Investor Presentation Q4 2015

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1 Investor Presentation Q4 2015

2 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 and uncertainties are described in detail in the Company s Securities and Exchange Commission filings.

3 Risks Serious complications may occur in any surgery, including da Vinci Surgery, up to and including death. Individual surgical results may vary. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on nonsurgical and surgical options in order to make an informed decision. Please also refer to for Important Safety Information.

4 Contents Outline Company Overview & Business Model Business Review Opportunities & Catalysts for Growth Corporate Assets & 2015 Priorities

5 Corporate Overview and Business Model

6 Corporate Overview Founded in 1995, IPO 2000 Over 3 million da Vinci procedures performed to date Approximately 570,000 da Vinci procedures performed in 2014 Q3 YTD 2015 da Vinci procedures up approximately 14% Q3 YTD 2015 Revenue up 12% 3,477 da Vinci System installed base as of 9/30/15 2,344 United States, 586 Europe, 547 Rest of World Numerous FDA and International Regulatory Clearances Primary Markets - Urology, Gynecology, General Surgery, Cardiothoracic.

7 Recurring Revenue Model Instruments & Accessories $700-$3,200 per procedure 2014 Rev $1,070M Annual Service Agreement da Vinci Surgical System $0.6M - $2.5M 2014 Rev = $633M $100K - $170K/Year 2014 Rev = $429M

8 2014 Range of Pricing to Meet Multiple Segments da Vinci Si-e $0.6M 2014: $1.5M da Vinci Surgical System ASP $2.5M Dual Console Xi Firefly Single-Site $ : $1,880 Inst & Accy Rev Per Procedure $3,200 Endowrist Vessel Sealer Stapler da Vinci Si-e 2014: $140K Dual Console Xi $100K Typically Benign Annual Service Rev Per System $170K Typically Cancer Includes company estimates and approximate ranges

9 da Vinci Ecosystem Advanced Platforms Imaging Advanced Instruments Clinical Validation Surgeon & Staff Training Technical Support Clinical Support Data Analytics & Genesis

10 Business Review

11 Areas of Strength Procedure growth U.S. general surgery, U.S. mature procedure patient trends, and international Expanding da Vinci Xi market and platform Japan Clearance End of Q1 15 Phase 2 instruments shipping Q2 15 Xi Table motion CE marked and FDA submission in Q2 15 Xi Single-Site FDA submissions Q3 15 Stapler Challenges Q3 YTD 2015 Commentary Increasing utilization in da Vinci procedures 30mm 510(k) submission Q3 15 Gross margin pressure FX headwinds; new product costs

12 Annual Worldwide Procedures 700, , : 9% Growth 2015 Guidance: 13-14% Growth 500, , , , , Urology Gynecology General Surgery Other Company Estimates Company estimates

13 U.S. Urology Procedures 100,000 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10, * Prostate Kidney Other * U.S. Preventive Services Task Force Recommends Against PSA testing 5/2012 Company estimates

14 U.S. Gynecology Procedures 250, , , ,000 50, Benign Hysterectomy Malignant Hysterectomy Other Company estimates

15 U.S. General Surgery Procedures 120, ,000 80,000 60,000 40,000 20, Upper GI / HPB Lower GI / Colorectal Other Company estimates

16 International Performance Approximately 121,000 procedures performed in 2014, up 20% from 2013; Q3 YTD 2015 up 26% Strength in Asia procedures: China, Japan, Korea Significant investments supporting long term growth Japan: Buildout of direct sales structure, efforts to obtain additional reimbursements Europe: Clinical data and analysis, sales coverage

17 OUS Annual Procedures 140, , ,000 80,000 60,000 40,000 20, Europe Asia Rest of World Company Estimates Company estimates

18 da Vinci Xi Designed for multi-quadrant surgical access Narrower arms with greater reach Lighter, slimmer endoscopes that can move between ports Computer assisted, streamlined set up Compatible surgical simulator

19 Why Xi Matters Despite my obvious interest in minimally invasive surgery I had resisted adopting previous da Vinci platforms because of what I felt were limitations. The da Vinci Xi platform is a game changer for me. I now feel that this technology will not just equal my standard laparoscopic abilities but actually will allow me to reach new levels in providing surgical care to my patients. B. Harkins, MD, FACS General Surgeon, Texas

20 System Placement Trend Q1 Q2 Q3 Q4 Q1 Q2 Q U.S. Europe Japan Rest-of-World

21 System Mix Trend 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Q114 Q214 Q314 Q414 Q115 Q215 Q315 S / Sie Si Xi

