of Stock Option Activity Under All Stock Plans

NSO activity for the year ended December 31, 2023, was as follows (in millions, except per share amounts):


	Stock Options Outstanding
	Number Outstanding	Weighted-Average Exercise Price Per Share
Balance as of December 31, 2022	10.8	$	144.86
Options granted	1.4	$	267.38
Options exercised	(2.3)	$	83.97
Options forfeited/expired	(0.1)	$	261.39
Balance as of December 31, 2023	9.8	$	174.90

Summary Of Significant Ranges Of Outstanding And Exercisable Options

The following table summarizes significant ranges of outstanding and exercisable options as of December 31, 2023 (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)
$39.22-$57.11	1.1	0.8	$	53.14			1.1		$	53.14
$57.85-$77.00	1.3	2.2	$	65.86			1.3		$	65.86
$77.04-$139.52	1.3	3.6	$	108.66			1.3		$	108.66
$143.49-$174.26	1.1	5.1	$	169.00			1.1		$	169.01
$175.53-$182.83	1.0	5.6	$	179.98			1.0		$	180.02
$182.90-$229.39	1.3	5.9	$	216.85			0.5		$	209.47
$235.20-$262.70	1.0	6.8	$	244.47			0.7		$	244.09
$271.22-$304.67	1.2	6.0	$	297.47			0.4		$	294.41
$313.64-$341.16	0.0	6.6	$	323.28			0.0		$	334.66
$347.42-$347.42	0.5	7.6	$	347.42			0.3		$	347.42





Total	9.8	4.6	$	174.89	$	1,589	7.7	4.2	$	151.68	$	1,441

Summary of PSU Activity

PSU activity for the year ended December 31, 2023, was as follows (in millions, except per share amounts):


	Shares	Weighted-Average Grant Date Fair Value Per Share
Unvested balance as of December 31, 2022	0.1	$	299.32
Granted	0.1	$	240.45
Vested	—	$	—
Performance change	—	$	—
Forfeited	—	$	235.84
Unvested balance as of December 31, 2023	0.2	$	259.60

Summary Of Share-Based Compensation Expense

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


	Years Ended December 31,
	2023		2022		2021
Cost of sales – products (before capitalization)	$	92.7	$	79.0	$	68.9
Amounts capitalized into inventory (1)	(84.3)		(17.2)		—
Amounts recognized in income for amounts previously capitalized in inventory	75.0		5.8		—
Cost of revenue—product	83.4		67.6		68.9
Cost of revenue—service	28.2		23.6		22.2
Total cost of revenue	111.6		91.2		91.1
Selling, general and administrative	274.8		261.1		231.6
Research and development	211.8		164.2		134.1
Share-based compensation expense before income taxes	598.2		516.5		456.8
Income tax benefit	117.4		101.7		93.7
Share-based compensation expense after income taxes	$	480.8	$	414.8	$	363.1

Summary of Weighted-Average Assumptions

The weighted-average estimated fair values of stock options and the rights to acquire stock under the ESPP, as well as the weighted-average assumptions used in calculating the fair values of stock options and the rights to acquire stock under the ESPP that were granted during the years ended December 31, 2023, 2022, and 2021, were as follows:


	Years Ended December 31,
	2023	2022	2021
RSUs
Fair value at grant date	$237.37	$272.97	$256.52
STOCK OPTIONS
Risk-free interest rate	4.6%	2.6%	0.8%
Expected term (in years)	3.2	3.2	4.1
Expected volatility	33%	38%	32%
Fair value at grant date	$77.45	$73.65	$78.23
PSUs
Fair value at grant date	$240.45	$299.32	$—
ESPP
Risk-free interest rate	5.0%	2.1%	0.1%
Expected term (in years)	1.2	1.2	1.2
Expected volatility	33%	39%	29%
Fair value at grant date	$89.42	$80.61	$89.98

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 249.6	$ 242.7
Accumulated Amortization	(210.5)	(192.9)
Net Carrying Amount	39.1	49.8
Patents and developed technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	206.3	199.1
Accumulated Amortization	(178.4)	(167.4)
Net Carrying Amount	27.9	31.7
Distribution rights and others
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	10.8	11.0
Accumulated Amortization	(9.2)	(7.4)
Net Carrying Amount	1.6	3.6
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	32.5	32.6
Accumulated Amortization	(22.9)	(18.1)
Net Carrying Amount	$ 9.6	$ 14.5

Net Income Per Share (Tables)

12 Months Ended

Dec. 31, 2023

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,
	2023		2022		2021
Numerator:
Net income attributable to Intuitive Surgical, Inc.	$	1,798.0	$	1,322.3	$	1,704.6
Denominator:
Weighted-average shares outstanding used in basic calculation	351.2		355.7		356.1
Add: dilutive effect of potential common shares	6.2		6.3		9.7
Weighted-average shares outstanding used in diluted calculation	357.4		362.0		365.8
Net income per share attributable to Intuitive Surgical, Inc.:
Basic	$	5.12	$	3.72	$	4.79
Diluted	$	5.03	$	3.65	$	4.66

Leases - Schedule of Maturities of Operating Lease Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
2024	$ 27.4
2025	27.1
2026	22.9
2027	9.7
2028	5.9
2029 and thereafter	3.1
Total lease payments	96.1
Less: imputed interest	(6.3)
Total operating lease liabilities	$ 89.8	$ 93.8

Summary Of Significant Accounting Policies - Estimated Useful Lives Of Assets (Details)	Dec. 31, 2023
Building
Property, Plant and Equipment [Line Items]
Useful Lives	30 years
Building improvements
Property, Plant and Equipment [Line Items]
Useful Lives	15 years
Equipment and furniture
Property, Plant and Equipment [Line Items]
Useful Lives	5 years
Operating lease assets \| Minimum
Property, Plant and Equipment [Line Items]
Useful Lives	1 year
Operating lease assets \| Maximum
Property, Plant and Equipment [Line Items]
Useful Lives	5 years
Computer and office equipment \| Minimum
Property, Plant and Equipment [Line Items]
Useful Lives	3 years
Computer and office equipment \| Maximum
Property, Plant and Equipment [Line Items]
Useful Lives	5 years
Enterprise-wide software \| Minimum
Property, Plant and Equipment [Line Items]
Useful Lives	5 years
Enterprise-wide software \| Maximum
Property, Plant and Equipment [Line Items]
Useful Lives	8 years
Purchased software
Property, Plant and Equipment [Line Items]
Useful Lives	3 years

Revenue - Summary of Contract Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Contract assets	$ 20.2	$ 45.0
Deferred revenue	$ 491.7	$ 438.3

Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2023

SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]

Valuation and Qualifying Accounts


	Balance at Beginning of Year		Additions		Deductions (1)		Balance at End of Year
Sales returns and allowances
Year ended December 31, 2023	$	14.5	$	58.8	$	(56.3)	$	17.0
Year ended December 31, 2022	$	13.1	$	44.4	$	(43.0)	$	14.5
Year ended December 31, 2021	$	15.5	$	41.7	$	(44.1)	$	13.1

(1)Primarily represents products returned.

