NeuroPace RNS Reimbursement Surge to $31,526, 2025 Revenue Up 25%
NeuroPace reported 2025 revenue of $100 million, up 25% year-over-year, with fourth-quarter RNS system sales rising 26% to $22.4 million and gross margin expanding to 80.5%. CMS’s Jan 1, 2026 reimbursement updates boost hospital payments for replacement procedures to $31,526 and physician fees by up to 45%, supporting 81.5–82.5% margin guidance.
1. Medicare Reimbursement Tailwinds
Effective January 1, 2026, CMS increased physician payments for RNS implantation and replacement by about 43% and 45%, respectively, and raised hospital reimbursement for replacement procedures to $31,526 from $21,444, enhancing procedure economics and supporting unit-economics as volume scales.
2. 2025 Financial Performance
NeuroPace delivered $100 million in 2025 revenue, up 25% year over year, driven by RNS system sales of $22.4 million in the fourth quarter (up 26%), service revenue of $0.9 million, and margin expansion with RNS gross margin at 80.5% and overall gross margin at 77.4%.
3. 2026 Outlook and Guidance
Management forecasts 2026 revenue of $98–100 million with core RNS growth of 20%–22%, first-quarter revenue of $21–22 million, adjusted operating expenses of $90–92 million and an adjusted EBITDA loss of $9–11 million, while targeting an adjusted gross margin of 81.5%–82.5%.
4. Platform Innovations and Indication Pipeline
The Seizure ID AI feature is expected to gain FDA approval in the first half of 2026 with no additional subscription fee, Remote Care submission is planned later in 2026, and a premarket approval supplement for idiopathic generalized epilepsy was filed in December 2025, offering long-term demand optionality.