Inspire Medical Systems, Inc. (INSP) Cash Flow Statement

NYSE: INSPOperating cash, capex, free cash flow and buybacks.

Where INSP’s cash came from and went, 2025

December 31, 2025 · U.S. dollars
Cash from operations
$117.0M
−10.2% vs 2024
Capital expenditures
$38.5M
4.2% of revenue
Free cash flow
$78.5M
8.6% margin
Returned to shareholders
$175.0M
223% of free cash flow
Change in cash
−$45.3M
cash at year-end $104.8M
Cash from operations: $117.0MCash from operations$117.0MInvestments (net): $59.9MInvestments (net)$59.9MDrawn from cash: $45.3MDrawn from cash$45.3MShare buybacks: $175.0MShare buybacks$175.0M · 79%Capital expenditures: $38.5MCapital expenditures$38.5M · 17%Other financing: $8.4MOther financing$8.4M · 4%$222.3M
Cash from operations
$117.0M
Capital expenditures
−$38.5M
Investments (net)
+$59.9M
Share buybacks (net)
−$175.0M
Other financing
−$8.4M
Change in cash
−$45.3M

Drawn to scale: where the cash came from and how it was used. Hover for values.

INSP operating cash flow, capex and free cash flow

Operating cash flowCapital expendituresFree cash flowFCF margin (right axis)

INSP cash flow trends, 2016–2025

Inspire Medical Systems, Inc. cash flow trends
MetricTrendThenLatestChange
Operating cash flow−$17.9M2016$117.0M2025—
Capital expenditures$306,0002016$38.5M2025+71.1%/yr
Free cash flow−$18.3M2016$78.5M2025—
Free cash flow margin−111.1%20168.6%2025+119.7 pts
Operating cash flow / net income2.4320240.802025−1.63
Stock-based compensation$248,0002016$130.3M2025+100.6%/yr
Share buybacks (net)$02016$175.0M2025—
Capex / revenue1.9%20164.2%2025+2.4 pts

Change is the average annual growth (CAGR) or the difference between the first and latest year.

INSP cash flow by activity

OperatingInvestingFinancingChange in cash

INSP net income vs operating cash flow

Net incomeOperating cash flow

Operating cash flow above net income usually means earnings are backed by cash (depreciation and stock-based pay are non-cash expenses).

INSP cash flow statement

Inspire Medical Systems, Inc. annual cash flow statement
2025202420232022202120202019201820172016
Operating activities
Net income$145.4M$53.5M−$21.2M−$44.9M−$42.0M−$57.2M−$33.2M−$21.8M−$17.5M−$18.5M
Depreciation & amortization$14.0M$6.5M$2.8M$1.9M$1.2M$840,000$1.4M$393,000$285,000$103,000
Stock-based compensation$130.3M$116.0M$82.5M$52.0M$26.2M$12.8M$6.2M$1.2M$243,000$248,000
Change in working capital−$87.4M−$37.7M−$40.8M$1.8M−$6.9M−$10.9M−$6.6M$861,000$777,000$243,000
Other non-cash items−$85.3M−$8.1M$1.3M$812,000$1.4M$1.4M−$1.2M$661,000$415,000−$15,000
Cash from operating activities$117.0M$130.2M$24.7M$11.6M−$20.1M−$53.0M−$33.4M−$18.7M−$15.8M−$17.9M
Investing activities
Capital expenditures−$38.5M−$39.1M−$23.6M−$9.1M−$4.7M−$2.5M−$2.7M−$250,000−$412,000−$306,000
Investments (net)$59.9M−$113.1M−$146.0M−$10.5M$33.8M$89.1M−$40.8M−$83.1M−$7.6M−$306,000
Acquisitions & other investing$0$39.1M−$125.1M$0$0$0$0$0$412,000$306,000
Cash from investing activities$21.4M−$113.1M−$294.8M−$19.6M$29.1M$86.6M−$43.6M−$83.4M−$7.6M−$306,000
Financing activities
Share repurchases & issuance (net)−$175.0M−$75.0M−$17.2M−$43,000$3.5M$2.4M$1.4M$182.4M$25.2M$12.8M
Net borrowing (repayment)—$0$0−$24.5M−$24.5M−$24.5M−$531,000$8.0M$458,000$458,000
Shares issued$0$0$0$243.8M$0$124.7M$124.7M$181.8M$0$0
Other financing−$8.4M$22.6M$31.1M$15.8M$36.0M$31.6M−$123.0M−$181.8M$0−$458,000
Cash from financing activities−$183.4M−$52.4M$13.9M$235.1M$14.9M$134.1M$2.5M$190.4M$25.7M$12.8M
Summary
Net change in cash−$45.3M−$35.4M−$256.1M$227.1M$23.9M$167.7M−$74.4M$88.3M$2.3M−$5.4M
Cash at end of period$104.8M$150.2M$185.5M$441.6M$214.5M$190.5M$22.9M$97.3M$9.0M$6.7M
Free cash flow$78.5M$91.1M$1.0M$2.5M−$24.8M−$55.5M−$35.6M−$18.9M−$16.2M−$18.3M
Free cash flow margin8.6%11.4%0.2%0.6%−10.6%−48.1%−43.4%−37.4%−56.7%−111.1%
Capex / revenue4.2%4.9%3.8%2.2%2.0%2.1%3.3%0.5%1.4%1.9%
Operating cash flow / net income0.802.43————————

Negative numbers are cash paid out. Quarterly columns are labeled by the month the quarter ended. Figures in U.S. dollars as reported; data from EODHD.

INSP cash generation

In fiscal 2025 (ended December 31, 2025), Inspire Medical Systems generated $117.0 million of cash from operations (down 10.2%) and spent $38.5 million on capital expenditures, leaving free cash flow of $78.5 million, 8.6% of revenue. It returned $175.0 million to shareholders through dividends ($0) and net share buybacks ($175.0 million). Cash and equivalents fell by $45.3 million over the year.

Related: INSP income statement, INSP balance sheet. See the INSP stock overview for the latest quote and news.

INSP cash flow FAQ

What is Inspire Medical Systems's free cash flow?

Inspire Medical Systems's free cash flow was $78.5 million in fiscal 2025: $117.0 million of operating cash flow minus $38.5 million of capital expenditures It was $91.1 million a year earlier..

How much cash does Inspire Medical Systems generate from operations?

Inspire Medical Systems generated $117.0 million of cash from operating activities in fiscal 2025, 0.80 times its net income of $145.4 million.

How much does Inspire Medical Systems spend on capital expenditures?

Inspire Medical Systems spent $38.5 million on capital expenditures in fiscal 2025, 4.2% of revenue, compared with $39.1 million the year before.

How much stock does Inspire Medical Systems buy back?

Inspire Medical Systems spent $175.0 million on net share repurchases in fiscal 2025.

Medical Devices: cash flow