Consolidated Balance Sheets (Parenthetical) - USD ($) shares in Millions, $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Accounts receivable, allowance for credit loss, current	$ 27.1	$ 22.4
Preferred stock, shares authorized (in shares)	2.5	2.5
Preferred stock, par value (usd per share)	$ 0.001	$ 0.001
Preferred stock, shares issued (in shares)	0.0	0.0
Preferred stock, shares outstanding (in shares)	0.0	0.0
Common stock, shares authorized (in shares)	600.0	600.0
Common stock, par value (usd per share)	$ 0.001	$ 0.001
Common stock, shares issued (in shares)	352.3	350.0
Common stock, shares outstanding (in shares)	352.3	350.0

Leases - Supplemental Balance Sheet Information (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Intangible and other assets, net	Intangible and other assets, net
Intangible and other assets, net (Right-of-use assets)	$ 79.3	$ 82.2
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other accrued liabilities	Other accrued liabilities
Other accrued liabilities	$ 25.3	$ 24.2
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other long-term liabilities	Other long-term liabilities
Other long-term liabilities	$ 64.5	$ 69.6
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	Liabilities	Liabilities
Total lease liabilities	$ 89.8	$ 93.8
Weighted-average remaining lease term	3 years 8 months 12 days	4 years 6 months
Weighted-average discount rate	3.40%	3.00%

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule Of Stock Repurchase Activities

The following table summarizes stock repurchase activities (in millions, except per share amounts):


	Years Ended December 31,
	2023		2022		2021
Shares repurchased	1.7		11.2		—
Average price per share	$	241.38	$	233.70	$	—
Value of shares repurchased	$	416.3	$	2,607.4	$	—

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

The components of accumulated other comprehensive income (loss), net of tax, attributable to Intuitive Surgical, Inc. are as follows (in millions):


	Year Ended December 31, 2023
	Gains (Losses) on Hedge Instruments		Unrealized Gains (Losses) on Available-for-Sale Securities		Foreign Currency Translation Gains (Losses)		Employee Benefit Plans		Total
Beginning balance	$	(2.9)	$	(154.2)	$	(6.6)	$	1.2	$	(162.5)
Other comprehensive income (loss) before reclassifications	(6.6)		124.6		26.0		(0.6)		143.4
Amounts reclassified from accumulated other comprehensive income (loss)	7.0		(0.1)		—		—		6.9
Net current-period other comprehensive income (loss)	0.4		124.5		26.0		(0.6)		150.3
Ending balance	$	(2.5)	$	(29.7)	$	19.4	$	0.6	$	(12.2)

	Year Ended December 31, 2022
	Gains (Losses) on Hedge Instruments		Unrealized Gains (Losses) on Available-for-Sale Securities		Foreign Currency Translation Gains (Losses)		Employee Benefit Plans		Total
Beginning balance	$	4.5	$	(16.0)	$	(7.9)	$	(4.8)	$	(24.2)
Other comprehensive income (loss) before reclassifications	(35.0)		(138.2)		1.3		5.8		(166.1)
Amounts reclassified from accumulated other comprehensive income (loss)	27.6		—		—		0.2		27.8
Net current-period other comprehensive income (loss)	(7.4)		(138.2)		1.3		6.0		(138.3)
Ending balance	$	(2.9)	$	(154.2)	$	(6.6)	$	1.2	$	(162.5)

Schedule of Amounts Recognized in Other Comprehensive Income (Loss)

The tax impacts for amounts recognized in other comprehensive income before reclassifications were as follows (in millions):


	Years Ended December 31,
Available-for-sale securities	2023		2022
Income tax benefit (expense) for net gains (losses) recorded in other comprehensive income (loss)	$	(35.7)	$	39.1

Cover Page - USD ($) $ in Billions	12 Months Ended
Cover Page - USD ($) $ in Billions	Dec. 31, 2023	Jan. 25, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Document Transition Report	false
Entity File Number	000-30713
Entity Registrant Name	Intuitive Surgical, Inc.
State or Other Jurisdiction of Incorporation or Organization	DE
I.R.S. Employer Identification No.	77-0416458
Entity Address, Address Line One	1020 Kifer Road
Entity Address, City or Town	Sunnyvale
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94086
City Area Code	(408)
Local Phone Number	523-2100
Title of Each Class	Common Stock, par value $0.001 per share
Trading Symbol	ISRG
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 119.6
Entity Common Stock, Shares Outstanding		352,325,863
Documents Incorporated by Reference	Part III incorporates information by reference to the definitive proxy statement for the Company’s Annual Meeting of Stockholders to be held on or about April 25, 2024, to be filed within 120 days of the registrant’s fiscal year ended December 31, 2023.
Entity Central Index Key	0001035267
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Amendment Flag	false

Stockholders' Equity - Additional Information (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	1 Months Ended	2 Months Ended	3 Months Ended	12 Months Ended
	Sep. 30, 2022	Sep. 30, 2022	Dec. 31, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Oct. 31, 2022	Aug. 31, 2022	Jul. 20, 2022
Equity, Class of Treasury Stock [Line Items]
Aggregate reduction in common stock and additional paid-in capital during stock repurchases				$ (19.0)	$ (211.0)	$ 0.0
Amount charged to retained earnings during stock repurchases				(400.0)	$ (2,400.0)	$ 0.0
Excise tax accrued				$ 0.0
August ASR Program
Equity, Class of Treasury Stock [Line Items]
Stock repurchase program, authorized amount								$ 1,000.0
Shares repurchased (in shares)	4,600	4,600
Share repurchases, average price per share (in dollars per share)		$ 217.52
October ASR Program
Equity, Class of Treasury Stock [Line Items]
Stock repurchase program, authorized amount							$ 1,000.0
Shares repurchased (in shares)			3,900
Share repurchases, average price per share (in dollars per share)			$ 254.48
Common stock
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)				1,700	11,200
Common stock \| Common Stock Repurchase Program
Equity, Class of Treasury Stock [Line Items]
Stock repurchase program, authorized amount				$ 10,000.0					$ 3,500.0
Stock repurchase program, remaining authorized amount				$ 1,100.0
Shares repurchased (in shares)				1,700	11,200	0

Summary Of Significant Accounting Policies - Additional Information (Details) $ / shares in Units, $ in Millions		12 Months Ended
	Sep. 27, 2021 $ / shares	Dec. 31, 2023 USD ($) segment $ / shares	Dec. 31, 2022 USD ($) $ / shares	Dec. 31, 2021 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Stock split ratio	3
Common stock, par value (usd per share) \| $ / shares	$ 0.001	$ 0.001	$ 0.001
Restricted cash		$ 20.0	$ 19.5
Depreciation expense		382.0	326.0	$ 280.0
Amortization expense for capitalized implementation costs		$ 10.2	6.4	$ 2.9
Number of operating segments \| segment		1
Material impairment losses on long-lived assets		$ 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.
System sales arrangement, warranty period		1 year
Capitalized contract acquisition costs		$ 89.3	$ 72.3
Operating lease terms		7 years
Market-based implied volatility (period)		1 year
Market-based implied volatility (percent)		100.00%
Cash flow hedges de-designated (period)		2 months
Long-lived assets, percent		84.00%	84.00%
Maximum
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life, intangible asset		9 years
Operating lease terms		84 months
Sales-type lease terms		84 months
Derivative contract term		13 months
Maximum \| Internal use software
Summary Of Significant Accounting Policies [Line Items]
Useful Lives		8 years
Minimum
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life, intangible asset		3 years
Operating lease terms		24 months
Sales-type lease terms		24 months
Accounts Receivable \| Geographic Concentration Risk \| U.S.
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage		65.00%	60.00%
Total Revenue \| Geographic Concentration Risk \| U.S.
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage		66.00%	67.00%	67.00%
Total Revenue \| Geographic Concentration Risk \| OUS
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage		34.00%	33.00%	33.00%

Consolidated Financial Statement Details - Other Long-Term Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income taxes – long-term	$ 233.8	$ 288.0
Deferred revenue – long-term	45.6	41.0
Other long-term liabilities	106.1	110.3
Total other long-term liabilities	$ 385.5	$ 439.3

Net Income Per Share - Additional Information (Details) - shares shares in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Earnings Per Share [Abstract]
Employee stock options excluded from computation of diluted net income per share	1.9	3.4	0.8

