Personally, I would use 19260, no modifier. In CPT, this code is defined as "excision of chest wall tumor including ribs," it doesn't specifically indicate what approach needs to be used.
The CT Coding Companion may describe this code as having an open incision but I would argue that those code explanations are just an example of how a procedure can be done.
Due to the fact that this code is not defined as "excision of chest wall tumor including ribs, open incision" I would feel comfortable using it.
Other coders may disagree with me. If you would be more comfortable, add the -52 modifier (many times the payer doesn't even reduce the reimbursement with this modifier). I wouldn't bill 32662 though.
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