Inspire expects a rebound before its new billing codes arrive

Inspire Medical Systems expects to return to low-single-digit revenue growth in 2027. The sleep-apnea device maker's new billing codes will not take effect until January 2028.

Inspire plans to support that growth by helping physicians navigate the existing codes and improving how it attracts and guides patients.

There are signs of progress. Q3 revenue rose 3% from Q2 to $206.7 million, with management citing improving U.S. sales. But revenue remained 7.9% below a year earlier.

What has to improve before 2028

Inspire says the American Medical Association approved new codes in September for single-lead devices that stimulate a tongue nerve to treat sleep apnea. The codes apply to procedures using systems such as Inspire V, but their Medicare payment values still have to be determined.

In the meantime, procedures continue under existing codes. Inspire says physicians have greater clarity about those codes, and it is investing in customer education and support. Coding and reimbursement uncertainty has weighed on sales this year.

Project Horizon, announced in August, is intended to free approximately $30 million of annual spending for reinvestment in growth. The focus includes helping patients move from an initial inquiry through consultations and treatment, rather than letting them drop out along the way.

The profit pressure extends beyond restructuring

Q3 included $24.1 million of restructuring charges, mostly a noncash write-down of production equipment. Inspire reported an operating loss of $28.7 million.

Its adjusted operating profit removes those charges and selected legal expenses, while also reversing a benefit from forfeited employee stock awards. That left $1.9 million.

Research by Ticker Byline shows that this adjusted profit was about 83% below the $10.9 million reported for the same quarter last year. The weaker result therefore extends beyond the restructuring charge.

A narrower forecast, with the same sales midpoint

Inspire narrowed its 2026 revenue forecast to $850 million to $860 million from $835 million to $875 million. The midpoint remains $855 million. Its adjusted operating margin forecast also narrowed around an unchanged 5% midpoint.

The adjusted earnings forecast is now $1.20 to $1.40 a share, compared with $1.05 to $1.45. The company still expects a GAAP net loss for the year.

The Inspire company profile tracks its latest results, cash position, forecasts and Project Horizon.