Share-Based Compensation - Weighted-Average Assumptions (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (usd per share)	$ 237.37	$ 272.97	$ 256.52
STOCK OPTIONS
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	4.60%	2.60%	0.80%
Expected term (in years)	3 years 2 months 12 days	3 years 2 months 12 days	4 years 1 month 6 days
Expected volatility (percent)	33.00%	38.00%	32.00%
Fair value at grant date (usd per share)	$ 77.45	$ 73.65	$ 78.23
PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (usd per share)	$ 240.45	$ 299.32	$ 0
ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	5.00%	2.10%	0.10%
Expected term (in years)	1 year 2 months 12 days	1 year 2 months 12 days	1 year 2 months 12 days
Expected volatility (percent)	33.00%	39.00%	29.00%
Fair value at grant date (usd per share)	$ 89.42	$ 80.61	$ 89.98

Employee Benefit Plans (Details)	12 Months Ended
Employee Benefit Plans (Details)	Dec. 31, 2023 USD ($)
Retirement Benefits [Abstract]
Maximum rate of employees' contribution to 401(k) plan	100.00%
Employer match percentage	200.00%
Employer matching contributions, per person, per year	$ 1,500

Financial Instruments - Gross Notional Amounts for Outstanding Derivatives (Details) - Forward contracts - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
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	$ 292.1	$ 188.4
Derivatives Designated as Hedging Instruments \| Prepaids 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	1.8
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	5.9	5.3
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	699.7	496.3
Derivatives Not Designated as Hedging Instruments \| Prepaids and other current assets
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Notional amounts of outstanding currency forward contracts	5.0	4.3
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	$ 6.6	$ 4.2

Share-Based Compensation - Share-Based Compensation Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 598.2	$ 516.5	$ 456.8
Income tax benefit	117.4	101.7	93.7
Share-based compensation expense after income taxes	480.8	414.8	363.1
Total cost of revenue
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	111.6	91.2	91.1
Total cost of revenue \| Cost of revenue—product
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	83.4	67.6	68.9
Total cost of revenue \| Cost of revenue—service
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	28.2	23.6	22.2
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	274.8	261.1	231.6
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	211.8	164.2	134.1
Cost of sales – products (before capitalization) \| Cost of revenue—product
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	92.7	79.0	68.9
Amounts capitalized into inventory \| Cost of revenue—product
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	(84.3)	(17.2)	0.0
Amounts recognized in income for amounts previously capitalized in inventory \| Cost of revenue—product
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense before income taxes	$ 75.0	$ 5.8	$ 0.0

Consolidated Statements Of Comprehensive Income - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 1,817.3	$ 1,344.4	$ 1,728.1
Other comprehensive income (loss), net of tax:
Change in foreign currency translation gains (losses)	25.7	(0.5)	(13.3)
Available-for-sale securities (net of tax):
Change in unrealized gains (losses)	124.6	(138.2)	(45.5)
Less: Reclassification adjustment for gains on securities	(0.1)	0.0	0.0
Net change	124.5	(138.2)	(45.5)
Hedge instruments (net of tax):
Change in unrealized gains (losses)	(6.6)	(35.0)	12.3
Less: Reclassification adjustment for (gains) losses on hedge instruments	7.0	27.6	(4.9)
Net change	0.4	(7.4)	7.4
Employee benefit plans (net of tax):
Change in unrealized gains (losses)	(0.6)	5.8	0.1
Less: Reclassification adjustment for losses on employee benefit plans	0.0	0.2	1.5
Net change	(0.6)	6.0	1.6
Other comprehensive income (loss), net of tax	150.0	(140.1)	(49.8)
Total comprehensive income	1,967.3	1,204.3	1,678.3
Less: comprehensive income attributable to noncontrolling interest	19.0	20.3	22.8
Total comprehensive income attributable to Intuitive Surgical, Inc.	$ 1,948.3	$ 1,184.0	$ 1,655.5

Consolidated Financial Statement Details (Details) - Prepaids and Other Current Assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Net investment in sales-type leases – short-term	$ 137.3	$ 131.2
Other prepaids and other current assets	176.7	168.6
Total prepaids and other current assets	$ 314.0	$ 299.8

Pay vs Performance Disclosure - USD ($) $ in Millions	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net income	$ 1,798.0	$ 1,322.3	$ 1,704.6

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Holiday [Line Items]
Swiss tax benefits, net of valuation allowance	$ 92.3	$ 0.0	$ 0.0
Swiss tax benefits, valuation allowance	67.3
One-time tax benefit	67.1	0.0	66.4
Excise tax accrued	0.0
Net operating loss carryforwards	38.2
Swiss tax credit carryforwards	122.4	0.0
Research and development credit carryforwards	193.2	156.7
Valuation allowance	269.8	168.6
Gross interest related to unrecognized tax benefits accrued	31.2	21.0	14.9
Total gross unrecognized tax benefits	260.4	252.6	$ 222.5	$ 176.3
Unrecognized tax benefits that would impact effective tax rate	181.8
Interest and penalties related to unrecognized tax benefits accrued		$ 13.6
Research Tax Credit Carryforward, Other
Income Tax Holiday [Line Items]
Research and development credit carryforwards	5.2
California Franchise Tax Board \| Research Tax Credit Carryforward, State
Income Tax Holiday [Line Items]
Research and development credit carryforwards	$ 267.7

Consolidated Statements Of Income - USD ($) shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenue:
Total revenue	$ 7,124.1	$ 6,222.2	$ 5,710.1
Cost of revenue:
Total cost of revenue	2,394.6	2,026.2	1,751.6
Gross profit	4,729.5	4,196.0	3,958.5
Operating expenses:
Selling, general and administrative	1,963.9	1,739.9	1,466.5
Research and development	998.8	879.0	671.0
Total operating expenses	2,962.7	2,618.9	2,137.5
Income from operations	1,766.8	1,577.1	1,821.0
Interest and other income, net	192.1	29.7	69.3
Income before taxes	1,958.9	1,606.8	1,890.3
Income tax expense	141.6	262.4	162.2
Net income	1,817.3	1,344.4	1,728.1
Less: net income attributable to noncontrolling interest in joint venture	19.3	22.1	23.5
Net income attributable to Intuitive Surgical, Inc.	$ 1,798.0	$ 1,322.3	$ 1,704.6
Net income per share attributable to Intuitive Surgical, Inc.:
Basic (usd per share)	$ 5.12	$ 3.72	$ 4.79
Diluted (usd per share)	$ 5.03	$ 3.65	$ 4.66
Shares used in computing net income per share attributable to Intuitive Surgical, Inc.:
Basic (shares)	351.2	355.7	356.1
Diluted (shares)	357.4	362.0	365.8
Joint venture
Operating expenses:
Less: net income attributable to noncontrolling interest in joint venture	$ 19.3	$ 22.1	$ 23.5
Product
Revenue:
Total revenue	5,956.3	5,198.0	4,793.9
Cost of revenue:
Total cost of revenue	2,041.8	1,700.3	1,464.1
Service
Revenue:
Total revenue	1,167.8	1,024.2	916.2
Cost of revenue:
Total cost of revenue	$ 352.8	$ 325.9	$ 287.5

Income Taxes - Schedule Of Income Tax Difference From Statutory Rate (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Federal tax at statutory rate	$ 411.4	$ 337.4	$ 397.0
State taxes, net of federal benefits	35.0	34.9	33.1
Foreign rate differential	(64.4)	(64.2)	(54.3)
U.S. tax on foreign earnings	70.9	75.4	40.1
Research and development credit	(48.6)	(41.7)	(30.7)
Excess tax benefits related to share-based compensation	(107.9)	(98.7)	(185.8)
Share-based compensation not benefited	29.5	24.1	17.8
Unrecognized tax benefits related to share-based compensation	4.4	3.3	13.6
Reversal of unrecognized tax benefits	(20.9)	(11.1)	(3.0)
Swiss tax benefits, net of valuation allowance	(92.3)	0.0	0.0
Deferred tax re-measurement	(67.1)	0.0	(66.4)
Other	(8.4)	3.0	0.8
Total income tax expense	$ 141.6	$ 262.4	$ 162.2

