ISRG options flow: unusual options activity in Intuitive Surgical Inc.
Updated 28 September 2026, 09:54 ET
Over the last week the tape recorded 78 unusual options prints in Intuitive Surgical Inc. (ISRG), $5.4M of tracked premium, leaning bullish. Bullish premium was $3.4M against $1.7M bearish; $3.4M went into calls and $2.1M into puts, a put call ratio of 0.61. The largest print was $263K of ISRG 18 Dec 2026 $430 puts on 24 September 2026, swept at ask. The last session with prints, 25 September 2026, added 18 prints and $1.4M of premium. ISRG closed at $405.18 on 25 September 2026, up 1.4%.
This week's unusual flow
Prints from 21 September 2026 to 25 September 2026, 5 sessions. Delayed tier: every print is shown twenty minutes after it executed, and the page is rebuilt after each session.
Net premium is bullish minus bearish premium. The put call ratio is put premium divided by call premium, weighted by money rather than by contract count. Sweeps is the share of prints executed across several exchanges at once. Read the guide: Reading the Pulse.
Largest prints of the week
| Date | Contract | Type | Size | Open int. | Premium | Execution | Sentiment | Tier |
|---|---|---|---|---|---|---|---|---|
| 24 Sep 2026 | ISRG 18 Dec 2026 $430 puts | Sweep | 59 | 189 | $263K | At ask | Bearish | Notable |
| 22 Sep 2026 | ISRG 16 Apr 2027 $380 calls | Trade | 40 | 41 | $256K | At ask | Bullish | Notable |
| 25 Sep 2026 | ISRG 16 Oct 2026 $395 calls | Trade | 170 | 239 | $255K | At ask | Bullish | Notable |
| 21 Sep 2026 | ISRG 21 Jan 2028 $210 calls | Trade | 12 | 16 | $253K | At ask | Bullish | Notable |
| 21 Sep 2026 | ISRG 16 Oct 2026 $400 calls | Sweep | 138 | 477 | $220K | At bid | Bearish | Notable |
| 23 Sep 2026 | ISRG 19 Mar 2027 $500 puts | Trade | 13 | 624 | $142K | At bid | Bullish | |
| 23 Sep 2026 | ISRG 19 Mar 2027 $410 puts | Trade | 31 | 28 | $135K | At bid | Bullish | Notable |
| 21 Sep 2026 | ISRG 20 Nov 2026 $365 puts | Trade | 127 | 43 | $130K | At ask | Bearish | Notable |
| 21 Sep 2026 | ISRG 16 Oct 2026 $405 calls | Sweep | 101 | 359 | $110K | At ask | Bullish | Notable |
| 24 Sep 2026 | ISRG 15 Jan 2027 $360 puts | Sweep | 77 | 236 | $109K | Below bid | Bullish | Notable |
| 25 Sep 2026 | ISRG 18 Dec 2026 $420 calls | Trade | 48 | 270 | $108K | At ask | Bullish | |
| 25 Sep 2026 | ISRG 16 Oct 2026 $350 calls | Trade | 20 | 141 | $108K | At bid | Bearish |
Size above open interest means the trade opened a position larger than everything that existed in the contract the night before. Above ask and below bid are the most aggressive executions. Read the guide: Size versus open interest.
Where the money is aimed
| Expiry | Prints | Premium | Calls share | Net premium |
|---|---|---|---|---|
| 16 Oct 2026 | 16 | $1.4M | 90% | -$61K |
| 18 Dec 2026 | 16 | $1.1M | 33% | +$250K |
| 17 Jun 2027 | 12 | $558K | 100% | +$325K |
| 15 Jan 2027 | 11 | $530K | 23% | +$206K |
| 19 Mar 2027 | 5 | $414K | 24% | +$414K |
| 21 Jan 2028 | 3 | $393K | 100% | +$217K |
The most premium, $1.4M, is aimed at the 16 Oct 2026 expiry.
A print in a contract expiring this week is a view about the next few days, often about a known event; a print months out is a different kind of statement. Read the guide: 0DTE options flow.
The last session, 25 September 2026
| Date | Contract | Type | Size | Open int. | Premium | Execution | Sentiment | Tier |
|---|---|---|---|---|---|---|---|---|
| 25 Sep 2026 | ISRG 16 Oct 2026 $395 calls | Trade | 170 | 239 | $255K | At ask | Bullish | Notable |
| 25 Sep 2026 | ISRG 18 Dec 2026 $420 calls | Trade | 48 | 270 | $108K | At ask | Bullish | |
| 25 Sep 2026 | ISRG 16 Oct 2026 $350 calls | Trade | 20 | 141 | $108K | At bid | Bearish | |
| 25 Sep 2026 | ISRG 18 Dec 2026 $420 calls | Trade | 44 | 270 | $102K | At ask | Bullish | |
| 25 Sep 2026 | ISRG 21 Jan 2028 $480 calls | Trade | 16 | 46 | $88K | At bid | Bearish |
Every print in ISRG with its full detail, the live tape, one tap filters and saved screeners: open ISRG in Options Sentiment Screener.
Price
The live quote and the price chart sit beside the ticker's flow in the app: open ISRG in Options Sentiment Screener.
Analysts
The most recent analyst targets on file, from 22 firms, have a median of $500, 23.4% above the last close. The last 90 days brought 1 upgrade and 1 downgrade.
Calls bought at a strike above the average target are a bet that the analysts are too cautious; puts far below the price in a name they like are protection or a strong disagreement. Read the guide: Reading one ticker's flow.
About Intuitive Surgical Inc.
- Exchange
- Nasdaq
- Sector
- Health Care
- Industry
- Medical Equipment
- Headquarters
- Sunnyvale, California
- Website
- intuitive.com
Intuitive Surgical, Inc. develops, manufactures, and markets products that enable physicians and healthcare providers to enhance the quality of and access to minimally invasive care in the United States and internationally. The company offers the da Vinci Surgical System to enable complex surgery using a minimally. invasive approach.
In the same sector
Flow pages for other Health Care names in the S&P 500:
LLY Eli Lilly & Co.JNJ Johnson & JohnsonABBV AbbVie Inc.MRK Merck & Co. Inc.UNH UnitedHealth Group Inc.TMO Thermo Fisher Scientific Inc.AMGN Amgen Inc.GILD Gilead Sciences, Inc.
Learn
- What unusual options activity means
- Reading one ticker's flow
- Sweeps, blocks and where a trade printed
- Size versus open interest
- Bullish or bearish, how a print's sentiment is inferred
- The conviction score and whale prints
The live tape for ISRG with every print's execution detail, one tap filters for calls, puts, sweeps and 0DTE, saved screeners and, for Realtime subscribers, push alerts and no delay. The same screen is in the iOS and Android apps.
Open ISRG in Options Sentiment Screener