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    MDT
    Earnings call· Apr 2026(Q4 FY26)

    Medtronic Q4 FY26 earnings call MDT

    Jun 3, 2026 Source

    Executive summary

    Medtronic plc Q4 FY26 — Strongest Top Line Growth in a Decade Driven by CAS and Hugo Momentum

    Medtronic delivered its strongest top-line performance in a decade, driven by robust organic growth across key segments like Cardiac Ablation Solutions and the emerging impact of its Hugo robotic system. While navigating tariff headwinds and a transitional product mix, the company is strategically investing in high-growth areas and innovation, positioning itself for continued durable growth in the upcoming fiscal year.

    Highlights

    5

    • Q4 revenue up 9.9% reported and 6.6% organically, marking the strongest top line performance in 10 years.

    • Cardiac Ablation Solutions (CAS) delivered 78% worldwide growth, gaining 8 points of U.S. share, with PFA growing 145% globally.

    • Symplicity Spyral annualizing at $100 million, with weekly procedure volumes doubling since NCD.

    • Hugo surgical robotic system's worldwide procedure volume growth is 2-3x the market, with utilization increasing.

    • MiniMed Diabetes business delivered 15% reported growth (8.1% organic), driven by international execution and U.S. CGM momentum.

    Concerns

    5

    • Tariffs impacted the business by $74 million (80 basis points) in Q4, with an anticipated $250 million impact in FY27.

    • Structural Heart performance was flat in Q4, with U.S. softness due to low-risk data, though weekly procedure volumes have stabilized.

    • Mix was unfavorable by 60 basis points in Q4, largely reflecting the diabetes business and higher mix of lower-margin capital in CAS.

    • FY27 guidance includes 2% dilution from M&A, 1 point higher than previously shared due to earlier deal timing.

    • FY27 guidance factors in a roughly 1 point headwind from increased fuel and transportation costs due to the Middle East conflict.

    Guidance & targets

    10
    CategoryTargetConfidence
    FY27 Organic Revenue Growth
    6.75% to 7.25%
    high materiality
    High
    Q1 FY27 Organic Revenue Growth
    11.5% to 12%
    medium materiality
    High
    FY27 Foreign Exchange Impact (Revenue)
    neutral to roughly $100 million headwind
    medium materiality
    High
    Q1 FY27 Foreign Exchange Impact (Revenue)
    neutral to $50 million tailwind
    low materiality
    High
    FY27 Operating Margin (excluding tariffs)
    roughly in line with the previous year
    medium materiality
    High
    FY27 Tariff Impact to COGS
    $250 million
    high materiality
    High
    FY27 Gross Margin (including tariffs)
    decrease by roughly 20 basis points
    medium materiality
    High
    FY27 Operating Margin
    up 60 basis points
    high materiality
    High
    FY27 Adjusted EPS
    $5.90 to $6.00
    high materiality
    High
    Q1 FY27 EPS
    $1.38 to $1.40
    medium materiality
    High

