Procept BioRobotics Receives Favorable CMS Decision, Boosting Aquablation Growth and Earnings Expectations.

Procept BioRobotics (PRCT) received a positive outlook from Leerink after the Centers for Medicare & Medicaid Services (CMS) proposed OPPS rule for 2026. Aquablation, a key procedure for Procept, will maintain its association with the level 6 Ambulatory Payment Classification (APC) code, with a payment rate increase to approximately $9,765, up from $9,247, marking a 5.6% rise year-over-year. Leerink finds this increase significant, as it is expected to further drive the growth of Aquablation procedures, and maintains an Outperform rating ahead of the upcoming Q2 earnings report.

Procept BioRobotics (PRCT) has received a positive outlook from Leerink following the Centers for Medicare & Medicaid Services (CMS) proposed OPPS rule for 2026. The firm highlighted that the Aquablation procedure, a key offering for Procept, will maintain its association with the level 6 Ambulatory Payment Classification (APC) code, with a payment rate increase to approximately $9,765, up from $9,247. This represents a 5.6% rise year-over-year. Leerink finds this increase significant, as it is expected to further drive the growth of Aquablation procedures. The firm maintains an Outperform rating ahead of the upcoming Q2 earnings report.

The 2026 Medicare Proposed Physician Fee Schedule (PFS) includes payment rates for a new Category I Current Procedural Terminology (CPT) code related to Aquablation therapy. The Category I CPT code 52XX1 will replace the Category III CPT code 0421T as the primary code for Aquablation therapy [2]. This transition recognizes the clinical value and widespread use of Aquablation therapy, which is designed to deliver durable symptom relief with a low risk of sexual side effects.

Leerink is encouraged by the healthy magnitude of the increase in the payment rate, which should support continued utilization growth for Aquablation procedures broadly. While its base case expectation was that Aquablation would remain mapped to its level 6 APC code, the firm’s impression is that the possibility of potential APC down-coding within the 2026 CMS OPPS was a consideration for some Procept’s bears based on its recent investor discussions. However, the update effectively takes that outcome off the table and is incrementally de-risking for shares. Overall, Leerink continues to like the risk-reward setup for Outperform-rated Procept both into Q2 EPS and beyond.

The proposed OPPS rule also includes a net 2.4% increase in Medicare hospital outpatient prospective payment system rates in calendar year 2026 compared to 2025 [3]. This includes a proposed 3.2% market basket update, offset by a 0.8 percentage point cut for productivity. The AHA expressed disappointment with the "inadequate" payment update, stating that many hospitals, especially those in rural and underserved communities, operate under challenging financial pressures.

References:
[1] https://www.tipranks.com/news/the-fly/leerink-sees-positive-readthrough-for-procept-after-cms-opps-proposed-rule-thefly?utm_medium=referral&utm_source=edition.cnn.com
[2] https://www.globenewswire.com/news-release/2025/07/15/3115292/0/en/Aquablation-Therapy-s-Assigned-Category-I-Code-in-2026-Medicare-Proposed-Physician-Fee-Schedule.html
[3] https://www.aha.org/news/headline/2025-07-15-cms-proposes-increasing-medicare-hospital-outpatient-department-payment-rates-24-cy-2026