Good morning, everyone. I'm Robbie Marcus, the MedTech analyst at JPMorgan. Very happy to host our next session with Intuitive Surgical. CEO Dave Rosa will give a presentation, and we'll be joined on stage by some Q&A. Dave?
Actually, no.
All right, thanks, Robbie, and good morning. I'm delighted to be here and represent the hard work of our teams, both in 2025, and talk a little bit about the future here in 2026 and beyond. I want to acknowledge that I'll be making some forward-looking statements, so I'd encourage you to review our SEC filings that are on the investor portion of our intuitive.com website. I believe that we occupy a very privileged position in MedTech and in healthcare, and it's well captured by our mission and vision. We have an opportunity to work with and develop and deliver some of the most advanced technology in the world around robotics and AI and advanced imaging systems and other aspects, and intersect that with the very human purpose of healthcare.
And I think when you look at that and how it's captured here, that is what drives so much of the passion at Intuitive. It enables us to recruit and attract some of the very best talent from around the world. It's been durable for 30 years, and I believe our mission and vision will be durable for the next 30. It's never enough to have the passion of the team. You have to deeply understand what do your customers care about? What is it that they're challenged by, and how can you help? And I think that is well understood and captured by the Quintuple Aim, what we know that it is today. From improving outcomes to lowering the total cost of care to expanding access to care, it's this framework that helps guide our work. It helps inform our strategy. It helps us measure ourselves.
And importantly, I believe it's how customers measure Intuitive and how we show up. And so I was an early employee at the company. I've had my hands in the platforms that you see represented here on the screen, five generations of our Multiport system, SP and Ion, along with the rest of the ecosystem. And I can say a foundational part of that has been the understanding of what customers care about. They have been part of the journey. I've worked side by side with them. Our teams work side by side with them to ensure that what we're doing matters and is solving their problems. And I believe there's no better representation of that than when a physician chooses one of our products, chooses Intuitive to treat a patient.
In Q4 of 2025, we hit a significant milestone of 20 million patients, 20 million times when physicians have made that choice. So as we built into that 20 million procedures over the last 30 or so years, you see the mix changing a little bit about how we've obtained that, with about 17% of procedures in 2005 having been done outside the U.S., and today it's 35% of procedures are happening outside the U.S. I think that's indicative of da Vinci and Ion bringing value beyond the U.S. borders. It's indicative of our teams delivering against what our customers expect. It is supported by the investments we've made over so many years. So 2025 was a strong year for Intuitive.
3.2 million procedures performed, with about 3 million on our Multiport platform, 55,000 on our Single-Port platform, and about 140,000 on Ion as part of that 20 million procedures. About 1,900 systems placed across all of our platforms, 1,600 or so on Multiport, 100 on Single-Port, and about 190 on Ion, leading to a 12,000 system installed base. And so it's not only the systems, but it's also the care teams, the surgeons, the executives, the researchers that surround those systems that are looking at the impact of robotics, the data that are generated by robotics, and how it's impacting the community as a whole. And you see 4,000 peer-reviewed publications published in 2025, and cumulatively about 48,000 articles talking about da Vinci, Multiport and Single-Port, and Ion and the impact in the world. So we look at economics and clinical outcomes.
We also want to understand how is Intuitive showing up with customers. Every year we engage a third party to survey our customers to see how we're doing as measured by our Net Promoter Score. Within the customer community, we survey physicians, we survey the care teams, and we survey executives, and our Net Promoter Score went up by a point this year to 76. As a reminder, anything above 70 is world-class, and so when you double-click into that and try to understand what is behind that, it really goes back to the Quintuple Aim, the fact that our products and our services and the things that we deliver to our customers are helping solve their problems, and importantly, that our teams and how they show up understand the issues that our customers are facing and are part of the solution.
So 2025, we've been consistent in our commentary throughout the year. We had a set of objectives we started the year with around launching da Vinci 5 and getting it out into the world, expanding procedures and the adoption of our procedures around the globe, ensuring that our manufacturing quality is at the level to meet the needs of our customers, and launching our digital ecosystem and making the feature releases happen throughout the year. And like any year, every year has its challenges, and 2025 was no different. Certainly around the trade environment that we were faced with, China continues to have its challenges with pricing and other robotic competitors coming to the market. We saw pressures in Japan and the U.K., and we see the ongoing impact of GLP-1s on our bariatric procedures.
