Stock CSV import, can it all stock or does it replace?

Shopify native CSV import can’t do that.
If you open to using apps, Matrixify can do that.
Check similar topic – Inventory importing
Note that Renars is with Matrixify, just in case.

If Matrixify is too expensive, technically it’s possible to natively upload this “delta” into a metafield, then have a free Flow app to loop over those products and apply delta from metafield to inventory levels.
Would need someone to create a flow for your though.