Mobia Medical makes and sells the Vivistim Paired Vagus Nerve Stimulation (Paired VNS) System, which it describes as the first and only FDA-approved device for treating chronic ischemic stroke survivors with moderate to severe upper extremity impairment. The device works by delivering precisely timed bursts of vagus nerve stimulation paired with physical therapy, triggering the release of neuromodulators that promote neuroplasticity and help patients rebuild motor function. The target patient is a stroke survivor who has plateaued after conventional rehabilitation. Mobia sells the Vivistim System directly to stroke hospitals — primarily the roughly 1,500 primary and comprehensive stroke centers in the U.S. — on a per-procedure basis. The implantable pulse generator and lead are sold as hardware; hospitals stock inventory and reorder as they perform procedures. Mobia uses two types of field sales staff: Territory Managers focused on surgeons and hospital administrators, and Therapy Development Specialists focused on the occupational and physical therapists who administer the therapy. The device carries an attractive gross margin profile, but Mobia runs large operating losses as it invests heavily in building out its commercial organization and creating what is effectively a new treatment category. The biggest adoption barrier is reimbursement — most commercial payers currently classify Vivistim Therapy as experimental, requiring prior authorization. Mobia's growth strategy centers on expanding its sales force, converting individual prior auth approvals into formal payer coverage policies, and building a real-world outcomes registry to strengthen the clinical and health economic case to payers.