    Segment performance

    28
    SegmentRevenueYoYQoQMargin
    Cardiovascular
    Led by 14% growth in the U.S. and 7% in international markets.
    		—10%——
    Cardiac Ablation Solutions (CAS)
    Strong momentum, annualizing over $2 billion in revenue and on track to reach $2 billion trailing in Q1 FY27.
    U.S. growth: 124%
    		—78%——
    Cardiac Rhythm Management (CRM)
    Growth in both U.S. and international markets.
    		—5%——
    Defibrillation
    Strong momentum in OmniaSecure defibrillation lead following indication expansion.
    ICD growth: high teensEV ICD growth: mid-60s
    		—mid-single-digit——
    Cardiac Pacing Therapies
    Micro growth: mid-teensSelect Secure 3830 lead for CSP growth: high teens
    		—mid-single-digit——
    Structural Heart
    Strong international performance, U.S. softer due to low-risk data. Weekly U.S. procedure volumes stabilized over last 8 weeks.
    		—flat——
    Coronary
    Decline offset by strength in renal denervation.
    		—declined——
    Peripheral Vascular Health
    		—low single-digit——
    Cardiac Surgery
    		—mid-single digit——
    Neuroscience
    Category leader across all segments, investing to advance pipeline innovation.
    International growth: 6%
    		—3%——
    Cranial and Spinal Technologies (CST)
    Growth in both U.S. and international markets.
    		—3%——
    Core Spine
    Gained share on continued module X expansion and distributor conversions.
    		—6%——
    Neurosurgery
    Supported by the launch of Stealth AXiS.
    Navigation growth: low double-digit
    		——improved sequentially—
    Specialty Therapies
    		—3%——
    Neurovascular
    Driven by healthy adoption in Euro garden RTs.
    Hemorrhagic growth: 11%
    		—6%——
    ENT
    International growth: high single-digit
    		—mid-single-digit——
    Pelvic Health
    Solid growth in Altaviva offset by broader market softness in sacral nerve modulation.
    		—flat——
    Neuromodulation
    Strategic focus and investment, including expansion in BVNA.
    		—low single digit——
    Medical Surgical
    Pleased with the finish to close the year.
    U.S. growth: 8%
    		—5%——
    Surgical
    Split evenly between U.S. and international markets, driven by Advanced Energy, Wound Management, and Hugo.
    		—3%——
    Advanced Energy
    		—high single-digit——
    Wound Management
    		—high single-digit——
    Endoscopy
    Driven by strong adoption of Endoflip in U.S. and Western Europe and market share gain in Nexpowder in the U.S.
    		—high single-digit——
    Acute Care and Monitoring (ACM)
    Outsized strength, anticipated to normalize in FY27.
    U.S. growth: high teens
    		—up——
    Nalcor Post Oximetry
    		—mid-teens——
    Respiratory and Airways
    		—high single-digit——
    Perioperative
    		—mid-single digit——
    Diabetes
    Driven by strong international execution and continued momentum in U.S. CGM and new patient starts.
    Organic growth: 8.1%
    		—15% reported——

    Operational metrics

    24
    Q4 Reported Revenue Growth
    9.9%
    Q4 FY26
    Q4 Organic Revenue Growth
    6.6%
    Q4 FY26
    FY26 Reported Revenue Growth
    8.4%
    FY26
    FY26 Organic Revenue Growth
    5.8%
    FY26

    Strongest top line performance in 10 years.

    Q4 Adjusted EPS
    $1.55
    Q4 FY26

    Ahead of expectations.

    FY26 Adjusted EPS
    $5.53
    FY26

    Ahead of expectations.

    Q4 Adjusted Gross Margin
    65.4%up 30 bps YoY, up 50 bps sequentially
    Q4 FY26

    Mix impact largely from diabetes business and higher mix of lower-margin capital in CAS.

    Tariff Impact
    $74 million
    Q4 FY26

    In line with expectations.

    Adjusted R&D as % of Revenue
    7%
    Q4 FY26

    Also 7% for full fiscal year.

    FY26 R&D Spend Increase
    $150 million
    FY26

    Marching towards higher investment goals.

    Q4 M&A and Venture Investments
    nearly $2 billion
    Q4 FY26

    Additional investments.

    FY26 Venture Investments
    $250 million
    FY26

    In growth accretive adjacencies.

    Adjusted SG&A as % of Revenue
    30.5%up 30 bps YoY
    Q4 FY26

    Deliberate decision to accelerate investment in commercial firepower.

    Q4 Adjusted Operating Profit
    $2.5 billion
    Q4 FY26
    Q4 Adjusted Operating Margin
    25.5%
    Q4 FY26
    Q4 Adjusted Tax Rate
    17.7%
    Q4 FY26

    Slightly better than expected.

    FY26 CapEx Spend Increase
    $50 million
    FY26

    Grew at a significantly lower rate than revenue.

