Major ClientsNarrow moat

Intuitive Surgical (ISRG) — moat facet

No customer above ten percent, and one payer decision per country that moves everything at once.

Intuitive's filings contain no customer concentration disclosure, because there is nothing material to disclose. About 11,710 da Vinci systems and 1,096 Ion systems sit across thousands of hospitals in dozens of countries1; domestic revenue was 68% of the total in 2025 and outside-the-United-States revenue 32%2. No single hospital, system or distributor is a meaningful share of anything.

Largest customer as a share of revenueCoreWeave67%Nvidia22%Kioxia20.4%Intuitive SurgicalNone above 10%Thousands of hospitals, 11,710 da Vinci and 1,096 Ion systems, and no disclosed concentration.
Diversified by name and correlated by nature: the same handful of payers funds all of them, and one decision moves the lot.

That is genuine diversification of the kind CoreWeave at 67% from one customer3, Nvidia at 22%4 and Kioxia's largest at 20.4%5 do not have. It is also, on the evidence of 2026, a great deal less protective than it looks, because Intuitive's customers are diversified by name and identical by exposure. They are almost all hospitals, and hospitals are almost all funded by a small number of payers.

The transaction has three parties and only one of them is the customer of record. A surgeon decides they want to operate robotically and has no budget. A hospital administrator signs for a $1.6 million system, or increasingly for a lease, and pays about $1,825 of instruments per case6. And an insurer or a government decides whether the procedure is reimbursed, at what rate, and — through coverage rules — whether the patient can have it at all.

For twenty-five years the third party was in the background. In 2026 it stepped forward. When enhanced Affordable Care Act premium subsidies expired, United States da Vinci procedure growth fell from 14% to 12% in a quarter, concentrated in deferrable benign categories, and the chief financial officer told investors that "the expiration of ACA enhanced premium subsidies had a modest adverse impact on U.S. da Vinci procedure volume in Q2"7.

The mirror image happened in the same quarter on the other side of the world. Japan expanded reimbursement for multiple robotic procedures on 1 June 2026 — the largest category being inguinal hernia — and added utilisation incentives; Japanese system placements went from 15 in the prior-year quarter to 258.

Two governments, opposite decisions, one quarter, and both showed up immediately in the numbers. That is what it means to have no customer concentration and total payer concentration.

There is no customer concentration to track, so the test has to be the volume itself: United States da Vinci procedure growth, 12% in the June 2026 quarter against 14% in the first.

Moat trajectory: Holding steady

No customer above ten percent and thousands of hospitals — and a payer environment that moves all of them at once. Diversified by name, concentrated by exposure, and neither half is changing.

The number that tests this moat
Reported
Recurring share of revenue, latest quarter
85% in Q2 2026

The hospital signs once and the recurring revenue depends on payers and patients using the system afterwards. The share holding up shows the volume those other parties decide still arriving.