Financial Instruments - Summary Of Cash And Available-For-Sale Securities (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	$ 2,750.1	$ 1,581.2
Total	4,632.6
Total assets measured at fair value, Amortized Cost	7,382.7	6,941.1
Gross Unrealized Gains	22.1	0.0
Gross Unrealized Losses	(60.5)	(198.5)
Allowance for Credit Loss	(1.1)	(1.1)
Total	4,593.1
Total assets measured at fair value, Fair Value	7,343.2	6,741.5
Short-term Investments	2,473.1	2,536.7
Long-term Investments	2,120.0	2,623.6
Cash
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	526.2	497.2
Fair Value	526.2	497.2
Level 1:
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	2,223.9	1,084.0
Total	5,074.1	3,799.2
Gross Unrealized Gains	20.1	0.0
Gross Unrealized Losses	(25.4)	(96.6)
Allowance for Credit Loss	0.0	0.0
Total	5,068.8	3,702.6
Short-term Investments	1,276.0	1,542.4
Long-term Investments	1,568.9	1,076.2
Level 1: \| Money market funds
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	2,223.9	1,084.0
Fair Value	2,223.9	1,084.0
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	0.0	0.0
Total	2,850.2	2,715.2
Gross Unrealized Gains	20.1	0.0
Gross Unrealized Losses	(25.4)	(96.6)
Allowance for Credit Loss	0.0	0.0
Total	2,844.9	2,618.6
Short-term Investments	1,276.0	1,542.4
Long-term Investments	1,568.9	1,076.2
Fair Value, Inputs, Level 2
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	0.0	0.0
Total	1,782.4	2,644.7
Gross Unrealized Gains	2.0	0.0
Gross Unrealized Losses	(35.1)	(101.9)
Allowance for Credit Loss	(1.1)	(1.1)
Total	1,748.2	2,541.7
Short-term Investments	1,197.1	994.3
Long-term Investments	551.1	1,547.4
Fair Value, Inputs, Level 2 \| Commercial paper
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents		0.0
Total		20.0
Gross Unrealized Gains		0.0
Gross Unrealized Losses		0.0
Allowance for Credit Loss		0.0
Total		20.0
Short-term Investments		20.0
Long-term Investments		0.0
Fair Value, Inputs, Level 2 \| Corporate debt securities
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	0.0	0.0
Total	1,300.4	2,022.0
Gross Unrealized Gains	0.0	0.0
Gross Unrealized Losses	(25.8)	(76.0)
Allowance for Credit Loss	(1.1)	(1.1)
Total	1,273.5	1,944.9
Short-term Investments	974.6	651.8
Long-term Investments	298.9	1,293.1
Fair Value, Inputs, Level 2 \| U.S. government agencies
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	0.0	0.0
Total	402.6	447.2
Gross Unrealized Gains	2.0	0.0
Gross Unrealized Losses	(7.3)	(19.9)
Allowance for Credit Loss	0.0	0.0
Total	397.3	427.3
Short-term Investments	149.5	247.8
Long-term Investments	247.8	179.5
Fair Value, Inputs, Level 2 \| Municipal securities
Schedule of Available-for-sale Securities [Line Items]
Cash and Cash Equivalents	0.0	0.0
Total	79.4	155.5
Gross Unrealized Gains	0.0	0.0
Gross Unrealized Losses	(2.0)	(6.0)
Allowance for Credit Loss	0.0	0.0
Total	77.4	149.5
Short-term Investments	73.0	74.7
Long-term Investments	$ 4.4	$ 74.8

Consolidated Financial Statement Details - Implementation Costs in Cloud Computing Arrangements (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Capitalized implementation costs	$ 50.7	$ 36.0
Less: Accumulated depreciation	(20.5)	(10.3)
Total capitalized implementation costs in intangible and other assets, net	$ 30.2	$ 25.7

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	COMMITMENTS AND CONTINGENCIES Commitments As of December 31, 2023, the Company’s commitments include an estimated amount of approximately $2.37 billion relating to the Company’s open purchase orders and contractual obligations that occur in the ordinary course of business, including commitments with contract manufacturers and suppliers for which the Company has not received the goods or services, commitments for capital expenditures and construction-related activities for which the Company has not received the services, and acquisition and licensing of intellectual property. 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. Additionally, the Company has committed to making 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. For instances in which the achievement of these milestones is neither probable nor reasonably estimable, such contingencies are not included in the estimated amount. Contingencies From time to time, the Company is involved in a variety of claims, lawsuits, investigations, and proceedings relating to securities laws, product liability, intellectual property, commercial, 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 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 the 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 condition, or future results of operations. During the years ended 2023 and 2021, pre-tax litigation charges were insignificant. The Company incurred $28.1 million of pre-tax litigation charges in 2022. 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. The Company disputes these allegations and is defending against these claims. The Company’s estimate of the anticipated cost of resolving the pending cases is based on negotiations with attorneys for the 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 condition, or 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 U.S. Patent Nos. 9,585,658 (“’658”); 8,479,969 (“’969”); 9,113,874 (“’874”); 8,998,058 (“’058”); 8,991,677 (“’677”); 9,084,601 (“’601”); and 8,616,431 (“’431”). A claim construction hearing occurred on October 1, 2018, and the Court issued a scheduling order on December 28, 2018. On March 20, 2019, the Court granted the Company’s Motion to Stay pending an Inter Partes Review to be held at the Patent Trademark and Appeals Board (“PTAB”) to review patentability of six of the seven patents noted above and vacated the trial date. On August 1, 2019, the Court granted the parties’ joint stipulation to modify the stay in light of Ethicon’s U.S. International Trade Commission (“USITC”) complaint against Intuitive involving U.S. Patent Nos. 8,479,969 and 9,113,874. The PTAB has issued final written decisions finding the asserted claims of Patent Nos. ’658, ’058, ’677, ’601, and ’431 unpatentable. On October 3, 2023, Ethicon confirmed that it would not further appeal the decisions by the USITC in that proceeding that claim 24 of the ’969 Patent and claim 19 of the ’874 Patent were not infringed by the asserted Intuitive products and that those patents were invalid. Outside of the above USITC proceeding, on October 4, 2023, the parties filed a Joint Status Report in the district court in which Ethicon stated that it was prepared to proceed in this case with respect to its allegations that the accused EndoWrist Stapler instruments infringe asserted claim 24 of the ’969 Patent and asserted claim 20 of the ’874 Patent. The parties are currently briefing whether the record before the court can be supplemented with the evidence developed before the USITC. 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 October 19, 2022, a jury rendered a verdict against the Company awarding $10 million in damages to Rex Medical, L.P. in a patent infringement lawsuit. On September 20, 2023, the court granted the Company’s post-trial motion and reduced the damages to Rex Medical L.P. to nominal damages of $1. On October 18, 2023, Rex Medical filed a notice of appeal to the United States Court of Appeals for the Federal Circuit and, on October 31, 2023, Intuitive filed its notice of cross appeal. Based on currently available information, the Company does not believe that any losses arising from this matter would be material. Commercial Litigation On May 10, 2021, Surgical Instrument Service Company, Inc. (“SIS”) filed a complaint in the Northern District of California Court alleging antitrust claims against the Company relating to EndoWrist service, maintenance, and repair processes. The Court granted in part and denied in part the Company’s Motion to Dismiss, and discovery has commenced. The Company filed an answer denying the antitrust allegations and filed counterclaims against SIS. The counterclaims allege that SIS violated the Federal Lanham Act, California’s Unfair Competition Law, and California’s False Advertising Law and that SIS is also liable to the Company for Unfair Competition and Tortious Interference with Contract. The parties have filed summary judgment and Daubert motions, and the court held a hearing on these motions on September 7, 2023. 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. Three class action complaints were filed against the Company in the Northern District of California Court alleging antitrust allegations relating to the service and repair of certain instruments manufactured by the Company. A complaint by Larkin Community Hospital was filed on May 20, 2021, a complaint by Franciscan Alliance, Inc. and King County Public Hospital District No. 1 was filed on July 6, 2021, and a complaint by Kaleida Health was filed on July 8, 2021. The Court has consolidated the Franciscan Alliance, Inc. and King County Public Hospital District No. 1 and Kaleida Health cases with the Larkin Community Hospital case, which is now captioned on the Larkin docket as “In Re: da Vinci Surgical Robot Antitrust Litigation.” A Consolidated Amended Class Action Complaint has been filed on behalf of each plaintiff named in the earlier-filed cases. On January 14, 2022, Kaleida Health voluntarily dismissed itself as a party to this case. On January 18, 2022, the Company filed an answer against the plaintiffs in this matter, and discovery has commenced. The parties have filed summary judgment and Daubert motions, and the court held a hearing on these motions on September 7, 2023. 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.

