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Side-by-side financial comparison of ACI WORLDWIDE, INC. (ACIW) and ICU MEDICAL INC (ICUI). Click either name above to swap in a different company.

ICU MEDICAL INC is the larger business by last-quarter revenue ($540.7M vs $481.6M, roughly 1.1× ACI WORLDWIDE, INC.). ACI WORLDWIDE, INC. runs the higher net margin — 13.4% vs -2.9%, a 16.3% gap on every dollar of revenue. On growth, ACI WORLDWIDE, INC. posted the faster year-over-year revenue change (6.3% vs -14.1%). ACI WORLDWIDE, INC. produced more free cash flow last quarter ($116.6M vs $36.0M). Over the past eight quarters, ACI WORLDWIDE, INC.'s revenue compounded faster (23.4% CAGR vs -2.3%).

ACI Worldwide is a digital payments software company headquartered in Elkhorn, Nebraska, that processes billions of transactions daily equating to trillions of U.S. dollars for customers in 94 countries. Banks, financial institutions, merchants, billers, acquirers, issuers, and other third-party payment service providers use its intelligent solutions to deploy secure payment rails across all channels.

ICU Medical, Inc. is a medical technology company based in San Clemente, California. ICU Medical products are designed to prevent bloodstream infections and protect healthcare workers from exposure to infectious diseases or hazardous drugs. ICU Medical product line includes intravenous therapy (IV) products, pumps, needle-free vascular access devices, custom infusion sets, closed system hazardous drug handling devices and systems, sensor catheters, needle-free closed blood sampling systems, a...

ACIW vs ICUI — Head-to-Head

Bigger by revenue
ICUI
ICUI
1.1× larger
ICUI
$540.7M
$481.6M
ACIW
Growing faster (revenue YoY)
ACIW
ACIW
+20.5% gap
ACIW
6.3%
-14.1%
ICUI
Higher net margin
ACIW
ACIW
16.3% more per $
ACIW
13.4%
-2.9%
ICUI
More free cash flow
ACIW
ACIW
$80.6M more FCF
ACIW
$116.6M
$36.0M
ICUI
Faster 2-yr revenue CAGR
ACIW
ACIW
Annualised
ACIW
23.4%
-2.3%
ICUI

Income Statement — Q4 FY2025 vs Q4 FY2025

Metric
ACIW
ACIW
ICUI
ICUI
Revenue
$481.6M
$540.7M
Net Profit
$64.3M
$-15.7M
Gross Margin
53.0%
37.5%
Operating Margin
22.6%
1.0%
Net Margin
13.4%
-2.9%
Revenue YoY
6.3%
-14.1%
Net Profit YoY
-34.7%
34.0%
EPS (diluted)
$0.61
$-0.63

Green = leading value per metric. Periods may differ when fiscal calendars don't align.

8-Quarter Revenue & Profit Trend

Side-by-side quarterly history. Quarters aligned by calendar period so offset fiscal years line up.

Revenue
ACIW
ACIW
ICUI
ICUI
Q4 25
$481.6M
$540.7M
Q3 25
$482.4M
$537.0M
Q2 25
$401.3M
$548.9M
Q1 25
$394.6M
$604.7M
Q4 24
$453.0M
$629.8M
Q3 24
$451.8M
$589.1M
Q2 24
$373.5M
$596.5M
Q1 24
$316.0M
$566.7M
Net Profit
ACIW
ACIW
ICUI
ICUI
Q4 25
$64.3M
$-15.7M
Q3 25
$91.3M
$-3.4M
Q2 25
$12.2M
$35.3M
Q1 25
$58.9M
$-15.5M
Q4 24
$98.6M
$-23.8M
Q3 24
$81.4M
$-33.0M
Q2 24
$30.9M
$-21.4M
Q1 24
$-7.8M
$-39.5M
Gross Margin
ACIW
ACIW
ICUI
ICUI
Q4 25
53.0%
37.5%
Q3 25
53.7%
37.4%
Q2 25
41.5%
37.9%
Q1 25
45.9%
34.7%
Q4 24
55.8%
36.1%
Q3 24
56.3%
34.8%
Q2 24
45.6%
34.8%
Q1 24
39.5%
32.7%
Operating Margin
ACIW
ACIW
ICUI
ICUI
Q4 25
22.6%
1.0%
Q3 25
26.5%
2.6%
Q2 25
8.7%
1.9%
Q1 25
14.8%
2.1%
Q4 24
27.0%
6.0%
Q3 24
27.1%
1.4%
Q2 24
14.4%
1.3%
Q1 24
3.0%
-1.9%
Net Margin
ACIW
ACIW
ICUI
ICUI
Q4 25
13.4%
-2.9%
Q3 25
18.9%
-0.6%
Q2 25
3.0%
6.4%
Q1 25
14.9%
-2.6%
Q4 24
21.8%
-3.8%
Q3 24
18.0%
-5.6%
Q2 24
8.3%
-3.6%
Q1 24
-2.5%
-7.0%
EPS (diluted)
ACIW
ACIW
ICUI
ICUI
Q4 25
$0.61
$-0.63
Q3 25
$0.88
$-0.14
Q2 25
$0.12
$1.43
Q1 25
$0.55
$-0.63
Q4 24
$0.92
$-0.97
Q3 24
$0.77
$-1.35
Q2 24
$0.29
$-0.88
Q1 24
$-0.07
$-1.63

Balance Sheet & Financial Strength

Snapshot of each company's liquidity, leverage and book value from the latest quarter.