22 Installs by Country and Region da Vinci System Installed Base Europe Canada Direct France 90 Germany 77 UK 55 Belgium 34 Switzerland 28 Sweden 26 Netherlands 21 USA 2,344 Denmark 18 Norway 11 Czech Republic 7 Austria 7 Finland 5 Ireland 3 Other 3 Distribution Italy 84 Turkey 34 Spain 31 Russia 25 Greece 9 Romania 7 Other 11 Asia 398 Middle East 36 Brazil 16 Mexico 7 Argentina 6 Chile 5 Venezuela 5 Other 8 Latin America 47 Saudi Arabia 14 Israel 7 Qatar 6 Other 9 South Africa 4 Intuitive sells directly to customers in the US, Korea, Japan, and the European countries indicated above. Sales are through distributor partners in all other areas of the world including, Canada, Latin America, the Middle East, Asia and Australia. Japan 215 South Korea 53 China 46 India 35 Taiwan 27 Singapore 7 Thailand 6 Other 9 Australia/ New Zealand 37

23 Trended da Vinci System Installed Base 3,500 United States 3,000 International 2,500 2,000 1,500 1, Q310 Q311 Q312 Q313 Q314 Q315

24 Opportunities and Catalysts for Growth

25 Open Surgery Remains Common U.S. Yr: % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Prostate Malignant Hyst Benign Hyst Robotic Other MIS Open Source: ISI data as well as estimates

26 Open Surgery Remains Common U.S. Yr: % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Prostate Malignant Hyst Benign Hyst Robotic Other MIS Open Source: ISI Data as well as Estimates

27 Open Surgery Remains Common U.S. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Prostate Yr: 2014 Malignant Hyst Benign Hyst Colorectal Ventral Hernia Robotic Other MIS Open Thoracic Source: ISI data as well as estimates

28 Open Surgery Remains Common OUS 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Yr: 2014 Prostate Malignant Colorectal Gastrectomy Thoracic Hyst Other MIS Robotic Open Source: ISI data as well as estimates. OUS defined as Western Europe, Canada, Australia, South Korea and Japan

29 Total Procedure Markets We estimate 2 4 million procedures available for products on the market today in countries for which we have clearances Over time, opportunity OUS will be greater than U.S. Roughly half of opportunity based on underlying cancer as cause

30 Clinical and Economic Validation Overview of the Database To date, there are approximately 9,500 peer-reviewed clinical publications studying da Vinci use Approximately 99% of these studies are independent of ISI Of these, approximately 1,400 are comparative studies In 2014, 1,600 new studies were published, of which ~400 were comparative There are now approximately 25 government sponsored assessments of da Vinci surgery spanning ~14 countries

31 Market Share % Populations Matter (e.g., Rectal Resection) Open Surgery Which is the right comparison? da Vinci LAR Laparoscopy } } Patient Perspective Open vs MIS MIS Surgeon Perspective dv vs Lap

32 Areas of Investment in Clinical and Economic Analyses U.S. Hernia registry, Gynecologic Oncology registry Japan Urology and General Surgery Germany Urology and General Surgery U.K. Colorectal registry France Colorectal registry Numerous economic studies

33 ISI Investments to Improve Surgery Advanced imaging (e.g., Firefly Fluorescence Imaging) Computer-enhanced precision at tissue (e.g., Smart-clamp for stapling) Less invasive access (e.g., single-port and natural orifice surgery) Training technologies (e.g., simulation, dualconsole, setup assist)

34 Product Milestones Continue da Vinci Xi Launch: Xi Vessel Sealer launched Q2 14 Xi Firefly launched Q3 14 Clearance in Korea Q mm Xi Stapler launched Q1 15 Clearance in Japan end of Q1 15 Xi Table motion CE Marked and 510(k) submitted in Q2 15 Xi Single-Site 510(k) submitted Q mm Xi Stapler 510(k) submitted Q3 15 Single-Site wristed needle driver for Si launched Q4 14

35 Integration of da Vinci Sp Current Xi Configuration Deliver technical milestones in Prototypes built Clinical evaluations Transoral and Transabdominal emphasis

36 Integration of da Vinci Sp Xi with Sp Patient Cart and Instruments Deliver technical milestones in Prototypes built Clinical evaluations Transoral and Transabdominal emphasis

37 2015 Priorities and Corporate Assets

38 2015 Priorities Expanding the application of da Vinci in general surgery, particularly colorectal surgery and hernia repair Filling out our product line for da Vinci Xi and launching in key markets globally Developing our organizational capabilities and markets in Europe and Asia Advancing our technologies to improve surgery Lowering our direct product costs

39 Corporate Assets Extraordinary people 3,477 da Vinci System installed base 9/30/15 Numerous FDA and international regulatory clearances Extensive instrument and accessory product line Intuitive Surgical training centers worldwide Ownership of or exclusive rights to over 1,900 U.S. and foreign patents and more than 1,500 US and foreign patent applications da Vinci patient awareness

40

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