Consolidated Financial Statement Details - Other Accrued Liabilities - Short-Term (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income and other taxes payable	$ 111.4	$ 96.1
Accrued construction-related capital expenditures	143.3	50.3
Other accrued liabilities	332.8	329.8
Total other accrued liabilities – short-term	$ 587.5	$ 476.2

Valuation and Qualifying Accounts (Details) - Sales returns and allowances - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	$ 14.5	$ 13.1	$ 15.5
Additions	58.8	44.4	41.7
Deductions	(56.3)	(43.0)	(44.1)
Balance at End of Year	$ 17.0	$ 14.5	$ 13.1

Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Summary of Cash and Available-For-Sale Securities

The following tables summarize the Company’s cash and available-for-sale debt securities’ amortized cost, gross unrealized gains, gross unrealized losses, allowance for credit loss, and fair value by significant investment category reported as cash and cash equivalents, short-term investments, or long-term investments as of December 31, 2023, and 2022 (in millions):


											Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Allowance for Credit Loss		Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2023
Cash	$	526.2	$	—	$	—	$	—	$	526.2	$	526.2	$	—	$	—
Level 1:
Money market funds	2,223.9		—		—		—		2,223.9		2,223.9		—		—
U.S. treasuries	2,850.2		20.1		(25.4)		—		2,844.9		—		1,276.0		1,568.9
Subtotal	5,074.1		20.1		(25.4)		—		5,068.8		2,223.9		1,276.0		1,568.9
Level 2:

Corporate debt securities	1,300.4		—		(25.8)		(1.1)		1,273.5		—		974.6		298.9
U.S. government agencies	402.6		2.0		(7.3)		—		397.3		—		149.5		247.8

Municipal securities	79.4		—		(2.0)		—		77.4		—		73.0		4.4
Subtotal	1,782.4		2.0		(35.1)		(1.1)		1,748.2		—		1,197.1		551.1



Total assets measured at fair value	$	7,382.7	$	22.1	$	(60.5)	$	(1.1)	$	7,343.2	$	2,750.1	$	2,473.1	$	2,120.0


											Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Allowance for Credit Loss		Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2022
Cash	$	497.2	$	—	$	—	$	—	$	497.2	$	497.2	$	—	$	—
Level 1:
Money market funds	1,084.0		—		—		—		1,084.0		1,084.0		—		—
U.S. treasuries	2,715.2		—		(96.6)		—		2,618.6		—		1,542.4		1,076.2
Subtotal	3,799.2		—		(96.6)		—		3,702.6		1,084.0		1,542.4		1,076.2
Level 2:
Commercial paper	20.0		—		—		—		20.0		—		20.0		—
Corporate debt securities	2,022.0		—		(76.0)		(1.1)		1,944.9		—		651.8		1,293.1
U.S. government agencies	447.2		—		(19.9)		—		427.3		—		247.8		179.5

Municipal securities	155.5		—		(6.0)		—		149.5		—		74.7		74.8
Subtotal	2,644.7		—		(101.9)		(1.1)		2,541.7		—		994.3		1,547.4



Total assets measured at fair value	$	6,941.1	$	—	$	(198.5)	$	(1.1)	$	6,741.5	$	1,581.2	$	2,536.7	$	2,623.6

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

The following table summarizes the contractual maturities of the Company’s cash equivalents and available-for-sale debt securities (excluding money market funds), as of December 31, 2023 (in millions):


	Amortized Cost		Fair Value
Mature in less than one year	$	2,512.5	$	2,473.1
Mature in one to five years	2,120.1		2,120.0
Total	$	4,632.6	$	4,593.1

Schedule Of Available-For-Sale Investments With Unrealized Losses

The following tables present the breakdown of the available-for-sale debt securities with unrealized losses as of December 31, 2023, and 2022 (in millions):


	Unrealized losses less than 12 months				Unrealized losses 12 months or greater				Total
December 31, 2023	Fair Value		Unrealized Losses		Fair Value		Unrealized Losses		Fair Value		Unrealized Losses
U.S. treasuries	$	48.5	$	—	$	1,112.9	$	(25.4)	$	1,161.4	$	(25.4)

Corporate debt securities	54.2		(0.1)		1,219.2		(25.8)		1,273.4		(25.9)
U.S. government agencies	29.8		—		185.6		(7.3)		215.4		(7.3)
Municipal securities	—		—		77.4		(1.9)		77.4		(1.9)
Total	$	132.5	$	(0.1)	$	2,595.1	$	(60.4)	$	2,727.6	$	(60.5)

December 31, 2022
U.S. treasuries	$	731.7	$	(26.0)	$	1,886.9	$	(70.6)	$	2,618.6	$	(96.6)

Corporate debt securities	631.4		(17.6)		1,221.9		(58.4)		1,853.3		(76.0)
U.S. government agencies	102.7		(4.4)		324.6		(15.5)		427.3		(19.9)
Municipal securities	44.6		(1.1)		104.9		(4.9)		149.5		(6.0)
Total	$	1,510.4	$	(49.1)	$	3,538.3	$	(149.4)	$	5,048.7	$	(198.5)

Debt Securities, Trading, and Equity Securities, FV-NI

The following table is a summary of the activity related to equity investments (in millions):


									Reported as:
	December 31, 2022 Carrying Value		Changes in Fair Value (1)		Purchases / Sales / Other (2)		December 31, 2023 Carrying Value		Prepaids and other current assets		Intangible and other assets, net
Equity investments with readily determinable value (Level 1)	$	4.3	$	(0.4)	$	(3.9)	$	—	$	—	$	—
Equity investments without readily determinable value (Level 2)	$	59.1	$	(5.9)	$	21.3	$	74.5	$	—	$	74.5

(1) Recorded in interest and other income, net.
(2) Other includes foreign currency translation gains/(losses).

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,
	2023		2022		2021
Recognized gains in interest and other income, net	$	4.8	$	26.9	$	15.5
Foreign exchange losses related to balance sheet re-measurement	$	(8.5)	$	(54.2)	$	(16.4)

Gross Notional Amounts for Outstanding Derivatives

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


	Derivatives Designated as Hedging Instruments				Derivatives Not Designated as Hedging Instruments
	December 31, 2023		December 31, 2022		December 31, 2023		December 31, 2022
Notional amounts:
Forward contracts	$	292.1	$	188.4	$	699.7	$	496.3
Gross fair value recorded in:
Prepaids and other current assets	$	3.1	$	1.8	$	5.0	$	4.3
Other accrued liabilities	$	5.9	$	5.3	$	6.6	$	4.2

- Definition

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (aaa)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-2

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481800/320-10-50-3

+ Details

Summary Of Significant Accounting Policies - Amortized Cost Basis By Year of Origination and Credit Quality Indicator (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	$ 78.7
2022	126.2
2021	106.9
2020	47.4
2019	11.0
Prior	1.4
Subtotal	371.6	$ 435.0
High
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	39.6
2022	70.2
2021	60.3
2020	24.4
2019	6.5
Prior	0.2
Subtotal	201.2
Moderate
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	37.6
2022	51.4
2021	43.1
2020	22.2
2019	4.5
Prior	1.0
Subtotal	159.8
Low
Sales-type Lease, Net Investment in Lease, Credit Quality Indicator [Line Items]
2023	1.5
2022	4.6
2021	3.5
2020	0.8
2019	0.0
Prior	0.2
Subtotal	$ 10.6

Summary Of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Basis of Presentation

Consolidation and Joint Ventures

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 the date of purchase of 90 days or less to be cash equivalents.

