If optometrist does the pre and post op care for cataract surgery, cpt 66984 and bills with modifiers 55 and 56, how does the payer know to only pay 70% to the surgeon for intra-operative portion and 30% to the optometrist when the modifier 54 includes all but post-op. (I'm assuming until the claim with the 56 modifier is received) The optometrist pre-op work is not done in global. A decision for surgery is usually stated with full exam and patient is brought back to consent and a-scan.