ISRG · 10-Q · 2026Q2 · Full report

Reimbursement and Payer Mix

INTUITIVE SURGICAL INC · 2026-07-21 · Importance 40 · Surprise 42 · In source text

Japan’s Ministry of Health, Labor, and Welfare reviews procedure reimbursement in April of even-numbered years, with university hospitals and surgical societies seeking coverage with Intuitive’s support. In April 2026, seven additional da Vinci procedures, including inguinal hernia repair, received reimbursement effective June 2026. Certain rectal robotic-assisted procedures received higher reimbursement than rectal laparoscopic procedures, and hospitals exceeding 200 qualifying robotic-assisted cases annually became eligible for incremental reimbursement. Intuitive cautions that adoption of the newly reimbursed procedures may lag prostatectomy and partial nephrectomy because reimbursement is generally equal to conventional laparoscopy for many procedures and laparoscopic penetration varies.

Key facts

• During the second quarter of 2026, China’s NHSA issued guidelines establishing a unified national framework for robotic-assisted surgery pricing and requiring all provinces to implement robotic-assisted surgery pricing within NHSA-mandated limits in the upcoming quarters. source
• The Japanese MHLW considers reimbursement for procedures in April of even-numbered years and in April 2026 an additional seven da Vinci procedures were granted reimbursement, including inguinal hernia repair, effective in June 2026. source
• Since 2022, several provinces in China have implemented significant limits on what hospitals can charge patients for surgeries using robotic-assisted surgical technology, including soft tissue surgery, which have impacted number of procedures and pricing of our instruments and accessories. source
• Certain rectal robotic-assisted procedures have been granted higher reimbursement compared to rectal laparoscopic procedure reimbursements in Japan, and MHLW introduced incremental reimbursement for hospitals that exceed robotic-assisted procedure volumes of 200 qualifying cases per year. source
• As of the date of this report, the limits implemented have not had a material impact on our business because only a small portion of our installed base in China is currently located in impacted provinces. source

Impact estimates