In spite of those environmental conditions and the things that were headwinds for us, our teams performed and delivered in a number of areas. We had strength in U.S. general surgery. We had the da Vinci 5 broad launch, and I'll touch a bit more on that. The overall capital performance of our U.S. team was quite strong, and we saw increased utilization in both SP and Ion. Those factors and more led to very strong operational and financial performance, with 19% total year-over-year procedure growth, 13% installed base growth, and 21% revenue growth to $10 billion. Now I want to click into each of our platforms a bit and talk a little bit more in detail about 2025 and where we're going. It was a strong da Vinci 5 launch globally. We now have clearances in the U.S., Korea, Japan, and Europe.
You see here about 270,000 procedures performed, 1,200 systems installed, and over 10,000 surgeons who have used da Vinci 5. I think the metric that stands out for me on this page is the 11% higher utilization than Xi as we measure it in the U.S., where we have the best data. That's really supporting the design intent. A portion of what we tried to do with da Vinci 5 was build in more surgeon autonomy, more efficiency, so that it would lead to higher utilization. We see that happening. We are in broad launch in the regions where we have clearance. We continue to invest to expand the regions where da Vinci 5 is available, to continue to expand the procedures that are cleared on da Vinci 5.
We have continued to fulfill the commitment we made when we launch any of our platforms, which is that when we launch it and then with follow-on feature releases, it will only get better from there, and so we've made those investments in da Vinci 5, and I'll share some of those with you, and so as customers evaluate their existing robotic programs, they're looking at trade-ins, perhaps for da Vinci 5.
They're looking at incremental systems. It may be a greenfield customer, and they look across the capabilities of the system, of course. They also look at what else is required to run a robust robotic program, including efficiencies and simplicity and teaching and the ecosystem that surrounds it and more, and as they evaluate their programs, we see them continue to choose da Vinci 5 and Intuitive as a whole, and so we're excited about the launch of da Vinci 5.
I would say it has exceeded our expectations, and we look forward to continuing into 2026 and beyond. One of the things about da Vinci 5 is we established a set of features. We launched with a set of features that we thought would be differentiated and have already continued to add in the past seven quarters or so since launch. You see Force Feedback is one of the early feature releases. We've since added Force Gauge to be a definitive measure of how much force is being applied.
We have UI improvements and other aspects of the system that have led to efficiency and have refined those. We've added one of a very core instrument in the curved vessel sealer, and the early launch has shown very positive feedback. And we've added 3D models, the ability for surgeons to import that model into the console and manipulate it real time.
And so that's where we are today. And I want to show you a little bit about where we're going tomorrow, just with some tidbits around da Vinci 5. And so we've talked about molecular imaging in the past and the investments we're making to show different types of anatomy with different kinds of fluorescing molecules. We have investments in a ureter molecule. We have investments in a prostate cancer molecule, both of which we expect to improve outcomes by reducing the number of injuries to ureters and by reducing the rate of positive margins in prostate cancer. We're working hard on an articulated wristed multi-fire clip applier. So this has been an instrument that has long been asked for by our customers, and our teams have worked hard to develop a way in which we can deliver clips around the bend of a wrist.
And so we're excited to continue this development, bring it to market where we expect to add to the autonomy and efficiency of surgeons in procedures like cholecystectomy. And the advances we continue to make in vision, we're using a form of hyperspectral imaging that we will deliver onto da Vinci 5 to show the oxygenation of tissue correlated to the underlying perfusion of that tissue. And we look forward to seeing how this will impact certain aspects of procedures as surgeons get this capability. And it doesn't stop here, of course. The digital journey is an important one. It is something that we have talked about over multiple quarters and multiple years. As you know, it starts with a great foundation of data. We are getting data from da Vinci 5. We get data when we have a contract in place with customers around electronic medical records.
Today, we're receiving over 1,000 cases a day of data that we're able to add to this foundation and enable our data scientists to mine that data and look for meaningful insights. What matters in surgery? What matters in interventions? And how does that express itself back to the surgeon through case insights? And I'll talk a little bit more about that. From there, as we understand what good is and what we are trying to impact during surgery, we want to add intraoperative guidance and bring that so that during the operation, surgeons can adjust what they might be doing. That can happen through telecollaboration tools that we have today with Intuitive Telepresence, where surgeons are talking and communicating and mentoring each other. It can happen through something like Force Gauge, where we show how much force is on a screen.