    Cash and Investments Balance
    $9.2 billion
    End of FY26

    Positioning the company favorably for M&A opportunities.

    Organic Revenue Growth Acceleration
    60 bpsfrom last quarter
    Q4 FY26

    On a far more challenging comp.

    U.S. Revenue Growth
    7%
    Q4 FY26
    International Revenue Growth
    6.2%
    Q4 FY26
    Neuroscience Robotics Penetration
    high single digits
    Q4 FY26

    Significant runway ahead.

    CST Consumables Revenue Mix
    50%
    Q4 FY26

    Of total CST revenue.

    Touch Surgery Digital Ecosystem Installations
    1,400+up 30% sequentially
    Q4 FY26

    Globally.

    Industry KPIs

    12
    MetricValueDetails
    System utilizationincreasing
    Pricing realized price30 bpsbps
    Market growth outgrowth20%%
    New product launch ramp$100 millionUSD
    Procedure volume growth2 to 3xx
    FCF conversion leverage guidance$5.4 billionUSD
    Installed base system placements40%%
    Segment franchise organic growth78%%
    Consumables recurring revenue mix50%%
    Sales force commercial capacity build200 doctorsdoctors
    Indicated addressable patient population18 millionpeople
    Pivotal trial clinical evidence milestones13.3 and 18.1 milligrams of mercurymmHg

    Product announcements

    3
    ProductTypeDetails
    Hugo Robotic Systemmilestone
    Pro Grip Advancedlaunch
    MiniMed Flexlaunch

    Deals & partnerships

    8
    MiniMeddivestiture

    Completed the MiniMed IPO, establishing it as a stand-alone publicly traded company.

    Cath Worksacquisition

    Closed on the Cath Works transaction. Their FFRangio system uses AI and advanced computational science to improve decision-making in the cath lab. Positive 1-year data from the all RISE trial validates FFRangio as a noninvasive technology for the $1 billion FFR segment.

    Scientiaacquisition

    Announced plans to acquire Scientia, which will meaningfully expand Medtronic's neurovascular platform with differentiated guidewire technologies for stroke.

    SPR Therapeuticsacquisition

    Announced plans to acquire SPR Therapeutics, which will build out Medtronic's portfolio of chronic pain management therapies.

    Beluga Medicalinvestment

    Investment will advance development of next-generation ICE catheters that will further advance Medtronic's EP toolkit.

    CardioACCinvestment

    Investment will advance development of next-generation ICE catheters that will further advance Medtronic's EP toolkit.

    Pulnovoventure

    Investment in emerging technologies, including Pulnovo, a first-of-its-kind minimally invasive system designed to address pulmonary artery renovation.

    Merit Medicalpartnership

    Entered into a distribution agreement with Merit Medical for ViaVerte, an FDA-cleared solution for chronic tibolgenic back pain.

    Risks & headwinds

    6
    Tariff ImpactQ4 FY26 and FY27

    $74 million (80 bps) in Q4 FY26; anticipated $250 million in FY27 ($65 million increase vs prior year), including $75 million in Q1 FY27.

    Mitigation: No government refund incorporated in guidance; monitoring environment.

    Structural Heart SoftnessQ4 FY26

    Flat performance in Q4 FY26, particularly in the U.S.

    Mitigation: Weekly U.S. procedure volumes have stabilized over the last 8 weeks; heavy investment in the business.

    Business Mix UnfavorabilityQ4 FY26

    60 bps negative impact on Q4 gross margin.

    Mitigation: Largely reflecting the diabetes business and higher mix of lower-margin capital in CAS; pressure from diabetes mix will disappear upon separation.

    M&A DilutionFY27

    2% dilution factored into FY27 guidance, 1 point higher than previously shared.

    Mitigation: Due to earlier timing of several deals.

    Increased Fuel and Transportation CostsFY27

    Roughly 1 point headwind.

    Mitigation: Due to the conflict in the Middle East.

    Bariatrics PressureQ4 FY26

    Continued pressure.

