Free cash flow margin has been highly volatile, ranging from -7.5% in 2025Q1 to 25.9% in 2025Q3 and reaching 18.8% in 2026Q3, indicating cash generation remains sensitive to working capital timing and stock-based compensation of $26.9M per quarter.
Inspire Medical Systems, Inc. (INSP) cash flow statement — 10-year operating, investing & financing cash flows
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 |
|---|
| Cash from Operations | 134.97M | 116.98M | 130.25M | 24.65M | 11.57M | -20.12M | -53.05M | -33.38M | -18.69M | -15.79M | -17.95M |
| Operating CF Margin % | - | 12.83% | 16.22% | 3.95% | 2.84% | -8.62% | -45.97% | -40.68% | -36.95% | -55.28% | -109.27% |
| Operating CF Growth % | 1000.71% | -10.19% | 428.32% | 113.1% | 157.5% | 62.07% | -58.93% | -78.54% | -18.38% | 12.02% | - |
| Net Income | 100.72M | 145.42M | 53.51M | -21.15M | -44.88M | -42.04M | -57.2M | -33.24M | -21.83M | -17.51M | -18.53M |
| Depreciation & Amortization | 18.67M | 13.96M | 6.55M | 2.85M | 1.86M | 1.22M | 840K | 1.4M | 393K | 285K | 103K |
| Stock-Based Compensation | 116.84M | 130.26M | 116.01M | 82.47M | 51.97M | 26.18M | 12.82M | 0 | 1.22M | 243K | 248K |
| Deferred Taxes | 14.55M | -88.75M | 0 | 0 | 0 | 0 | -22K | 0 | -53K | 100K | -195K |
| Other Non-Cash Items | -67.34M | 3.47M | -7.51M | 1.27M | 812K | 1.38M | 1.4M | 5.04M | 714K | 315K | 180K |
| Working Capital Changes | -48.46M | -87.38M | -37.71M | -40.78M | 1.81M | -6.86M | -10.88M | -6.57M | 861K | 777K | 243K |
| Change in Receivables | 3.46M | -26.23M | -2.6M | -30.22M | -27.02M | -9.24M | -11.84M | -6.48M | -2.84M | -1.77M | -760K |
| Change in Inventory | -37.18M | -65.17M | -46.23M | -22M | 5.34M | -8.75M | -2.65M | -3.17M | 1M | -315K | 612K |
| Change in Payables | -17.79M | -3.75M | 604K | 9.3M | 14.36M | 4.78M | 2.05M | 1.03M | 439K | 1.82M | -480K |
| Cash from Investing | -2.57M | 21.45M | -113.12M | -294.82M | -19.6M | 29.14M | 86.63M | -43.56M | -83.39M | -7.6M | -306K |
| Capital Expenditures | -37.08M | -38.5M | -39.12M | -23.63M | -9.1M | -4.67M | -2.46M | -2.74M | -250K | -412K | -306K |
| CapEx % of Revenue | 4.21% | 4.22% | 4.87% | 3.78% | 2.23% | 2% | 2.13% | 3.34% | 0.49% | 1.44% | 1.86% |
| Acquisitions | 0 | 0 | 0 | 0 | 0 | 0 | -89.08M | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 0 | 0 | 0 | 0 | -10.5M | 0 | 89.08M | 0 | -83.14M | -7.19M | 0 |
| Cash from Financing | -54.31M | -183.45M | -52.39M | 13.95M | 235.08M | 14.95M | 134.06M | 2.5M | 190.38M | 25.66M | 12.81M |
| Debt Issued (Net) | 0 | 0 | 0 | 0 | -24.5M | 0 | 0 | 0 | 8M | 458K | 0 |
| Equity Issued (Net) | -44.6M | -160.41M | -47.23M | 31.11M | 259.62M | 14.95M | 134.06M | 2.5M | 182.38M | 25.2M | 12.81M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -50.01M | -175.02M | -75M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | -9.72M | -23.04M | -5.17M | -17.16M | -43K | 0 | 0 | 0 | 0 | 0 | 0 |
| Net Change in Cash | 77.96M | -45.34M | -35.39M | -256.06M | 227.13M | 23.95M | 167.66M | -74.43M | 88.33M | 2.27M | -5.44M |
| Free Cash Flow | 97.89M | 78.48M | 91.12M | 1.02M | 2.47M | -24.79M | -55.5M | -35.59M | -18.94M | -16.2M | -18.25M |
| FCF Margin % | 11.11% | 8.61% | 11.35% | 0.16% | 0.61% | -10.62% | -48.1% | -43.37% | -37.44% | -56.72% | -111.13% |
| FCF Growth % | -0.94% | -13.88% | 8798.73% | -58.59% | 109.98% | 55.34% | -55.96% | -87.84% | -16.92% | 11.24% | - |
| FCF per Share | 3.38 | 2.64 | 2.98 | 0.03 | 0.09 | -0.91 | -2.13 | -1.49 | -1.30 | -1.20 | -1.46 |
| FCF Conversion (FCF/Net Income) | 0.97x | 0.80x | 2.43x | -1.17x | -0.26x | 0.48x | 0.93x | 1.00x | 0.86x | 0.90x | 0.97x |
| Interest Paid | 122K | 0 | 22K | 0 | 2.32M | 1.89M | 0 | 2.03M | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Quick answers to the most common questions about buying INSP stock.
