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Inspire Medical Systems
(NYSE:INSP)
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Rating:61Neutral
Price Target:
$55.00
▼(-4.50% Downside)
Action:Reiterated
Date:05/09/26
INSP’s score is supported primarily by strong financial performance (rapid growth, very high gross margins, improving profitability/cash flow, and a low-leverage balance sheet). The score is held back by weak technicals (sharp downtrend across all key moving averages with bearish MACD) and a cautious near-term outlook from the latest earnings call due to significant reimbursement/WISER headwinds and reduced 2026 guidance; valuation is also a drag given the negative P/E and no dividend yield provided.
Positive Factors
Very high gross margins
Sustained gross margins above ~85% indicate strong product-level economics and pricing power for an implanted therapy. High margins provide structural resilience to reimbursement pressure, enable reinvestment in commercialization and R&D, and support long-term profitability even if volumes fluctuate.
Negative Factors
Coding and payer ambiguity
Persistent coding differences across payers create structural case approval friction, increasing administrative burden and delaying procedures. Because a permanent CPT solution isn't expected until 2028, this reduces revenue predictability, raises commercial costs, and hampers consistent procedure volumes for multiple quarters.
Read all positive and negative factors
Positive Factors
Negative Factors
Very high gross margins
Sustained gross margins above ~85% indicate strong product-level economics and pricing power for an implanted therapy. High margins provide structural resilience to reimbursement pressure, enable reinvestment in commercialization and R&D, and support long-term profitability even if volumes fluctuate.
Read all positive factors
Inspire Medical Systems Key Performance Indicators (KPIs)
Any
Revenue by Geography
Shows how much revenue comes from the U.S. versus international markets. For Inspire Medical Systems, a U.S.-heavy mix points to strong domestic clinical adoption and reimbursement, while rising international sales signal successful approvals and new growth lanes. Large geographic concentration increases exposure to U.S. policy or payer changes; broadening global sales can smooth growth and reduce single-market risk.
Shows how much revenue comes from the U.S. versus international markets. For Inspire Medical Systems, a U.S.-heavy mix points to strong domestic clinical adoption and reimbursement, while rising international sales signal successful approvals and new growth lanes. Large geographic concentration increases exposure to U.S. policy or payer changes; broadening global sales can smooth growth and reduce single-market risk.
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The Fly
The FlyInspire Medical Systems (INSP) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$1.48B
Dividend YieldN/A
Average Volume (3M)1.07M
Price to Earnings (P/E)11.5
Beta (1Y)0.60
Revenue Growth8.94%
EPS Growth102.92%
CountryUS
Employees1,246
SectorHealthcare
Sector Strength45
IndustryMedical - Devices
Share Statistics
EPS (TTM)4.53
Shares Outstanding28,813,152
10 Day Avg. Volume1,359,144
30 Day Avg. Volume1,069,062
Financial Highlights & Ratios
PEG Ratio0.11
Price to Book (P/B)3.47
Price to Sales (P/S)2.97
P/FCF Ratio34.52
Enterprise Value/Market Cap0.75
Enterprise Value/Revenue1.22
Enterprise Value/Gross Profit1.42
Enterprise Value/Ebitda13.93
Forecast
1Y Price Target
$51.91Price Target Upside-9.86% Downside
Rating ConsensusHold
Number of Analyst Covering13
EPS Forecast (FY)0.9
Revenue Forecast (FY)$843.82M
Inspire Medical Systems Business Overview & Revenue Model
Company Description
Inspire Medical Systems, Inc. operates as a medical technology enterprise, concentrating on the development and commercialization of advanced, minimally intrusive therapies for patients diagnosed with obstructive sleep apnea (OSA) across both dome...
How the Company Makes Money
Inspire Medical Systems primarily makes money by selling its Inspire therapy system for obstructive sleep apnea. Revenue is generated mainly from U.S. and international sales of the implantable neurostimulation device and its associated components...
Inspire Medical Systems Earnings Call Summary
Earnings Call Date:May 04, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Aug 03, 2026
Earnings Call Sentiment Neutral
Balanced/Neutral — The company delivered modest revenue growth, margin expansion, stronger operating cash flow, a solid cash position, and meaningful clinical progress, but faces material near-term headwinds from coding and reimbursement uncertainty and the WISER pilot that prompted a significant revenue guide reduction and short-term profitability pressure. Management outlined actions to mitigate the disruption (education, field reimbursement hiring, inventory strategy, targeted investments) and expects improvement later in 2026, while a permanent coding solution (new CPT) is not expected until 2028.Positive Updates
Revenue Growth Despite Headwinds
Revenue increased 1.6% year-over-year to $204.6 million in Q1 2026, driven by increased market penetration despite coding/reimbursement and WISER-related disruptions.
Negative Updates
Coding and Reimbursement Uncertainty
Significant ambiguity between Medicare and commercial coding for Inspire V (Medicare MACs using C-code/64582, many commercial payers still using 64568 or 64999), requiring manual reviews and creating case submission slowdowns and pipeline reduction.
Read all updates
Q1-2026 Updates
Positive
Negative
Revenue Growth Despite Headwinds
Revenue increased 1.6% year-over-year to $204.6 million in Q1 2026, driven by increased market penetration despite coding/reimbursement and WISER-related disruptions.