    Q&A highlights

    6

    Asked about the underlying 5.5-6% organic growth for FY27, excluding the extra week, and how Medtronic plans to achieve this acceleration given concerns about CAS slowing down, inquiring about offsetting segments.

    Geoff Martha clarified that CAS's impact on growth would be similar to FY26, expecting mid-to-high teens market growth and Medtronic to grow north of 2x that rate, with the business annualizing at $2 billion. Thierry Pieton detailed expected contributions from Cardiovascular (strong momentum in CAS, CRM, Ardian, stable Structural Heart), Neuroscience (acceleration across segments with Stealth AXiS, Neurovascular, Altaviva), and MedSurg (strong Q4 momentum normalizing).

    “we're not talking about CAS slowing down its impact on our growth. I just laid out what I think it will grow, but the impact is strong.”

    asked by Vijay Kumar · answered by Geoffrey Martha

    2 min read7 chapters

    Detailed Narrative

    01

    Cardiac Ablation Solutions (CAS) Leadership

    Medtronic's CAS segment delivered exceptional Q4 growth of 78% worldwide, with PFA growing 145% globally. The company gained 8 points of U.S. share and expanded its U.S. installed base by 40% sequentially. New innovations like PRISM 2 mapping software and the Sphere-360 catheter (CE-marked, U.S. trial enrolling) are enhancing the EP ecosystem, alongside strategic investments in ICE catheter technology.

    02

    Hypertension Management with Symplicity Spyral

    The Symplicity Spyral system for renal denervation is gaining significant traction, annualizing at $100 million in revenue and doubling weekly procedure volumes since the NCD. Long-term data presented at CRT reinforced sustained systolic blood pressure reductions, highlighting its potential to redefine hypertension management for 18 million uncontrolled patients in the U.S.

    03

    Hugo Robotic Surgical System Momentum

    The Hugo robotic system is demonstrating strong early impact, with worldwide procedure volume growth 2-3x the market rate and increasing utilization. Medtronic recently submitted for FDA 510(k) clearance for general surgery and gynecologic indications, as well as for its LigaSure RAS vessel sealer, expanding its capabilities. The Touch Surgery Digital Ecosystem now has over 1,400 installations, up 30% sequentially.

    04

    Altaviva and Pelvic Health Growth

    Altaviva, Medtronic's urge urinary incontinence device, is building momentum with nearly 1,000 physicians trained since launch. Sequentially, active implanters are up 3x and patients treated are up 2.5x, indicating accelerating adoption as physicians gain experience and navigate prior authorizations more efficiently.

    05

    Strategic M&A and Venture Investments

    Medtronic completed the MiniMed IPO and made significant strategic investments, including the acquisition of Cath Works (FFRangio system for coronary decision-making), planned acquisitions of Scientia (neurovascular) and SPR Therapeutics (chronic pain), and investments in Beluga Medical and CardioACC (ICE catheters). These tuck-in investments, totaling nearly $2 billion in Q4, are aimed at accelerating innovation and growth in high-growth adjacencies.

    06

    Neuroscience Portfolio Strength

    The neuroscience portfolio delivered 3% revenue growth globally, with strong performance in Cranial and Spinal Technologies (CST) driven by Stealth AXiS, which received FDA and CE Mark clearances. Neurovascular grew 6%, supported by innovation and the planned Scientia acquisition. Pelvic Health saw solid Altaviva growth, and Neuromodulation is a strategic focus with expansion in BVNA and the SPR Therapeutics acquisition.

    07

    Operational Rigor and Financial Performance

    Medtronic achieved Q4 adjusted EPS of $1.55 and FY26 adjusted EPS of $5.53, ahead of expectations. Adjusted gross margin improved by 30 basis points year-over-year, driven by disciplined pricing and COGS efficiency programs. Free cash flow reached $5.4 billion in FY26, the strongest since 2022, positioning the company favorably for M&A.

    AI-generated summary of the company’s earnings call. Not investment advice.