Restricted Cash

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 to 5 years
Enterprise-wide software			5 to 8 years
Purchased software			Lesser of 3 years or life of license

Capitalized Software Costs for Internal Use

Implementation Costs in a Cloud Computing Arrangement

Business Combinations

Goodwill and Intangible Assets

Impairment of Long-lived Assets

Revenue Recognition

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

Intuitive System Leasing

Other Leasing Arrangements

Credit Losses


	2023		2022		2021		2020		2019		Prior		Net Investment
Credit Rating:
High	$	39.6	$	70.2	$	60.3	$	24.4	$	6.5	$	0.2	$	201.2
Moderate	37.6		51.4		43.1		22.2		4.5		1.0		159.8
Low	1.5		4.6		3.5		0.8		—		0.2		10.6
Total	$	78.7	$	126.2	$	106.9	$	47.4	$	11.0	$	1.4	$	371.6

For the year ended December 31, 2023, and 2022, credit losses related to the net investment in sales-type leases were not material.

Allowance for Sales Returns

Share-Based Compensation

Restricted stock units. The fair value of restricted stock units (“RSUs”) is determined based on the closing quoted price of the Company’s common stock on the date of the grant.

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.

See “Note 10. Share-Based Compensation” for a detailed discussion of the Company’s stock plans and share-based compensation expense.

Computation of Net Income per Share

Research and Development Expenses

Foreign Currency and Other Hedging Instruments

Income Taxes

Segments

Legal Contingencies

Recent Accounting Pronouncements and Recently Issued Accounting Pronouncements

Recently Adopted Accounting Pronouncements

Troubled Debt Restructurings and Vintage Disclosures

Recently Issued Accounting Pronouncements

Leases - Maturities of Operating Lease Payments (Details) $ in Millions	Dec. 31, 2023 USD ($)
Leases [Abstract]
2024	$ 277.2
2025	232.3
2026	169.4
2027	103.0
2028	43.6
2029 and thereafter	11.2
Total	$ 836.7

Share-Based Compensation - Outstanding and Exercisable Options Ranges (Details) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($) $ / shares shares
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Options Outstanding, Number of Shares \| shares	9.8
Options Outstanding, Weighted Average Remaining Contractual Life	4 years 7 months 6 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 174.89
Options Outstanding, Aggregate Intrinsic Value \| $	$ 1,589.0
Options Exercisable, Number of Shares \| shares	7.7
Options Exercisable, Weighted Average Remaining Contractual Life	4 years 2 months 12 days
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 151.68
Options Exercisable, Aggregate Intrinsic Value \| $	$ 1,441.0
Closing stock price (usd per share)	$ 337.36
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)	39.22
Range of Exercise Prices, maximum (usd per share)	$ 57.11
Options Outstanding, Number of Shares \| shares	1.1
Options Outstanding, Weighted Average Remaining Contractual Life	9 months 18 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 53.14
Options Exercisable, Number of Shares \| shares	1.1
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 53.14
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)	57.85
Range of Exercise Prices, maximum (usd per share)	$ 77.00
Options Outstanding, Number of Shares \| shares	1.3
Options Outstanding, Weighted Average Remaining Contractual Life	2 years 2 months 12 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 65.86
Options Exercisable, Number of Shares \| shares	1.3
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 65.86
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)	77.04
Range of Exercise Prices, maximum (usd per share)	$ 139.52
Options Outstanding, Number of Shares \| shares	1.3
Options Outstanding, Weighted Average Remaining Contractual Life	3 years 7 months 6 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 108.66
Options Exercisable, Number of Shares \| shares	1.3
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 108.66
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)	143.49
Range of Exercise Prices, maximum (usd per share)	$ 174.26
Options Outstanding, Number of Shares \| shares	1.1
Options Outstanding, Weighted Average Remaining Contractual Life	5 years 1 month 6 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 169.00
Options Exercisable, Number of Shares \| shares	1.1
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 169.01
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)	175.53
Range of Exercise Prices, maximum (usd per share)	$ 182.83
Options Outstanding, Number of Shares \| shares	1.0
Options Outstanding, Weighted Average Remaining Contractual Life	5 years 7 months 6 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 179.98
Options Exercisable, Number of Shares \| shares	1.0
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 180.02
Exercise Price Range 6
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	182.90
Range of Exercise Prices, maximum (usd per share)	$ 229.39
Options Outstanding, Number of Shares \| shares	1.3
Options Outstanding, Weighted Average Remaining Contractual Life	5 years 10 months 24 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 216.85
Options Exercisable, Number of Shares \| shares	0.5
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 209.47
Exercise Price Range 7
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	235.20
Range of Exercise Prices, maximum (usd per share)	$ 262.70
Options Outstanding, Number of Shares \| shares	1.0
Options Outstanding, Weighted Average Remaining Contractual Life	6 years 9 months 18 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 244.47
Options Exercisable, Number of Shares \| shares	0.7
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 244.09
Exercise Price Range 8
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	271.22
Range of Exercise Prices, maximum (usd per share)	$ 304.67
Options Outstanding, Number of Shares \| shares	1.2
Options Outstanding, Weighted Average Remaining Contractual Life	6 years
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 297.47
Options Exercisable, Number of Shares \| shares	0.4
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 294.41
Exercise Price Range 9
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	313.64
Range of Exercise Prices, maximum (usd per share)	$ 341.16
Options Outstanding, Number of Shares \| shares	0.0
Options Outstanding, Weighted Average Remaining Contractual Life	6 years 7 months 6 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 323.28
Options Exercisable, Number of Shares \| shares	0.0
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 334.66
Exercise Price Range 10
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of Exercise Prices, minimum (usd per share)	347.42
Range of Exercise Prices, maximum (usd per share)	$ 347.42
Options Outstanding, Number of Shares \| shares	0.5
Options Outstanding, Weighted Average Remaining Contractual Life	7 years 7 months 6 days
Options Outstanding, Weighted Average Exercise Price Per Share (usd per share)	$ 347.42
Options Exercisable, Number of Shares \| shares	0.3
Options Exercisable, Weighted Average Exercise Price Per Share (usd per share)	$ 347.42

Leases - Supplemental Cash Flow Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Cash paid for leases that were included within operating cash outflows	$ 30.2	$ 33.8	$ 23.2
Right-of-use assets recognized related to new lease obligations	$ 27.8	$ 34.0	$ 30.6

Net Income Per Share

12 Months Ended

Dec. 31, 2023

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,
	2023		2022		2021
Numerator:
Net income attributable to Intuitive Surgical, Inc.	$	1,798.0	$	1,322.3	$	1,704.6
Denominator:
Weighted-average shares outstanding used in basic calculation	351.2		355.7		356.1
Add: dilutive effect of potential common shares	6.2		6.3		9.7
Weighted-average shares outstanding used in diluted calculation	357.4		362.0		365.8
Net income per share attributable to Intuitive Surgical, Inc.:
Basic	$	5.12	$	3.72	$	4.79
Diluted	$	5.03	$	3.65	$	4.66

Share-based compensation awards of approximately 1.9 million, 3.4 million, and 0.8 million shares for the years ended December 31, 2023, 2022, and 2021, 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.