We will add telesurgery to the da Vinci 5 platform at a subsequent release and add to the telecollaboration suite. And ultimately, leading to augmented dexterity, where we can introduce no-fly zones to protect critical anatomy, where we should be able to control instruments and further helping the surgeon autonomy and the efficiency of procedures. So this is a long multi-year journey. We're at the very beginning, but excited about the impact this can have in the future. And so it's, again, not enough. You have this data. You have these understandings of what good might look like in surgery, but it doesn't matter if you can't deliver that to the surgeon and to the care team in a way that matters to them and that they can act upon. And so My Intuitive Plus is our way of kind of bringing that together.
SimNow, it's our way of saying, "We understand where you need to improve, surgeon, and let us point you to simulation exercises." For telepresence, so we can give these objective performance indicators to certain surgeons, and they can communicate them to the folks they are mentoring. And again, we'll add telesurgery as a component of that. And Case Insights is kind of the foundational software, if you will, that sort of collects data, allows us to analyze it, and deliver it back to the surgeon and care team overall. And so you see the blue bar charts there. Each one of these are adopting more or less in line with the DV5 adoption.
And though we're excited and we're excited to see where customers are, again, there is a lot of work to do here for us to continue to build the foundation, to add some of the capabilities that we need to add and to show that these indicators make a difference ultimately. And so now turning our attention to da Vinci SP, you see we've made progress in adding indications in the U.S., including nipple-sparing mastectomy. We've added several geographies outside the U.S. We continue our innovation pathway there with SureForm Stapler having been introduced on SP, and we're working hard on a vessel sealer for a future instrument release that we're quite excited about. SP had a strong year, 87% procedure growth, 39% installed-base growth, and 29% utilization growth.
And so if you look at now our da Vinci business, the Multiport business and the Single-Port business, the opportunity for it, we're quite excited about. And so we just finished about 3 million procedures in 2025. And if we stand back and look at the opportunity that exists out there, first we look at the number of soft tissue procedures that we see in the areas that we support. We believe that's about 23 million procedures, and that includes open surgery and minimally invasive approaches. That's all procedures. Of that, about 20 million, we believe should and can be done with a minimally invasive approach. And so if you look inside that 20 million, what we've included are clearances, reimbursements, and economics that we are investing in today that we expect to come to fruition over the long term.
So we're making investments in order to expand that nine million line of sight into that 20. As part of that 20 million, a significant portion is the benign surgery outside of the U.S. And then we look at the nine million line of sight procedures. Those are the ones where we have the products, clearances, and economics that are supportive of a robotic program right in front of us. And that's what our commercial teams are working hard for every day. And as we look forward and as if we continue to make progress and the evidence that are being generated shows that it's beneficial, we expect the nine to continue to grow into the 20 as we look forward. Now shifting to Ion, our bronchoscopic platform, really the foundation of Ion is to navigate the lung and provide value.
Today, we're in the lung cancer by biopsying suspect nodules. We expect it in the future to have an impact for benign lung disease as a whole. Ion also had a strong year, 51% procedure growth, 24% installed-base growth, and 9% utilization. What I want to do is stand back just for a minute and remind you of the North Star that we have started with Ion, and that is to improve survivability of lung cancer. If you might know today, five-year survival rate of lung cancer is around 25%. One in four people will be alive in five years once diagnosed with lung cancer. If you diagnose it early at stage 1A, that can be above 90%. So it is clear that the importance of getting it early is critical.
If you look at what is the general pathway today, once a nodule is detected, treatment can be over six months. And you can imagine within that six months, cancer can progress. The anxiety on the patient is not measurable, but you can imagine what that is. And we've already made investments to try to streamline this with Ion and what we're doing in biopsy and certainly for treatment with da Vinci and surgery. What we believe, though, is this: we can shrink this down. We can bring this to under a month through continued innovation on Ion by bringing ROSE, so real-time assessment of the tissue sample that the physician obtains, and ultimately determining whether or not the cells that are obtained are cancerous. And so we're making investments in ROSE technology to help streamline this pathway.
We are making investments in endobronchial ultrasound, EBUS, to integrate that into the Ion system and, again, make it easier and more efficient for physicians to biopsy lymph nodes and stage them to understand what is happening with the patient. We continue on the treatment side to make investments in focal therapy, as do many companies outside the four walls of Intuitive. And so we're excited when we look at what is possible for lung cancer, how we can change a 200-day pathway, compress that to less than a month, and make it easier for caregivers to provide care for patients facing lung cancer. And this is already happening. And I wanted to share with you a bit of data out of the University of Zurich, where they have adopted Ion plus cone beam CT here, and you can see that kind of starting in 2024.