Metric
ACIW
ACIW
ICUI
ICUI
Cash + ST InvestmentsLiquidity on hand
$196.5M
Total DebtLower is stronger
$817.6M
Stockholders' EquityBook value
$1.5B
$2.1B
Total Assets
$3.1B
$4.1B
Debt / EquityLower = less leverage
0.54×

8-quarter trend — quarters aligned by calendar period.

Cash + ST Investments
ACIW
ACIW
ICUI
ICUI
Q4 25
$196.5M
Q3 25
$199.3M
Q2 25
$189.7M
Q1 25
$230.1M
Q4 24
$216.4M
$308.6M
Q3 24
$177.9M
$312.5M
Q2 24
$157.0M
$302.6M
Q1 24
$183.4M
$251.4M
Total Debt
ACIW
ACIW
ICUI
ICUI
Q4 25
$817.6M
Q3 25
$867.8M
Q2 25
$898.0M
Q1 25
$845.9M
Q4 24
$924.6M
Q3 24
$994.3M
Q2 24
$1.0B
Q1 24
$1.0B
Stockholders' Equity
ACIW
ACIW
ICUI
ICUI
Q4 25
$1.5B
$2.1B
Q3 25
$1.5B
$2.1B
Q2 25
$1.4B
$2.1B
Q1 25
$1.5B
$2.0B
Q4 24
$1.4B
$2.0B
Q3 24
$1.3B
$2.0B
Q2 24
$1.2B
$2.0B
Q1 24
$1.3B
$2.1B
Total Assets
ACIW
ACIW
ICUI
ICUI
Q4 25
$3.1B
$4.1B
Q3 25
$3.2B
$4.1B
Q2 25
$3.1B
$4.1B
Q1 25
$3.2B
$4.2B
Q4 24
$3.0B
$4.2B
Q3 24
$3.1B
$4.3B
Q2 24
$3.4B
$4.3B
Q1 24
$3.3B
$4.3B
Debt / Equity
ACIW
ACIW
ICUI
ICUI
Q4 25
0.54×
Q3 25
0.59×
Q2 25
0.64×
Q1 25
0.57×
Q4 24
0.65×
Q3 24
0.75×
Q2 24
0.82×
Q1 24
0.81×

Cash Flow & Capital Efficiency

How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.

Metric
ACIW
ACIW
ICUI
ICUI
Operating Cash FlowLast quarter
$121.8M
$60.6M
Free Cash FlowOCF − Capex
$116.6M
$36.0M
FCF MarginFCF / Revenue
24.2%
6.6%
Capex IntensityCapex / Revenue
1.1%
4.6%
Cash ConversionOCF / Net Profit
1.89×
TTM Free Cash FlowTrailing 4 quarters
$309.9M
$91.8M

8-quarter trend — quarters aligned by calendar period.

Operating Cash Flow
ACIW
ACIW
ICUI
ICUI
Q4 25
$121.8M
$60.6M
Q3 25
$73.0M
$56.7M
Q2 25
$49.8M
$11.2M
Q1 25
$78.2M
$51.3M
Q4 24
$126.5M
$40.2M
Q3 24
$54.0M
$36.1M
Q2 24
$55.0M
$82.0M
Q1 24
$123.2M
$45.8M
Free Cash Flow
ACIW
ACIW
ICUI
ICUI
Q4 25
$116.6M
$36.0M
Q3 25
$69.6M
$27.6M
Q2 25
$47.6M
$-8.5M
Q1 25
$76.1M
$36.7M
Q4 24
$119.5M
$16.1M
Q3 24
$50.5M
$16.2M
Q2 24
$53.3M
$62.5M
Q1 24
$120.0M
$29.9M
FCF Margin
ACIW
ACIW
ICUI
ICUI
Q4 25
24.2%
6.6%
Q3 25
14.4%
5.1%
Q2 25
11.9%
-1.5%
Q1 25
19.3%
6.1%
Q4 24
26.4%
2.6%
Q3 24
11.2%
2.7%
Q2 24
14.3%
10.5%
Q1 24
38.0%
5.3%
Capex Intensity
ACIW
ACIW
ICUI
ICUI
Q4 25
1.1%
4.6%
Q3 25
0.7%
5.4%
Q2 25
0.5%
3.6%
Q1 25
0.5%
2.4%
Q4 24
1.5%
3.8%
Q3 24
0.8%
3.4%
Q2 24
0.5%
3.3%
Q1 24
1.0%
2.8%
Cash Conversion
ACIW
ACIW
ICUI
ICUI
Q4 25
1.89×
Q3 25
0.80×
Q2 25
4.08×
0.32×
Q1 25
1.33×
Q4 24
1.28×
Q3 24
0.66×
Q2 24
1.78×
Q1 24

Financial Flow Comparison

Revenue → gross profit → operating profit → net profit for each company.

Revenue Breakdown by Segment

ACIW
ACIW

Issuing And Acquiring$183.7M38%
License$158.3M33%
Maintenance$50.8M11%
Software And Platform Service$49.6M10%
Merchant Payments$42.4M9%

ICUI
ICUI

Infusion Consumables$284.7M53%
Infusion Systems$176.3M33%
Vital Care$79.7M15%

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