Summary Of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Estimated Useful Lives Of 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 to 5 years
Enterprise-wide software			5 to 8 years
Purchased software			Lesser of 3 years or life of license


	December 31,
Property, plant, and equipment, net	2023		2022
Land	$	457.3	$	388.6
Building and building/leasehold improvements	1,002.1		866.5
Machinery and equipment	724.2		566.4
Operating lease assets – Intuitive System Leasing	1,149.7		806.4
Computer and office equipment	153.8		134.7
Capitalized software	257.8		240.9
Construction-in-process	1,354.7		608.6
Gross property, plant, and equipment	5,099.6		3,612.1
Less: Accumulated depreciation*	(1,562.0)		(1,237.9)
Total property, plant, and equipment, net	$	3,537.6	$	2,374.2
*Accumulated depreciation associated with operating lease assets – Intuitive System Leasing	$	(434.3)	$	(285.8)

Amortized Cost Basis By Year of Origination and Credit Quality Indicator

The following table summarizes the amortized cost basis by year of origination and by credit quality for the net investment in sales-type leases as of December 31, 2023 (in millions):


	2023		2022		2021		2020		2019		Prior		Net Investment
Credit Rating:
High	$	39.6	$	70.2	$	60.3	$	24.4	$	6.5	$	0.2	$	201.2
Moderate	37.6		51.4		43.1		22.2		4.5		1.0		159.8
Low	1.5		4.6		3.5		0.8		—		0.2		10.6
Total	$	78.7	$	126.2	$	106.9	$	47.4	$	11.0	$	1.4	$	371.6

Income Taxes - Schedule Of Gross Unrecognized Income Tax Benefits (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of Unrecognized Tax Benefits [Roll Forward]
Beginning balance	$ 252.6	$ 222.5	$ 176.3
Increases related to tax positions taken during the current year	48.5	49.5	40.6
Increases related to tax positions taken during a prior year	0.0	4.9	11.2
Decreases related to tax positions taken during a prior year	(18.9)	(16.5)	(1.3)
Decreases related to settlements with tax authorities	(1.0)	(1.2)	(0.2)
Decreases related to expiration of statute of limitations	(20.8)	(6.6)	(4.1)
Ending balance	$ 260.4	$ 252.6	$ 222.5

Financial Instruments

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Financial Instruments

FINANCIAL INSTRUMENTS

Cash, Cash Equivalents, and Investments


											Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Allowance for Credit Loss		Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2023
Cash	$	526.2	$	—	$	—	$	—	$	526.2	$	526.2	$	—	$	—
Level 1:
Money market funds	2,223.9		—		—		—		2,223.9		2,223.9		—		—
U.S. treasuries	2,850.2		20.1		(25.4)		—		2,844.9		—		1,276.0		1,568.9
Subtotal	5,074.1		20.1		(25.4)		—		5,068.8		2,223.9		1,276.0		1,568.9
Level 2:

Corporate debt securities	1,300.4		—		(25.8)		(1.1)		1,273.5		—		974.6		298.9
U.S. government agencies	402.6		2.0		(7.3)		—		397.3		—		149.5		247.8

Municipal securities	79.4		—		(2.0)		—		77.4		—		73.0		4.4
Subtotal	1,782.4		2.0		(35.1)		(1.1)		1,748.2		—		1,197.1		551.1



Total assets measured at fair value	$	7,382.7	$	22.1	$	(60.5)	$	(1.1)	$	7,343.2	$	2,750.1	$	2,473.1	$	2,120.0


											Reported as:
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Allowance for Credit Loss		Fair Value		Cash and Cash Equivalents		Short-term Investments		Long-term Investments
December 31, 2022
Cash	$	497.2	$	—	$	—	$	—	$	497.2	$	497.2	$	—	$	—
Level 1:
Money market funds	1,084.0		—		—		—		1,084.0		1,084.0		—		—
U.S. treasuries	2,715.2		—		(96.6)		—		2,618.6		—		1,542.4		1,076.2
Subtotal	3,799.2		—		(96.6)		—		3,702.6		1,084.0		1,542.4		1,076.2
Level 2:
Commercial paper	20.0		—		—		—		20.0		—		20.0		—
Corporate debt securities	2,022.0		—		(76.0)		(1.1)		1,944.9		—		651.8		1,293.1
U.S. government agencies	447.2		—		(19.9)		—		427.3		—		247.8		179.5

Municipal securities	155.5		—		(6.0)		—		149.5		—		74.7		74.8
Subtotal	2,644.7		—		(101.9)		(1.1)		2,541.7		—		994.3		1,547.4



Total assets measured at fair value	$	6,941.1	$	—	$	(198.5)	$	(1.1)	$	6,741.5	$	1,581.2	$	2,536.7	$	2,623.6


	Amortized Cost		Fair Value
Mature in less than one year	$	2,512.5	$	2,473.1
Mature in one to five years	2,120.1		2,120.0
Total	$	4,632.6	$	4,593.1

Actual maturities may differ from contractual maturities, because certain borrowers have the right to call or prepay certain obligations. Gross realized gains and losses recognized on the sale of investments were immaterial for the years ended December 31, 2023, and 2022.

As of December 31, 2023, and 2022, net unrealized losses on available-for-sale debt securities, net of tax, of $29.7 million and $154.2 million, 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 debt securities with unrealized losses as of December 31, 2023, and 2022 (in millions):


	Unrealized losses less than 12 months				Unrealized losses 12 months or greater				Total
December 31, 2023	Fair Value		Unrealized Losses		Fair Value		Unrealized Losses		Fair Value		Unrealized Losses
U.S. treasuries	$	48.5	$	—	$	1,112.9	$	(25.4)	$	1,161.4	$	(25.4)

Corporate debt securities	54.2		(0.1)		1,219.2		(25.8)		1,273.4		(25.9)
U.S. government agencies	29.8		—		185.6		(7.3)		215.4		(7.3)
Municipal securities	—		—		77.4		(1.9)		77.4		(1.9)
Total	$	132.5	$	(0.1)	$	2,595.1	$	(60.4)	$	2,727.6	$	(60.5)

December 31, 2022
U.S. treasuries	$	731.7	$	(26.0)	$	1,886.9	$	(70.6)	$	2,618.6	$	(96.6)

Corporate debt securities	631.4		(17.6)		1,221.9		(58.4)		1,853.3		(76.0)
U.S. government agencies	102.7		(4.4)		324.6		(15.5)		427.3		(19.9)
Municipal securities	44.6		(1.1)		104.9		(4.9)		149.5		(6.0)
Total	$	1,510.4	$	(49.1)	$	3,538.3	$	(149.4)	$	5,048.7	$	(198.5)

The current unrealized losses on the Company’s available-for-sale debt securities were caused by interest rate increases. The contractual terms of those investments do not permit the issuer to settle the securities at a price less than the amortized cost basis of the investments. As of December 31, 2023, the Company does not intend to sell the investments in unrealized loss positions, and it is not more-likely-than-not that the Company will be required to sell any of the investments before recovery of their amortized cost basis, which may be at maturity. Therefore, the Company does not expect to realize any losses on these available-for-sale debt securities. Additional factors considered in determining the treatment of unrealized losses include the financial condition and near-term prospects of the investee, the extent of the loss related to the credit of the issuer, and the expected cash flows from the security.

Equity Investments

The following table is a summary of the activity related to equity investments (in millions):


									Reported as:
	December 31, 2022 Carrying Value		Changes in Fair Value (1)		Purchases / Sales / Other (2)		December 31, 2023 Carrying Value		Prepaids and other current assets		Intangible and other assets, net
Equity investments with readily determinable value (Level 1)	$	4.3	$	(0.4)	$	(3.9)	$	—	$	—	$	—
Equity investments without readily determinable value (Level 2)	$	59.1	$	(5.9)	$	21.3	$	74.5	$	—	$	74.5

(1) Recorded in interest and other income, net.
(2) Other includes foreign currency translation gains/(losses).

