Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	6 Months Ended
Jun. 30, 2023	Jun. 30, 2022
Operating activities:
Net income	$ 786.8	$ 683.0
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and loss on disposal of property, plant, and equipment	180.0	157.5
Amortization of intangible assets	10.0	12.3
Gain on sale of business	0.0	(3.8)
Loss on investments, accretion of discounts, and amortization of premiums on investments, net	14.4	33.8
Deferred income taxes	(17.7)	(40.1)
Share-based compensation expense	286.3	247.5
Amortization of contract acquisition assets	14.9	13.6
Changes in operating assets and liabilities, net of effects of acquisitions:
Accounts receivable	39.3	(56.0)
Inventory	(288.6)	(245.5)
Prepaids and other assets	(13.8)	(90.1)
Accounts payable	36.5	12.4
Accrued compensation and employee benefits	(55.0)	(71.5)
Deferred revenue	12.2	(3.1)
Other liabilities	31.8	19.7
Net cash provided by operating activities	1,037.1	669.7
Investing activities:
Purchase of investments	(14.0)	(1,376.2)
Proceeds from sales of investments	37.5	0.0
Proceeds from maturities of investments	1,486.9	1,865.1
Purchase of property, plant, and equipment	(372.4)	(224.1)
Acquisition of businesses, net of cash, and intellectual property and other investing activities	(7.3)	(13.3)
Net cash provided by investing activities	1,130.7	251.5
Financing activities:
Proceeds from issuance of common stock relating to employee stock plans	174.8	106.6
Taxes paid related to net share settlement of equity awards	(140.6)	(179.0)
Repurchase of common stock	(350.0)	(606.6)
Payment of deferred purchase consideration	(2.1)	(3.0)
Net cash used in financing activities	(317.9)	(682.0)
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	7.0	6.0
Net increase in cash, cash equivalents, and restricted cash	1,856.9	245.2
Cash, cash equivalents, and restricted cash, beginning of period	1,600.7	1,306.0
Cash, cash equivalents, and restricted cash, end of period	$ 3,457.6	$ 1,551.2

Depreciation and Gain (Loss) on Disposition of Property Plant Equipment

No definition available.

Name:	isrg_DepreciationandGainLossonDispositionofPropertyPlantEquipment
Namespace Prefix:	isrg_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration

- Definition

The sum of the periodic adjustments of the differences between securities' face values and purchase prices that are charged against earnings. This is called accretion if the security was purchased at a discount and amortization if it was purchased at premium. As a noncash item, this element is an adjustment to net income when calculating cash provided by or used in operations using the indirect method.