For years, their program was a steady state diagnosing about 35, 40 patients with stage 1A cancer. And upon the adoption of Ion and cone beam CT, you see a market increase by about 30 percentage points to 55% of their patients at stage 1A, which we know what that means to survivability. This is multifactorial, as many things are. Some of it is their program is growing and they're recruiting more patients. But importantly, an aspect of this is that they can now biopsy patients that previously would have been sent to watchful waiting. And so this is what the Ion journey and some of the investments we're making is about. And so if we look at the opportunity for Ion, we just finished about 140,000 procedures in 2025.
The line of sight for Ion, again, where we have the products, clearances, and supportive economics, we believe is about 700,000 procedures. If you look at the total biopsy market, we believe that to be about 1.5 million procedures, and in there, as ROSE and staging as our development efforts progress, and when that comes to commercialization, we believe that Intuitive can add even further value to the evaluation, diagnosis, and treatment pathway for lung cancer patients. When you look out to treatment and if focal therapy for lung cancer becomes a standard of care for certain patients, and as we make investments and advance the work we're doing with COPD, with benign lung disease, we have an opportunity to impact even more patients, and so our 2026 priorities: platform growth, global expansion of da Vinci SP and Ion, and continuing to build that digital ecosystem underneath.
Procedure adoption as we drive the value through physician choice by country through our training and commercial activities and market access efforts. Continuing to build the infrastructure of Intuitive, our ability to manufacture at high quality at the scale required to meet customer needs. And then finally, innovating to reach more patients so that we're advancing our early-stage R&D programs for new disease states and continuing, as we talked about, to expand the line of sight procedures. And so I'll close with this. I think innovation can take many forms. It can take the forms of products that I showed some of the slides were shown to you here today. It can take the form of business models and how we support our customers commercially. It can take the form of how you analyze data and communicate that back to care team, surgeons, and executives.
And again, for me, we at Intuitive have core capabilities in all of those areas. And those are the areas we're focused on. And when those match one of those unmet needs out in the world, that's when we can advance the quintuple aim and improve minimally invasive care for patients and their surgeons around the globe. So thank you. I know that the management team at Intuitive, myself, everybody, we are excited about the potential of 2026 and what's ahead of us. And so thank you for being here. And I think, Robbie, we can turn to Q&A. So thank you.
Where do you want us? You want to sit over here?
Is that okay?
Okay.
Well, great. Dave, first, a warm welcome to your first JP Morgan up on the big stage here.
Yeah, thank you.
Had a great fourth quarter that you announced this morning with 17% da Vinci procedure volume growth, 18% overall. Maybe talk to some of the trends you saw. You had a really strong third quarter utilization, fourth quarter continued and improved on that. Just talk to what you're seeing US versus OUS in those results.
I can take it. So if you look at the geographical breakdown in Q4, US procedure growth was 15%. That reflected general surgery and, in particular, underneath that, after-hours procedures, which we think are a proxy for acute care. After-hours procedures grew 35% in Q4. That's procedures like cholecystectomy and appendectomy. The 15% performance for the U.S. in Q4 was strong. In our OUS markets combined, we grew 21%. There's about a percentage-ish point impact from seasonality. So normalized, that would have been 22% on a day-adjusted basis.
In OUS markets, what you see is some impact, as we've described, in China, which was just above the corporate average in terms of procedure growth, and Japan, where we saw actually procedure growth below the corporate average. China, we see some competitive impacts, as Dave described. Japan is impacted by recent capital placements. But in terms of strength in OUS markets, we saw India, Korea, distributor markets, Canada all perform well within that 21% outcome.
Maybe we could touch on procedure volume guidance for 2026, 13%-15%. We've seen you the past few years got 13%-16%. Part one is, is this a signal that we should pick up on? And part two, how do you think about what's assumed in the low end and the high end of the range?
