Arthroscopic surgeries take more training and are more difficult to perform than open procedures. So the "comparison" code, whatever that is, should just be a starting point for the insurance company, it's not the final destination. In short I agree with your surgeon. I think adding the modifier -22 to the unlisted code is more than appropriate in this case to help capture the full complexity of this procedure. Years ago I actually worked with the person at an insurance company whos job it was to work unlisted codes and determine their value for payment. Each one received individualized attention. I can only hope that is still the case today.I billed the 29916 and the doctor thinks it should be unlisted because it is a lot more work then just doing a repair. I saw that post for unlisted comparing it to 29916 but then you aren’t getting paid for more work. I thought about mod 22. Will have to ask her if that would be an option.