Inspire Medical Systems Stock Earnings Reports

Inspire Medical Systems reported Q1 2026 revenue of $204.6M (up 1.6%) but faced meaningful near-term headwinds from coding/reimbursement uncertainty (commercial/Medicare CPT differences) and the Medicare WISER prior-authorization pilot in six states. Management estimates these disruptions reduced Q1 revenue by about $20M and now expect the total 2026 impact from coding/WISER to be roughly $120M–$150M, prompting a revised full-year revenue outlook of $825M–$875M (down vs. prior guidance). Adjusted operating margin is now expected at 2%–4% and adjusted diluted EPS $0.75–$1.25. The company emphasizes disciplined cost control, targeted investments in revenue-generating activities (reimbursement support, field reimbursement staffing, marketing, digital experience, R&D), and maintaining a strong balance sheet ($400M cash/investments, no debt). Management believes the long-term solution is a new single-lead CPT code (potentially effective 01/01/2028) and is implementing short-term coding remedies (e.g., CMS C-code for Inspire V facility payments) while supporting centers on prior authorizations. Clinical and real-world data programs (Inspire V trial, ADHERE 5k cohort, PREDICTOR publication, cardiovascular outcomes studies) were highlighted as ongoing drivers of long-term adoption. Management expects Q2 to show the biggest near-term revenue pressure (estimated $40M–$50M impact), with sequential improvement in H2 2026 as centers gain experience and confidence with coding and WISER processes.