Yeah, I think, Robbie, the da Vinci procedure growth guidance considers potential range of outcomes for the factors in our guidance, which I describe as follows. In the U.S., we expect the growth drivers in 2026 to be similar to those in 2025, led by general surgery in acute care, recognizing the impact of the law of large numbers. There's also consideration for the potential impact of changes to ACA premium subsidies and changes in Medicaid funding on hospital and patient behavior. Bariatrics in the U.S., it's a little bit less than 3% of total procedures. There are new pharmaceutical products coming in 2026. Outside the U.S., capital pressure in parts of Europe related to macroeconomic impact and shifting governmental priorities in some cases. As Jamie mentioned, China tender volumes and competitive intensity in that market.
Then lastly, in Japan, capital challenges in 2025 and how long those persist as well.
I would just add, Robbie, when we think about growth, let's say on a midterm basis, there's really kind of three drivers of growth. Dave, I think, described them well. There is growth within the line of sight, the three million we did this year versus the nine million line of sight opportunity. That's one. Second is how we expand the nine million into the 20, and we routinely make investments to have that grow. You can see that from the last couple of years as we come to JPM and update you on what that opportunity is. The third is outside of soft tissue surgery, where we see opportunities for new platforms.
Ion was our first example of a new platform, and you get to add indications that expand the opportunity. Those are generally on longer time horizons in terms of the R&D and the clinical work that you have to do to get those to market. But we kind of think about how we drive growth in the midterm in those three buckets.
Maybe we could touch on Ion. It's the first quarter you've broken out specifics in terms of some of the reported procedures. And it's adding about a percentage point to total company growth. So now of scale and materiality, this is one you've been talking about for a long time. And when we do our doc checks, it has a ton of potential to expand both in new indications and help more patients.
So maybe talk about why break it out now and some of the opportunities you see with Ion and maybe some other platforms?
Yeah, Ion's been in the marketplace now since 2019. It's progressed really nicely for use of Ion for biopsy in the U.S. We've passed the halfway point just about. And so we have kind of relatively strong insights as to how that business is performing and therefore wanted to make sure that was available to investors. Obviously, we're much earlier in international markets. We have clearance for Ion in Europe, China, a couple of other markets, which are in earlier stages. They will take more work, particularly on the market access and reimbursement side. But given the relative size of Ion now, how long it's been in the marketplace, we wanted to provide investors additional color as to the components of its performance.
As you think about whether it's Ion, whether it's single port, whether it's multiport, to expand that 9 million line of sight procedures, that's what you have today. How should we think about what Intuitive Surgical is focused on to move that 9 million up? You spend a lot on R&D each year. I imagine a lot of that is hardware, some of that software. I imagine a lot of that is also on clinical trials and data generation to expand that. How should we think about the next indications of note?
Yeah, what I would say, Robbie, is from the 9 into the 20, a lot of that has to do with economics.
And when you look outside the U.S., the benign surgery, which is a significant portion, I think people understand the value, that clinical value that robotics can bring, and they want to incorporate that into their practice. And they're just trying to say, how do the economics work for my given country and reimbursement payer system? And so the work now is both how do we generate the local evidence, like you said, to support the value and work through some of the market access efforts and reimbursement efforts that are kind of bespoke per given country and have those two meet in a way that we can generate the support of economics and continue to grow that 9.
There are opportunities for additional products and clearances between that 9 and that 20, but the significant portion of it is benign OUS.
And we think as the DV5 launch broadens, the trade-in cycle progresses and we get Xi back. You see with refurbished Xi, we placed 23 of them in Q4. There's an opportunity now for us to have great segmentation in the portfolio, particularly where there is cost sensitivity. And so Xi-R, I think, has an opportunity in ASCs in the U.S. and in those markets that are much more sensitive to the capital acquisition cost. And so I think we're excited about the role Xi-R can play, in particular, because it leverages the existing ecosystem that we have.
I think that's a great point, right? You can either get better reimbursement outside the U.S. in these countries, which is difficult, or you can lower the cost to operate there. And part of that is the Xi-R, the refurbished.
So how much do you think the Xi-R, bringing the cost to purchase the initial system down, can help knock down some of those barriers where cost is a problem?
When you talk to customers, all of them have a slightly different feel of how do they value, what are the economic considerations. But I think the way we want to sort of structure our communications with customers is around the utilization of da Vinci. So we talk a lot about the cost of a platform, but what's important is, is the utilization supporting per procedure economics that matter for them? And so, yes, cost of a platform like Xi-R is an important consideration, but we want to ensure too that the utilization of that platform is meeting their needs both clinically and economically.
And so that's where the ecosystem that Jamie referred to, the support structure, our training infrastructure, all of that to drive the health of the program.