In 2023, Company recognized a net decrease in fair value of $5.9 million primarily due to an impairment, partially offset by net increases in observable prices for certain equity investments that lack readily determinable market values (Level 2), which were also reflected in interest and other income, net.

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, intercompany balances, and other monetary assets or liabilities denominated in currencies other than the U.S. dollar (“USD”). The terms of the Company’s derivative contracts are generally thirteen months or shorter. 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”), the Korean Won (“KRW”), and the New Taiwan Dollar (“TWD”). The Company also enters into

currency forward contracts as cash flow hedges to hedge certain forecasted expense transactions denominated in EUR and the Swiss Franc (“CHF”).

For these derivatives, the Company reports the unrealized after-tax gain or loss from the hedge as a component of accumulated other comprehensive loss in stockholders’ equity and reclassifies the amount into earnings in the same period in which the hedged 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, TWD, Indian Rupee (“INR”), Mexican Peso (“MXN”), Chinese Yuan (“CNY”), and Canadian Dollar (“CAD”), and Swedish Kronor (“SEK”).

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,
	2023		2022		2021
Recognized gains in interest and other income, net	$	4.8	$	26.9	$	15.5
Foreign exchange losses related to balance sheet re-measurement	$	(8.5)	$	(54.2)	$	(16.4)

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


	Derivatives Designated as Hedging Instruments				Derivatives Not Designated as Hedging Instruments
	December 31, 2023		December 31, 2022		December 31, 2023		December 31, 2022
Notional amounts:
Forward contracts	$	292.1	$	188.4	$	699.7	$	496.3
Gross fair value recorded in:
Prepaids and other current assets	$	3.1	$	1.8	$	5.0	$	4.3
Other accrued liabilities	$	5.9	$	5.3	$	6.6	$	4.2

Leases - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease terms	7 years
Operating lease expense	$ 26.8	$ 25.7	$ 20.4

Consolidated Financial Statement Details - Supplemental Cash Flow Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Income taxes paid	$ 447.8	$ 444.2	$ 180.0
Supplemental non-cash investing and financing activities:
Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment	422.4	279.2	302.4
Acquisition of property, plant, and equipment in accounts payable and accrued liabilities	$ 153.7	$ 73.4	$ 32.1

Net Income Per Share - Computation Of Basic And Diluted Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Earnings Per Share [Abstract]
Net income	$ 1,798.0	$ 1,322.3	$ 1,704.6
Weighted-average shares outstanding used in basic calculation (shares)	351.2	355.7	356.1
Add: dilutive effect of potential common shares (shares)	6.2	6.3	9.7
Weighted-average shares outstanding used in diluted calculation (shares)	357.4	362.0	365.8
Basic net income per share (usd per share)	$ 5.12	$ 3.72	$ 4.79
Diluted net income per share (usd per share)	$ 5.03	$ 3.65	$ 4.66

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

Intangible Assets

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

GOODWILL AND INTANGIBLE ASSETS

Acquisitions

There were no material acquisitions in 2023, 2022, or 2021.

Goodwill

The following table summarizes the changes in the carrying amount of goodwill (in millions):


	Amount
Balance as of December 31, 2021	$	343.6
Acquisition activity	6.5
Translation and other	(1.6)
Balance as of December 31, 2022	348.5
Acquisition activity	—
Translation and other	0.2
Balance as of December 31, 2023	$	348.7

The Company completed its annual goodwill impairment test and determined that no impairment existed. As of December 31, 2023, there has been no impairment of goodwill.

Intangible Assets

The following table summarizes the components of gross intangible asset, accumulated amortization, and net intangible asset balances as of December 31, 2023, and 2022 (in millions):


	December 31, 2023						December 31, 2022
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Patents and developed technology	$	206.3	$	(178.4)	$	27.9	$	199.1	$	(167.4)	$	31.7
Distribution rights and others	10.8		(9.2)		1.6		11.0		(7.4)		3.6
Customer relationships	32.5		(22.9)		9.6		32.6		(18.1)		14.5
Total intangible assets	$	249.6	$	(210.5)	$	39.1	$	242.7	$	(192.9)	$	49.8

Amortization expense related to intangible assets was $20.2 million, $27.8 million, and $27.4 million for the years ended December 31, 2023, 2022, and 2021, respectively.

The estimated future amortization expense related to intangible assets as of December 31, 2023, is as follows (in millions):


Fiscal Year	Amount
2024	$	16.9
2025	12.0
2026	5.3
2027	2.9
2028	1.3
2029 and thereafter	0.7
Total	$	39.1

The preceding expected amortization expense is an estimate. Actual amounts of amortization expense may differ from estimated amounts due to additional intangible asset acquisitions, measurement period adjustments to intangible assets, changes in foreign currency exchange rates, impairments of intangible assets, accelerated amortization of intangible assets, and other events.

Consolidated Financial Statement Details

12 Months Ended

Dec. 31, 2023

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,
Accounts receivable, net	2023		2022
Trade accounts receivable, net	$	1,042.2	$	864.9


Unbilled accounts receivable and other	105.0		91.7
Sales returns and allowances	(17.0)		(14.5)
Total accounts receivable, net	$	1,130.2	$	942.1


	December 31,
Inventory	2023		2022
Raw materials	$	454.7	$	382.9
Work-in-process	159.9		159.9
Finished goods	606.0		350.4
Total inventory	$	1,220.6	$	893.2


	December 31,
Prepaids and other current assets	2023		2022
Net investment in sales-type leases – short-term	137.3		131.2




Other prepaids and other current assets	176.7		168.6
Total prepaids and other current assets	$	314.0	$	299.8


	December 31,
Property, plant, and equipment, net	2023		2022
Land	$	457.3	$	388.6
Building and building/leasehold improvements	1,002.1		866.5
Machinery and equipment	724.2		566.4
Operating lease assets – Intuitive System Leasing	1,149.7		806.4
Computer and office equipment	153.8		134.7
Capitalized software	257.8		240.9
Construction-in-process	1,354.7		608.6
Gross property, plant, and equipment	5,099.6		3,612.1
Less: Accumulated depreciation*	(1,562.0)		(1,237.9)
Total property, plant, and equipment, net	$	3,537.6	$	2,374.2
*Accumulated depreciation associated with operating lease assets – Intuitive System Leasing	$	(434.3)	$	(285.8)


	December 31,
Implementation costs in cloud computing arrangements	2023		2022
Capitalized implementation costs	$	50.7	$	36.0
Less: Accumulated depreciation	(20.5)		(10.3)
Total capitalized implementation costs in intangible and other assets, net	$	30.2	$	25.7


	December 31,
Other accrued liabilities – short-term	2023		2022
Income and other taxes payable	$	111.4	$	96.1
Accrued construction-related capital expenditures	143.3		50.3




Other accrued liabilities	332.8		329.8
Total other accrued liabilities – short-term	$	587.5	$	476.2


	December 31,
Other long-term liabilities	2023		2022
Income taxes – long-term	$	233.8	$	288.0
Deferred revenue – long-term	45.6		41.0
Other long-term liabilities	106.1		110.3
Total other long-term liabilities	$	385.5	$	439.3

Supplemental Cash Flow Information

The following table provides supplemental non-cash investing and financing activities (in millions):


	Years Ended December 31,
	2023		2022		2021
Income taxes paid	$	447.8	$	444.2	$	180.0
Supplemental non-cash investing and financing activities:
Equipment transfers, including operating lease assets, from inventory to property, plant, and equipment	$	422.4	$	279.2	$	302.4
Acquisition of property, plant, and equipment in accounts payable and accrued liabilities	$	153.7	$	73.4	$	32.1