HOPPS CY27: Healthy HOPD Increases; (+)AXGN/INSP/LIVN/GKOS/FOC; (-)PRCT

Research evidence excerpt

HOPPS CY27: Healthy HOPD Increases; (+)AXGN/INSP/LIVN/GKOS/FOC; (-)PRCT

USA | Medical Supplies & Devices EquityJulyResearch2, 2026

HOPPS CY27: Healthy HOPD Increases;

(+)AXGN/INSP/LIVN/GKOS/FOCL; (-)PRCT

Key takes for our coverage from CMS CY27 HOPPS proposal: 1) CMS proposed

payment reductions to 340B drug pricing program, redirected savings leading to

healthy HOPD reimbursement increases; 2) +ve for AXGN, +7-11% increases; 3)

-ve for PRCT due to healthy rates hikes for PAE incl +30%/y/y in ASC setting; 4)

+ve for INSP given +12-15% y/y reimbursement hikes; 5) +ve for GKOS, +13-14%

increase for iStent, iDose in HOPD; 6) +FOCL, +12% increase in HOPD.

CMS released its CY27 hospital outpatient prospective payment system (HOPPS) proposal. CMS

proposed healthy LDD to MT y/y reimbursement increases in the HOPD setting for many

procedure categories relevant to our coverage. This reflects CMS' proposal to reduce payment

rates for drugs purchased under 340B Drug Pricing Program with the related savings redirected

toward non-drug services due to budget neutrality requirements. The public comment period ends

8.31; CMS usually publishes its final rule in Nov.

We note the CMS proposal was positive for Buy-rated AXGN, which remains our top pick. See

company note here.

In BPH, CMS proposed CY27 reimbursement increases in the LDD to MT range in the HOPD

setting incl a +~15% y/y increases for TURP (CPT code 52601), Greenlight, and HOLEP in the

HOPD and +12% increase for PRCT (Hold, Sarcone) Aquablation. Reimbursement for PAE (codes

37242, 37243) received a 13% increase, which has driven an increase in the excess dollar

reimbursement over other respective procedures. CMS also proposed a 33% y/y increase in PAE

reimbursement in the ASC setting.