I think artificial intelligence is touching everybody's lives. It's making it difficult for healthcare investors the past few years as it gets so much attention. But that's actually a positive for Intuitive Surgical. As many companies talk about it, you actually integrate it, monetize it, and it's a key part of your platform here. So maybe talk about how Intuitive Surgical thinks about AI and where you are today and where it can bring you in the future with surgical robotics.
Yeah, sure. I mean, I think everybody knows
AI can have both kind of corporate impact and product impact.
And so on the corporate side or on the product side, I tried to just show a little bit in the slides around that digital journey. Today, we have AI already making a difference in Ion, for example, where we use AI and machine learning for segmentation of the CT scan of the lung, and so that can be incorporated into the procedure. We use it to help to reduce CT to body divergence. And so even today, we have aspects of AI that are sprinkled throughout our ecosystem. And again, that you're saying is already making a difference. And if you look tomorrow, really AI is foundational to a lot of that digital journey that we described, that the data that is so important that we continue to build and really the importance of that cannot be overstated.
From there, taking it into aspects of how do we deliver information to customers, how do we deliver intraoperative guidance, ultimately getting to areas where we can augment the dexterity, if you will, of the system through things like no-fly zones, instrument control, and other aspects. So again, it's one of these things that's a very long journey, but we'll have, I think, a very important measurable impact as we look forward.
Maybe we could touch on competition for a second. Intuitive Surgical has a decade-plus head start in surgical robotics around the world in soft tissue. We now have one larger competitor approved for urology in the U.S. Another one is filing for their robot this year. How do you think about Intuitive Surgical's ability to compete and maintain its leadership position? You have an extremely large installed base. I love the slide.
I didn't see it this year about how many IDN networks have 20 or more da Vinci's, how many hospitals have seven or more, and it's gone vertical the past several years. So how do you think your ability to continue to innovate and stay ahead of competition?
I like our chances, Robbie. So today, again, competition to me, if you step back and you say, what is competition about in the healthcare space? It is about the best way to treat a given disease state. And we see competition, for instance, in bariatric disease around GLP-1s, right? And so you start there to say, what's the best option?
Then it goes to, if surgery is the best option, then it's our job to say, okay, how do we provide the best products, the best support structure, the best ecosystem so that it all comes together and enables customers to deliver the very best care possible? And so assuming that surgery is the choice, then our job today, I think it's more than comparing features. It's how does your program customer meet your needs, Quintuple aim? How does it serve to treat patients? How do you do so reliably every day with different teams who are available to service and support the system? And so competition, if you will, as new robotic competitors come to the market, is more than just they have a system and we have a couple of instruments. It's the entirety of the ecosystem that has to be considered.
And then as I look forward, we have thousands of engineers and heavy R&D investment to try to, again, move the ball forward and make it such that customers see the value in what we're offering and we get the choice.
Great. I would just add, Robbie, in addition to the ecosystem effect, which I think at least as things stand today is significant with the things that Dave described, we also have the advantage of the segmented system portfolio. And that allows us to obviously sell based on what the program of the customer is, what their relative financial objectives are, and there are the feature value, cost trade-offs that afford us. And again, XIR will play a key role in that segmentation.
Jamie, maybe with the last minute or two here, I want to touch on 2026. We'll get the full guidance on the fourth quarter earnings call.
You generally guide to gross margin and operating expense growth. There's a lot of moving pieces in 2026 as you launched the Xi-R trade-in cycle. It is booming and back up there. Any considerations you can give us on how to think about margins down the P&L in 2026?
Yeah, I think I would just say back to procedures for a second. The growth drivers will largely be consistent, which is general surgery in the U.S., and then the procedure specialties outside of urology in the international markets. And we'll look for DV5 SP and Ion to continue to progress. And what we've seen in our financials is kind of the pricing premium for DV5 start to manifest in system ASPs, in service pricing per system, etc.
If I look down the rest of the P&L for what I would say before the earnings call, we'll have a full year of tariffs in gross margin, wherever those tariff rates land. As the trade-in cycle progresses, the proportion of those that are purchased, you will have obviously a higher trading credit for an Xi to a dV5, and that therefore impacts the system ASP and margin. But beyond that, I think I'd leave our P&L comments to the 23rd.
Great. Well, I'm excited. Congratulations on a good fourth quarter. Appreciate a great discussion, and thanks everybody for joining today.