Not sure that I am going to be of much help but I will see what I can put together.
First, it seems to me that the surgeon was going in to deal with the pes anserine bursitis issue and when he opened the knee, he encountered the thickened fat. In my opinion, this was something he encountered along the way and so I would consider that just part of the overall procedure of the decompression. If you encounter a barricade in your travel to the intended target, you need to deal with it and you can't always charge for each "fork in the road". As for the lysis of the adhesions, the reason you would not go with 29877 mainly is because that is an arthroscopy code. Again, I might consider the lysis of the adhesions as inherent to the main procedure.
The main thing to remember when dealing with surgery on the knee is how many compartments are you working on...it appears that your doc mainly worked in the one targested compartment.
Since it is late in the day, I am attributing my not being able to find any better advise to that.
Hope this helps at least a little...
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