investor presentation q4 2019 - intuitive surgical

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Investor Presentation Q4 2019

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Page 1: Investor Presentation Q4 2019 - Intuitive Surgical

Investor PresentationQ4 2019

Forward looking statement

These slides and any accompanying oral presentation by Intuitive Surgical

Inc contain estimates and forward-looking statements Actual results may

differ materially from those expressed or implied as a result of certain risks

and uncertainties These risks anduncertainties are described in detail in

the CompanyrsquosSecurities and Exchange Commission filings

2

Note Some products shown in this presentation may not yet have obtained

regulatory clearances in this country These products are therefore not for sale in

this market Please check with your local Regulatory contact for current status

As of 2018 there werehellip

1500+ peer reviewed articles published

1000000+procedures performed

3

900da Vinci systems placed

18000+ peer reviewed articles published

6000000+procedures performed

4986da Vinci systems placed globally

Cumulative

Worldwide Procedure Trend

4

0

250000

500000

750000

1000000

1250000

2013 2014 2015 2016 2017 2018 2019

Urology Gynecology General Surgery Other

2018

18 Growth

2019 Guidance

17-18 Growth

UrologyGynecologyGeneral SurgeryOther Estimated Growth

Growth in procedure categories Global over past 10 years

0

50000

100000

150000

200000

250000

300000

350000

400000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

General Surgery Gynecology Urology Thoracic Surgery TORS

5

Gynecology

TORS

General Surgery

Urology

Thoracic

As of December 31 2018

System Placements

6

0

100

200

300

400

500

600

700

800

900

2016 2017 2018

Rest-of-World Asia Europe US

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2016 2017 2018

Rest-of-World Asia Europe US

+35 +13

Installed Base

Total Revenue

7

Dollar amounts in millions

$0

$500

$1000

$1500

$2000

$2500

$3000

$3500

2013 2014 2015 2016 2017 2018

Systems Service Instrumentsamp Accessories

2018

19 Growth

71 Recurring

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 2: Investor Presentation Q4 2019 - Intuitive Surgical

Forward looking statement

These slides and any accompanying oral presentation by Intuitive Surgical

Inc contain estimates and forward-looking statements Actual results may

differ materially from those expressed or implied as a result of certain risks

and uncertainties These risks anduncertainties are described in detail in

the CompanyrsquosSecurities and Exchange Commission filings

2

Note Some products shown in this presentation may not yet have obtained

regulatory clearances in this country These products are therefore not for sale in

this market Please check with your local Regulatory contact for current status

As of 2018 there werehellip

1500+ peer reviewed articles published

1000000+procedures performed

3

900da Vinci systems placed

18000+ peer reviewed articles published

6000000+procedures performed

4986da Vinci systems placed globally

Cumulative

Worldwide Procedure Trend

4

0

250000

500000

750000

1000000

1250000

2013 2014 2015 2016 2017 2018 2019

Urology Gynecology General Surgery Other

2018

18 Growth

2019 Guidance

17-18 Growth

UrologyGynecologyGeneral SurgeryOther Estimated Growth

Growth in procedure categories Global over past 10 years

0

50000

100000

150000

200000

250000

300000

350000

400000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

General Surgery Gynecology Urology Thoracic Surgery TORS

5

Gynecology

TORS

General Surgery

Urology

Thoracic

As of December 31 2018

System Placements

6

0

100

200

300

400

500

600

700

800

900

2016 2017 2018

Rest-of-World Asia Europe US

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2016 2017 2018

Rest-of-World Asia Europe US

+35 +13

Installed Base

Total Revenue

7

Dollar amounts in millions

$0

$500

$1000

$1500

$2000

$2500

$3000

$3500

2013 2014 2015 2016 2017 2018

Systems Service Instrumentsamp Accessories

2018

19 Growth

71 Recurring

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 3: Investor Presentation Q4 2019 - Intuitive Surgical

As of 2018 there werehellip

1500+ peer reviewed articles published

1000000+procedures performed

3

900da Vinci systems placed

18000+ peer reviewed articles published

6000000+procedures performed

4986da Vinci systems placed globally

Cumulative

Worldwide Procedure Trend

4

0

250000

500000

750000

1000000

1250000

2013 2014 2015 2016 2017 2018 2019

Urology Gynecology General Surgery Other

2018

18 Growth

2019 Guidance

17-18 Growth

UrologyGynecologyGeneral SurgeryOther Estimated Growth

Growth in procedure categories Global over past 10 years

0

50000

100000

150000

200000

250000

300000

350000

400000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

General Surgery Gynecology Urology Thoracic Surgery TORS

5

Gynecology

TORS

General Surgery

Urology

Thoracic

As of December 31 2018

System Placements

6

0

100

200

300

400

500

600

700

800

900

2016 2017 2018

Rest-of-World Asia Europe US

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2016 2017 2018

Rest-of-World Asia Europe US

+35 +13

Installed Base

Total Revenue

7

Dollar amounts in millions

$0

$500

$1000

$1500

$2000

$2500

$3000

$3500

2013 2014 2015 2016 2017 2018

Systems Service Instrumentsamp Accessories

2018

19 Growth

71 Recurring

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 4: Investor Presentation Q4 2019 - Intuitive Surgical

