Victoria Hospital alone is in need of £50 million of maintenance.
Aside from the tower block, the 1960s-built north laboratory is in very poor condition and Hayfield House, where there are a number of offices, is experiencing substantial settlement and may have a limited life.
Mr Fairgrieve said an added issue was the fact Historic Scotland had visited the hospital with a view to listing five of the buildings, including the tower and podium, Hayfield House and the labs.
He said this could have a bearing on a final masterplan for the site.
Whyteman’s Brae Hospital, which is in need of £5.3m of maintenance, could also be listed by Historic Scotland.
Elsewhere, Cameron Hospital in Windygates – where services include care of the elderly and rehabilitation – is in need of £3.7m of maintenance work, with the heating system on the point of collapse and the road infrastructure described as extremely poor.
Many of the hospital’s buildings are already empty and Mr Fairgrieve said the plan was to maintain those which were still open at minimal cost until the completion of a review of community services.
He said the site could prove difficult to sell if it is declared surplus to requirements however, as 70% lies in a potential blast zone for the neighbouring Diageo distillery and council planners have indicated they will not allow development within high risk areas.
Around £8.3m of upgrades are needed at Queen Margaret Hospital, Dunfermline, where heating systems are past their recommended life.
Stratheden Hospital needs £7m of work and hundreds of thousands of pounds of maintenance is required at community hospitals and health centres across the region.
