CMS coding update puts Inspire Medical Systems (INSP) in focus

Recent confirmation that new CMS hypoglossal nerve stimulation C codes will share the same APC 5465 as CPT 64582, keeping hospital facility fees broadly unchanged, has put Inspire Medical Systems (INSP) back on investor watchlists.

The latest CMS coding clarity arrives as the share price trades at US$54.99, with a 1 day share price return of 2.52% and a 7 day share price return of 9.69%, contrasting with a 1 year total shareholder return of 61.26% and a 5 year total shareholder return of 74.83%.

If this kind of reimbursement driven move has your attention, it can be useful to widen the lens and see what is happening across other healthcare AI names through the 36 healthcare AI stocks.

With the share price sitting at US$54.99, a value score of 5 and a quoted analyst price target of US$79.42, you have to ask: is Inspire Medical Systems undervalued, or is the market already pricing in future growth?

Most Popular Narrative: 30.8% Undervalued

With Inspire Medical Systems last closing at $54.99 against a narrative fair value of $79.42, the current pricing gap is built around reimbursement assumptions and future earnings power.

Expanded coverage and proposed reimbursement increases for Inspire's procedures (notably the expected 2026 Medicare OPPS rule enhancements and near-complete payer coverage of the new CPT code) will reduce patient out-of-pocket costs and incentivize additional adoption, supporting both revenue growth and longer-term earnings visibility.

Consider what kind of revenue path and margin profile are needed to back that fair value, and how much earnings compression is built into the story.

Result: Fair Value of $79.42 (UNDERVALUED)

However, there are still clear pressure points, including a slower Inspire V rollout and potential shifts in sleep apnea treatments, that could challenge these reimbursement driven expectations.

Next Steps

With the article highlighting both upside potential and real risks, the key is to move quickly, review the underlying data, and decide where you stand based on the 3 key rewards.

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This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.