Read all positive updates
Company Guidance
On the Q1 2026 call Inspire revised full‑year revenue to $825–$875M, citing an estimated $120–$150M total adverse impact this year from coding/reimbursement uncertainty and the WISER pilot (six states); Q1 revenue was $204.6M (up 1.6%) and management estimated Q1 was hurt by ~ $20M with a $40–$50M headwind forecast for Q2, implying a 9–11% year‑over‑year revenue decline for 2026. Profitability guidance was updated to adjusted operating margin of 2–4%, diluted EPS $0.07–$0.62, adjusted diluted EPS $0.75–$1.25, an expected effective tax rate of 65–70% (adjusted 27–29%), and an anticipated Q2 adjusted operating loss of $10–$15M; in Q1 adjusted EBITDA margin improved 100 bps to 17.5%, adjusted diluted EPS was $0.10 (GAAP diluted EPS loss $0.39), and Q1 effective tax rate was 571.2% (Q1 adjusted effective tax rate 25.7%). Cash flow and operational metrics include Q1 operating cash flow $12.8M (up ~$20M YoY), $400M cash and investments, no debt, ~284 U.S. territories, 288 U.S. field clinical reps (13 hired in the quarter), ~29.4M weighted average diluted shares, and capex guidance of $40–$45M; management noted a long‑term CPT code target effective January 1, 2028.Inspire Medical Systems Financial Statement Overview
Summary
Income Statement
84
Very Positive
Balance Sheet
90
Very Positive
Cash Flow
78
Positive
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 915.25M | 911.98M | 802.80M | 624.80M | 407.86M | 233.39M |
| Gross Profit | 785.06M | 778.76M | 679.82M | 528.22M | 341.74M | 200.12M |
| EBITDA | 80.09M | 79.79M | 65.03M | -17.06M | -40.73M | -38.62M |
| Net Income | 131.14M | 145.42M | 53.51M | -21.15M | -44.88M | -42.04M |
Balance Sheet | ||||||
| Total Assets | 911.38M | 907.32M | 808.38M | 676.81M | 564.88M | 295.08M |
| Cash, Cash Equivalents and Short-Term Investments | 283.83M | 308.27M | 445.55M | 460.38M | 451.41M | 214.47M |
| Total Debt | 29.55M | 32.16M | 31.79M | 24.85M | 16.41M | 34.09M |
| Total Liabilities | 119.04M | 126.16M | 118.69M | 104.30M | 68.87M | 66.04M |
| Stockholders Equity | 792.34M | 781.16M | 689.70M | 572.51M | 496.01M | 229.05M |
Cash Flow | ||||||
| Free Cash Flow | 96.71M | 78.48M | 91.12M | 1.02M | 2.47M | -24.79M |
| Operating Cash Flow | 136.53M | 116.98M | 130.25M | 24.65M | 11.57M | -20.12M |
| Investing Cash Flow | 11.75M | 21.45M | -113.12M | -294.82M | -19.60M | 29.14M |
| Financing Cash Flow | -103.17M | -183.45M | -52.39M | 13.95M | 235.08M | 14.95M |
Inspire Medical Systems Technical Analysis
Positive
57.59
Price Trends
44.70
Positive
50.90
Positive
70.69
Negative
Market Momentum
1.84
Negative
71.35
Negative
91.31
Negative
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For INSP, the sentiment is Positive. The current price of 57.59 is above the 20-day moving average (MA) of 45.05, above the 50-day MA of 44.70, and below the 200-day MA of 70.69, indicating a neutral trend. The MACD of 1.84 indicates Negative momentum. The RSI at 71.35 is Negative, neither overbought nor oversold. The STOCH value of 91.31 is Negative, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for INSP.
Inspire Medical Systems Risk Analysis
Inspire Medical Systems disclosed 60 risk factors in its most recent earnings report. Inspire Medical Systems reported the most risks in the "Legal & Regulatory" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Inspire Medical Systems Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
71 Outperform | $4.53B | 41.59 | 9.13% | ― | 12.40% | ― | |
69 Neutral | $2.49B | 14.20 | 41.92% | ― | 30.24% | 244.83% | |
61 Neutral | $1.48B | 11.47 | 17.98% | ― | 8.94% | 102.92% | |
61 Neutral | $3.12B | 23.04 | 8.23% | ― | 5.48% | 77.43% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
49 Neutral | $3.87B | -135.69 | -20.60% | ― | 27.36% | 72.52% | |
48 Neutral | $1.12B | -11.47 | -27.70% | ― | 29.26% | -7.59% |
* Healthcare Sector Average
INSP
Inspire Medical Systems
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Inspire Medical Systems Corporate Events
Business Operations and StrategyRegulatory Filings and Compliance
Inspire Medical Hosts June Investor Meetings and Presentation
Neutral
Jun 26, 2026
In June 2026, Inspire Medical Systems plans to meet with investors and analysts, using a prepared set of presentation materials to support its discussions. The company has made these materials available through its investor relations website, unde...
Business Operations and StrategyExecutive/Board ChangesRegulatory Filings and ComplianceShareholder Meetings
Inspire Medical Shareholders Approve Board Declassification and Governance Changes
Positive
May 5, 2026
At its April 30, 2026 annual meeting, Inspire Medical Systems’ stockholders approved a key amendment to the company’s certificate of incorporation to phase out its classified board structure, moving to annual elections for all director...
Business Operations and StrategyFinancial Disclosures
Inspire Medical Cuts 2026 Outlook Amid Reimbursement Headwinds
Negative
May 4, 2026
Inspire Medical Systems reported first‑quarter 2026 results on May 4, 2026, showing revenue up 1.6% year over year to $204.6 million and gross margin improving to 86.5%, driven by a higher mix of its Inspire V system. The company posted a ne...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.