Intuitive Surgical is trading at $404.10, down 7.67% in pre-market on October 21, as investors focused on its narrowed 2026 procedure-growth forecast following the October 20 earnings release. - Revenue of $3.05 billion and adjusted EPS of $3.00 beat estimates; U.S. da Vinci procedure growth slowed. - A $450 million pre-tax antitrust settlement charge weighed on GAAP profit. - Broader markets were modestly higher, making the earnings outlook the clearest identified catalyst.