Source: Intuitive Surgical Q2 2026 results release ↗
Dig deeper
DIG DEEPER 01
No Customer Above Ten Percent
Diversified by name and identical by exposure — thousands of hospitals funded by a handful of payers.
DIG DEEPER 02
The Payer Who Is Never in the Room
A Japanese committee meeting in April of even-numbered years moves more volume than any competitor has.
DIG DEEPER 03
The Patient Who Defers
More than half of these operations are benign, and a benign operation waits until the household can afford it.
DIG DEEPER 04
The Distributors Intuitive Is Buying Back
The sale is not the relationship; the field presence afterwards is, which is why Italy, Spain and Portugal have just been taken in-house.
References
  1. ReportedAbout 11,710 da Vinci systems and 1,096 Ion systems sit across thousands of hospitals in dozens of countries; domestic revenue was 68% of the total in 2025 and outside-the-United-States revenue 32%.
    Intuitive Surgical Form 10-Q, quarter ended June 30, 2026 (installed base 11,710 da Vinci systems up 12%, 468 placements of which 246 were da Vinci 5, the operating-lease share, the distributor acquisitions in Italy, Spain and Portugal, cash and investments of $8.63 billion, and the factors expected to affect future placements) — Q2 2026 and the first six months · publ. July 21, 2026 · source ↗
  2. ReportedAbout 11,710 da Vinci systems and 1,096 Ion systems sit across thousands of hospitals in dozens of countries; domestic revenue was 68% of the total in 2025 and outside-the-United-States revenue 32%.
    Intuitive Surgical Form 10-K, fiscal year ended December 31, 2025 - consolidated financial statements and notes (balance sheet, cash and investments, property and equipment, lease arrangements, revenue disaggregation by geography, accounts receivable, share-based compensation and share counts) — FY2025 · publ. February 3, 2026 · source ↗
  3. ReportedThat is genuine diversification of the kind CoreWeave at 67% from one customer, Nvidia at 22% and Kioxia's largest at 20.4% do not have.
    CoreWeave Form 10-K, fiscal 2025 — revenue $5.13B (+168%), net loss ~−$1.2B; customer concentration disclosed (largest customer ~2/3 of revenue) — FY2025 · publ. early 2026 · source ↗
  4. ReportedThat is genuine diversification of the kind CoreWeave at 67% from one customer, Nvidia at 22% and Kioxia's largest at 20.4% do not have.
    NVIDIA Form 10-K, FY2026 — "For fiscal year 2026, sales to one direct customer represented 22% of total revenue and sales to another direct customer represented 14% of total revenue"; FY2025: one at 12% and two at 11% each; FY2024: one at 13%. Direct customers include OEMs, ODMs, distributors and system integrators; indirect customers (CSPs, Neocloud builders, AI model makers, enterprises, public sector) buy through them, and NVIDIA "estimate[s] some individually representing 10% or more of our revenue". "Our revenue is concentrated among a limited number of direct and indirect customers and this trend may continue." — FY2026 (ended Jan 25, 2026) · publ. February 2026 · source ↗
  5. ReportedThat is genuine diversification of the kind CoreWeave at 67% from one customer, Nvidia at 22% and Kioxia's largest at 20.4% do not have.
    Kioxia Holdings Corporation, Annual Securities Report for the year from 1 April 2025 to 31 March 2026 (8th Period) — revenue ¥2,337,628M against ¥1,706,460M, gross profit ¥1,012,904M, operating profit ¥869,013M, profit for the year ¥554,490M; research and development cost ¥141,052M against ¥132,798M; purchases of property, plant and equipment ¥281,062M against ¥223,847M; operating cash flow ¥616,540M; proceeds from government grants ¥56,396M against ¥43,748M, from an approved ceiling of ¥150.0bn for flash production at the Yokkaichi and Kitakami plants with about ¥31.8bn not yet received. Revenue by application: SSD & Storage ¥1,362,638M, Smart Devices ¥759,978M, Other ¥215,012M — 'Other' including retail products and sales to the Sandisk group recorded through the three manufacturing joint ventures. Revenue by geography: Japan ¥263,252M, North America and Europe ¥1,217,643M, Asia ¥856,733M, with the United States ¥1,098,832M, China ¥381,857M and Taiwan ¥300,932M. Non-current assets: Japan ¥1,658,950M, North America and Europe ¥1,986M, Asia ¥6,298M. Major customers: Apple group ¥476,014M (20.4%), with the Sandisk and Dell groups omitted for the year as each fell below 10% of sales. Flash Partners Ltd., Flash Alliance Ltd. and Flash Forward LLC are accounted for as joint operations with 50.1% of the voting rights and equal decision-making rights shared with Sandisk. Net interest-bearing debt ¥552,085M against equity of ¥1,398,929M — a net debt-to-equity ratio of 0.39 times, from ¥931,035M against ¥737,565M and 1.26 times a year earlier; USD-denominated senior notes at 6.25% (2030) and 6.625% (2033); goodwill of ¥395,585M from the 1 June 2018 acquisition of the former Toshiba Memory Corporation. Bain Capital funds indirectly hold 21.87% and Toshiba Corporation 17.59% of outstanding common shares, both having sold substantial holdings during the year. Risk factors state that the Yokkaichi Plant is located in an area with a high risk of earthquakes and floods and the Kitakami Plant in an area severely damaged by the 2011 Tohoku Earthquake, and name US-China trade frictions and US tariff policy among factors that may materially affect the business. The company does not provide plans or progress reports for the overall fiscal year. — year to 31 March 2026 · publ. 2026-06 · source ↗
  6. Moat Explorer calcA hospital administrator signs for a $1.6 million system, or increasingly for a lease, and pays about $1,825 of instruments per case.
    Moat Explorer calculation - arithmetic on figures reported in Intuitive's Form 10-K and Form 10-Q: instruments and accessories of $6,018.9M over 3,153,000 da Vinci plus 144,100 Ion procedures ($1,825 a procedure), service revenue of $1,572.1M over the installed base (about $134,000 a system), variable lease revenue of $531M over 1,810 usage-based systems (about $293,000), procedures over the average installed base (about 300 a system), each revenue line as a share of the $10,064.7M total, and US general surgery as a share of US procedures — FY2025 · publ. September 2026 · source ↗
  7. ReportedWhen enhanced Affordable Care Act premium subsidies expired, United States da Vinci procedure growth fell from 14% to 12% in a quarter, concentrated in deferrable benign categories, and Intuitive's chief executive told investors that...
    Intuitive Surgical Q2 2026 earnings call - the Extended Use Program raising permitted uses on selected EndoWrist instruments from the first half of 2027, US da Vinci procedure growth of 12% against 14% attributed to the expiry of enhanced Affordable Care Act premium subsidies, full-year guidance of 13.5% to 15.5% nearer the midpoint, gross-margin guidance raised to 68-69%, and Japanese placements of 25 against 15 — Q2 2026 · publ. July 16, 2026 · source ↗
  8. ReportedJapan expanded reimbursement for multiple robotic procedures on 1 June 2026 — the largest category being inguinal hernia — and added utilisation incentives; Japanese system placements went from 15 in the prior-year quarter to 25.
    Intuitive Surgical Q2 2026 earnings call - the Extended Use Program raising permitted uses on selected EndoWrist instruments from the first half of 2027, US da Vinci procedure growth of 12% against 14% attributed to the expiry of enhanced Affordable Care Act premium subsidies, full-year guidance of 13.5% to 15.5% nearer the midpoint, gross-margin guidance raised to 68-69%, and Japanese placements of 25 against 15 — Q2 2026 · publ. July 16, 2026 · source ↗
Sources
Generated September 23, 2026