Intuitive Surgical$ISRG.US beat expectations on all three metrics, but fell 10.6% after hours. Revenue was $3.049 billion versus expectations of $2.91 billion; adjusted EPS was $3.00 versus $2.65; and procedure volume grew 15%, while the market had expected just 13.5%. Shares closed at $438, up 1.11%, then dropped to $391.40 after the earnings report.

The drop wasn't about this quarter. Full-year guidance is still 14% to 15%, unchanged from three months ago, and Q3's 15% was already at the top of that range.

Profitability, by contrast, was solid. The adjusted net margin was 34.60%, versus 34.69% in the same period last year—essentially unchanged. Excluding the $347 million after-tax litigation expense, the reported net margin was 28.53%, higher than last year's 28.17%. The $16.3 billion in market value wiped out in one day was 36 times the $450 million settlement.

Growth itself is slowing: it was 18.9% in the same period last year. The company offered no new guidance, leaving little room for Q4. The litigation expense is one-off; the valuation is pricing in acceleration.

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