Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
Sep. 30, 2024	Sep. 30, 2023
Operating activities:
Net income	$ 1,649.5	$ 1,206.6
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and loss on disposal of property, plant, and equipment	323.7	283.5
Amortization of intangible assets	13.6	15.1
Loss (gain) on investments, accretion of discounts, and amortization of premiums on investments, net	(38.2)	14.7
Deferred income taxes	(104.5)	(61.0)
Share-based compensation expense	499.8	442.4
Amortization of contract acquisition assets	27.0	22.6
Changes in operating assets and liabilities, net of effects of acquisitions:
Accounts receivable	(21.8)	(19.7)
Inventory	(650.9)	(528.2)
Prepaids and other assets	(79.6)	37.5
Accounts payable	21.2	27.7
Accrued compensation and employee benefits	(58.9)	(26.8)
Deferred revenue	(6.1)	(1.0)
Other liabilities	17.6	172.1
Net cash provided by operating activities	1,592.4	1,585.5
Investing activities:
Purchase of investments	(3,709.6)	(820.2)
Proceeds from sales of investments	100.2	47.7
Proceeds from maturities of investments	2,400.0	2,092.4
Purchase of property, plant, and equipment	(799.2)	(628.7)
Acquisition of businesses, net of cash, and intellectual property and other investing activities	0.0	(7.1)
Net cash provided by (used in) investing activities	(2,008.6)	684.1
Financing activities:
Proceeds from issuance of common stock relating to employee stock plans	367.5	252.2
Taxes paid related to net share settlement of equity awards	(257.5)	(155.4)
Repurchase of common stock	0.0	(350.0)
Cash dividends paid by joint venture to noncontrolling interest	(8.0)	0.0
Payment of deferred purchase consideration	(0.5)	(2.9)
Net cash provided by (used in) financing activities	101.5	(256.1)
Effect of exchange rate changes on cash, cash equivalents, and restricted cash	(9.1)	8.7
Net increase (decrease) in cash, cash equivalents, and restricted cash	(323.8)	2,022.2
Cash, cash equivalents, and restricted cash, beginning of period	2,770.1	1,600.7
Cash, cash equivalents, and restricted cash, end of period	$ 2,446.3	$ 3,622.9

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.