Worldwide Procedure Trend

4

0

250000

500000

750000

1000000

1250000

2013 2014 2015 2016 2017 2018 2019

Urology Gynecology General Surgery Other

2018

18 Growth

2019 Guidance

17-18 Growth

UrologyGynecologyGeneral SurgeryOther Estimated Growth

Growth in procedure categories Global over past 10 years

0

50000

100000

150000

200000

250000

300000

350000

400000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

General Surgery Gynecology Urology Thoracic Surgery TORS

5

Gynecology

TORS

General Surgery

Urology

Thoracic

As of December 31 2018

System Placements

6

0

100

200

300

400

500

600

700

800

900

2016 2017 2018

Rest-of-World Asia Europe US

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2016 2017 2018

Rest-of-World Asia Europe US

+35 +13

Installed Base

Total Revenue

7

Dollar amounts in millions

$0

$500

$1000

$1500

$2000

$2500

$3000

$3500

2013 2014 2015 2016 2017 2018

Systems Service Instrumentsamp Accessories

2018

19 Growth

71 Recurring

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 5: Investor Presentation Q4 2019 - Intuitive Surgical

Growth in procedure categories Global over past 10 years

0

50000

100000

150000

200000

250000

300000

350000

400000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

General Surgery Gynecology Urology Thoracic Surgery TORS

5

Gynecology

TORS

General Surgery

Urology

Thoracic

As of December 31 2018

System Placements

6

0

100

200

300

400

500

600

700

800

900

2016 2017 2018

Rest-of-World Asia Europe US

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2016 2017 2018

Rest-of-World Asia Europe US

+35 +13

Installed Base

Total Revenue

7

Dollar amounts in millions

$0

$500

$1000

$1500

$2000

$2500

$3000

$3500

2013 2014 2015 2016 2017 2018

Systems Service Instrumentsamp Accessories

2018

19 Growth

71 Recurring

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 6: Investor Presentation Q4 2019 - Intuitive Surgical

System Placements

6

0

100

200

300

400

500

600

700

800

900

2016 2017 2018

Rest-of-World Asia Europe US

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2016 2017 2018

Rest-of-World Asia Europe US

+35 +13

Installed Base

Total Revenue

7

Dollar amounts in millions

$0

$500

$1000

$1500

$2000

$2500

$3000

$3500

2013 2014 2015 2016 2017 2018

Systems Service Instrumentsamp Accessories

2018

19 Growth

71 Recurring

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 7: Investor Presentation Q4 2019 - Intuitive Surgical

Total Revenue

7

Dollar amounts in millions

$0

$500

$1000

$1500

$2000

$2500

$3000

$3500

2013 2014 2015 2016 2017 2018

Systems Service Instrumentsamp Accessories

2018

19 Growth

71 Recurring

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 8: Investor Presentation Q4 2019 - Intuitive Surgical

Q3 YTD 2019 Highlights

Da Vinci Procedure Growth

18 vs Q3 YTD 2018

17 US Driven by general surgery thoracic urology

and benign gynecology procedures

21 OUS Driven by urology early stage general

surgery and gynecology

Strength in Germany France Japan and Korea

Da Vinci Surgical Systems Shipped

783 vs 636 Q3 YTD 2018

Da Vinci Installed Base

5406 globally up 12 vs Sep 30 2018

8

FDA 510(k) Clearances

Iontrade endoluminal system for lung biopsy

Iristrade augmented reality overlay software

Da Vinci SPreg transoral surgery indication

SureFormtrade 45mm stapler

Da Vinci Handheld Camera

Revenue

$32 billion

20 growth vs Q3 YTD 2018

Proforma Operating Profit

$13 billion (40 of net revenue)

14 growth vs Q3 YTD 2018

Non-GAAP Financial Measure Non-GAAP adjusted measure should be viewed in addition to and not as an alternative for financial

results prepared in accordance with US GAAP See Financial Data Tables published on the Companyrsquos website for more information about

these non-GAAP financial measures and for a reconciliation of the non-GAAP measure to the most comparable GAAP measures

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 9: Investor Presentation Q4 2019 - Intuitive Surgical

da Vincireg Surgical System

$05M - $25M

2018 Rev $1127M

Recurring Revenue Model

Service

$80K - $190KYear

2018 Rev $635M

Instruments amp Accessories

$700-$3500 per Procedure

2018 Rev $1962M

2018 71 Recurring Revenue

bull Including $51M Systems Leasing

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 10: Investor Presentation Q4 2019 - Intuitive Surgical

