Core Viewpoint - Inspire Medical Systems is navigating reimbursement and coding uncertainties related to its Inspire 5 system, which could significantly impact professional fees and revenue outlook for 2026 [3][4][16]. Financial Performance - Q4 2025 revenue was $269 million, representing a 12% increase, while full-year revenue reached $912 million, up 14% [5][11]. - The company reported a net income per diluted share of $4.66 for Q4 and $4.89 for the full year, both showing substantial increases from the previous year [15]. - Cash and investments totaled $405 million, with share buybacks amounting to $175 million for the full year [5][15]. Coding and Reimbursement - The coding for the Inspire 5 procedure is expected to transition to CPT 64582 with a -52 modifier, potentially reducing professional fees by 10% to 50% [3][6][17]. - Inspire has revised its 2026 revenue guidance to a range of $950 million to $1.0 billion, reflecting the impact of coding changes and physician reimbursement uncertainties [13][16]. Operational Updates - Over 90% of centers are now implanting the Inspire 5 system, with significant progress in the U.S. launch [14]. - The company is nearing completion of manufacturing for Inspire 4 systems and expects stable inventory through 2026 [9]. Clinical and R&D Developments - Inspire 5 has shown promising clinical results, with a 79.5% responder rate in a Singapore study, compared to 66% in the STAR Phase III trial [8]. - The company has received FDA approval for 3 Tesla MRI compatibility and is advancing R&D towards Inspire 6, which will include enhanced features for sleep detection and therapy activation [10]. Marketing and Cost Management - Inspire is focusing on cost discipline and flexibility in spending, with marketing efforts expected to remain flat to slightly up, emphasizing social media and digital channels [18].