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(Repeats story published on Jan 20, no changes)
By Lewis Krauskopf
NEW YORK, Jan 20 (Reuters) - In a beaten-up stock market, Intuitive Surgical Inc stands out as the best-performing large-cap U.S. healthcare stock that is not an acquisition target.
Shares of Intuitive, which boasts a dominant position in surgical robotic systems, have climbed 13 percent over six months. Over the same period, the Standard & Poor's healthcare sector index has slid 13 percent, and the only stock in the index to top Intuitive's performance was Baxalta Inc , which recently agreed to be acquired for $32 billion by Shire Plc.
Intuitive's signature product, the $1.5 million da Vinci robotic system used in gynecological and prostate surgeries, has been used in more procedures and the company has seen improving profit margins, said RBC Capital Markets analyst Brandon Henry.
"They're kind of clicking on all cylinders" in recent quarters, he said.
A test for the stock's momentum could come after the market closes on Thursday, when the $20 billion market-cap company reports fourth-quarter results. The Sunnyvale, California, company has already announced that it expects a 12 percent increase in fourth-quarter revenue, which topped analysts' views, and expects procedures using the da Vinci system to rise about 9 percent to 12 percent in 2016.
It was unclear whether investors will find more to like in Thursday's report, or sell on confirmation of the pre-report. Pricing in the options market on Wednesday suggested a move of 6.3 percent in either direction by Friday.
With the S&P healthcare index down 7 percent on the year, Intuitive Surgical is one of only a few in the index in positive territory for 2016.
Intuitive's dominance in its market appealed to Baltimore investment counselor D.F. Dent & Co, which owned about 170,000 shares as of the latest filing data.
"If you run a hospital and want to buy a surgical robot, Intuitive Surgical is basically the only option you have," said Gary Wu, vice president at D.F. Dent.
Wu said D.F. Dent was neither adding to or reducing its position. He said some investors could be reluctant to purchase Intuitive shares because of its valuation.
At $556 a share, the stock is trading at about 27 times forward 12 months earnings estimates, nearly double the 15 times for the broader S&P 500 index. Still, a pricey multiple is not unusual for the company, with its current P/E ratio below the 35 times the stock has traded at on average over the past decade.
Looming competition could sway the stock going forward.
Large medical device companies, such as Johnson & Johnson and Medtronic, are developing competing robotics products as are smaller firms such as Titan Medical Inc and TransEnterix.
"Intuitive has been the only game in town for the last 10 years," said Greg Chodaczek, an analyst at Sterne Agee CRT. In Medtronic and J&J, "you have two formidable competitors on the horizon."
On Thursday, the company is expected to provide a more complete picture of its results, including its quarterly earnings and margins.
"The stock has had a decent move, so if they don't say anything new, do folks take some of the profits and wait until next quarter? Maybe," said Tao Levy, an analyst at Wedbush Securities, who is bullish on the prospect for adoption of robotic procedures and rates the stock "outperform." (Reporting by Lewis Krauskopf, additional reporting by Saqib Iqbal Ahmed; Editing by David Gregorio; editing by Linda Stern and David Gregorio)