Da Vinci Systems Operating Leasing Program

10

bull Da Vinci direct leasing program established in 2013 with

expansion to date

bull Enables customers to establish or expand their robotics

programs without the initial capital investment

bull Revenue and gross profit earned ratably over the lease term

rather than at the time of placement for systems sold

bull Gross margins for leasing arrangements during the term of

the lease are similar to gross margins for purchased systems

bull 33 of Q3 YTD 2019 system placements and 10 of Q3

2019 ending installed base were under operating leases

231200

251

290

332 322 335

0

10

20

30

40

50

60

70

80

90

100

2018 Q1 2018 Q2 2018 Q3 2018 Q4 2019 Q1 2019 Q2 2019 Q3

US Non-US Leasing Percentage

Le

as

ed

Sys

tem

Pla

ce

me

nts

194 231

279

350

423

486

560

45

67

89

10

-

100

200

300

400

500

600

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e In

stal

led

Bas

e

Operating Leases of Total Installed Base

$95M$115M

$140M

$164M

$204M

$251M

$274M

$579k $593k $606k$588k $583k $593k

$564k

$0

$5

$10

$15

$20

$25

$30

Q118 Q218 Q318 Q418 Q119 Q219 Q319

Op

erat

ing

Leas

e Sy

stem

Rev

enu

e

Operating Lease Revenue Avg Revenue per System

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 11: Investor Presentation Q4 2019 - Intuitive Surgical

da Vinci System Installed Base

5406 Worldwide as of September 30 2019

Europe

936

Asia

718

Rest of World 293560 of 5406 installed systems under operating lease

USA 3459

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 12: Investor Presentation Q4 2019 - Intuitive Surgical

Where are we heading in 2019 and beyond

12

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 13: Investor Presentation Q4 2019 - Intuitive Surgical

Our goal is not a mystery

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

requires

13

more than minimally

invasive tools

more than digital

technology

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 14: Investor Presentation Q4 2019 - Intuitive Surgical

How we get there Through ingenuity and intelligent technology that expands the potential of physicians to heal without constraints

14

Better outcomes

Better patient experience

Better care team experience

Lower total cost of care

Advanced tools

amp technologies

Augmentation of

care team capabilities

Data analytics for deep

insight and guidance

Substitution of

Invasive modalities

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 15: Investor Presentation Q4 2019 - Intuitive Surgical

15

FDA 510(k)

Clearance

Q1 lsquo19

Da Vinci SP for

transoral

surgery

indication

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 16: Investor Presentation Q4 2019 - Intuitive Surgical

16

FDA 510(k)

Clearance

Q1 lsquo19

Iontrade endoluminal

system to enable

minimally invasive

biopsy in the

peripheral lung

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 17: Investor Presentation Q4 2019 - Intuitive Surgical

17

FDA 510(k)

Clearance Q1 rsquo19

Iristrade augmented

reality product

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 18: Investor Presentation Q4 2019 - Intuitive Surgical

18

Simulation

is becoming

increasingly

capable

More than

3200 da

Vinci

simulators

installed as

of 93019

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 19: Investor Presentation Q4 2019 - Intuitive Surgical

Meaningful insights are key to achieving more predictable

outcomes

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 20: Investor Presentation Q4 2019 - Intuitive Surgical

Minimally invasive interventions are a

sophisticated ecosystem of highly trained

professionals organized around the care for

an ill person

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 21: Investor Presentation Q4 2019 - Intuitive Surgical

Care team Control center

22

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 22: Investor Presentation Q4 2019 - Intuitive Surgical

Intelligent Surgery

23

Smart systems

amp instruments

Cloud-based systems

EndoWrist instruments

Advanced visualization

Human

understanding

Time and Motion Studies

Design

Human Factors

Digital

insights

Procedure reports

Strategic and financial insights

OR operational Insights

+ +

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 23: Investor Presentation Q4 2019 - Intuitive Surgical

Our investment philosophy

24

The need for improvement

in acute interventions is

substantial and durable we

are assertive in pursuit of

organic innovation in products

and regions as first priority

As we grow we invest in

operational efficiencies at

scale to allow for flexibility in

pricing for customers and re-

investment in our business

We pursue collaborations

and acquisitions that can

accelerate outcome and

efficiency improvements

We return capital to

shareholders with a

focus on long-term value

At this point in time we believe we have a unique

opportunity to expand the benefits of minimally

invasive medical interventions around the world and

will continue to invest in the business accordingly

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 24: Investor Presentation Q4 2019 - Intuitive Surgical

Intuitive Japan

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018(Est)

April 2012

Prostatectomy reimbursed

June 2014

Intuitive opens direct office

April 2018

Additional procedures reimbursedJa

pa

n P

roce

du

res

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 25: Investor Presentation Q4 2019 - Intuitive Surgical

Recent Regional Investments

26

Invested in China through Intuitive Fosun

Pharma joint venture ndash Chindex division of Fosun

Pharma integration into JV starting in Q1 2019

Acquired Intuitive business in Taiwan in Q4 2018

Acquired Intuitive business in India in Q2 2018

Germany - Acquired Schoumllly Fiberoptics robotic

endoscope business

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 26: Investor Presentation Q4 2019 - Intuitive Surgical

2019 PrioritiesAccelerate access to and quality of surgery and acute interventions

Support Adoption in General Surgery and in key procedures in OUS markets

Launch da Vinci SP and Ion platforms

Drive intelligent surgery innovation

Drive clinical and economic validation in emerging regions amp procedures

27

Intuitivecom

Page 27: Investor Presentation Q4 2019 - Intuitive Surgical

Intuitivecom