Inspire Medical Systems, Inc. (INSP) generated $117.0M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Inspire Medical Systems, Inc. (INSP) generated $78.5M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Inspire Medical Systems, Inc. (INSP) spent $38.5M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, Inspire Medical Systems, Inc. (INSP) spent $175.0M on share repurchases. This shows the company's commitment to returning capital to its equity investors.
Key Metrics
Top Statement Risk
Operating Cash Flow Volatility
Metrics are mathematically derived from official filings.
Operating Cash Conversion Diverges From Earnings
As reported in financial statements, INSP's operating cash flow has repeatedly departed from net income, with 2026Q2 operating cash flow of $23.2M against net income of just $314.0K, a ratio that signals earnings-to-cash timing gaps rather than stable conversion.
The gap between net income and operating cash flow is the central signal in this dataset, and it cuts in both directions across the ten quarters. Quarters such as 2026Q3, where net loss of $24.4M coincided with operating cash flow of $46.4M, suggest that non-cash charges including the $26.9M of stock-based compensation and $5.1M of depreciation are carrying a large share of cash generation. Investors should monitor whether this add-back dependence persists, since SBC is a real economic cost even when it does not consume cash directly.
Free Cash Flow Margins Swing With Working Capital
Based on INSP's reported figures, free cash flow margin ranged from a negative 7.5% in 2025Q1 to 25.9% in 2025Q3, indicating that quarterly cash generation is highly sensitive to timing rather than tracking a steady underlying trend.
The wide dispersion in FCF margin appears driven more by working capital swings, such as the $42.6M and $43.4M outflows in 2025Q2 and 2025Q1, than by changes in capital intensity, since capex has held in a tight 2.9% to 6.3% of revenue band. The most recent quarters show FCF of $38.9M in 2026Q3 and $14.1M in 2026Q2, which is encouraging but insufficient on its own to confirm a durable trajectory. Analysts should weigh trailing multi-quarter averages more heavily than any single quarter.
Receivable and Inventory Timing Dominates Cash Swings
According to recent SEC filings, INSP's working capital change moved from a $43.4M outflow in 2025Q1 to a $25.4M inflow in 2025Q3, a swing that accounts for most of the quarterly variance in operating cash flow.
Because revenue recognition occurs at shipment and the business is seasonally weighted toward the fourth quarter, year-end receivable collections and inventory drawdowns likely explain the inflow pattern in late-year quarters. The recurring outflows in the first half of the year may reflect inventory rebuilds and receivable build-up ahead of seasonal demand. Without disclosed days-sales-outstanding or inventory turnover in the supplied data, the efficiency of these cycles cannot be verified, and the conclusion should be treated as directional.
Cumulative Cash Lags Reported Profitability
Based on INSP's reported figures across the ten quarters, cumulative operating cash flow appears to track cumulative net income in a broadly similar range, but quarterly distortions from non-operating items indicate reported earnings quality should be treated with caution.
Summing the displayed quarters, the company generated meaningful positive operating cash flow, yet the 2025Q4 net income of $136.1M far exceeded operating cash flow of $52.5M, a divergence that suggests a large non-cash or non-operating contribution. This pattern is consistent with prior income statement findings that operating income was far smaller than reported net income in that quarter. Investors should monitor whether future reported profits are backed by equivalent cash generation over a full cycle.
Stock Compensation Masks Cash Economics
As reported in financial statements, INSP's stock-based compensation of $26.9M to $41.7M per quarter is a material add-back that lifts operating cash flow relative to a cash-cost view of the business.
Adding back SBC of this magnitude means that a meaningful portion of reported operating cash generation reflects equity compensation rather than cash-funded operations, which may overstate the cash economics available to shareholders. Investors may wish to model free cash flow net of SBC to assess the company's true cash-generating capacity. This adjustment is analytical rather than disclosed as a management objective, and the sensitivity of conclusions to it should be considered.