Developing an outpatient clinic at Melbourne University could make room for more beds and theatres at the "obsolete and ageing" Royal Melbourne Hospital.
Melbourne Health, in partnership with the university, is calling for advice on whether the project is possible, and if it would allow the hospital to be redeveloped should government funding become available.
In documents seen by AAP, a winning tender would consider planning for an Ambulatory Care Centre on sites owned or occupied by the university as well as provide opportunities for biomedical research and training partnerships.
By 2026, the hospital will need almost 200 extra beds and four additional theatres.
Because the site doesn't have expansion room there is no other option but to move some services out of the main building to create more space, the hospital says.
Opened in 1848 on Lonsdale Street, the Royal Melbourne Hospital was Victoria's first hospital.
It moved to Parkville in the early 1940s.
Royal Melbourne Hospital's acting chief executive Ruth Vine said the ambulatory service was the primary focus of the tender but it was also an important stage for future plans.
"This Request for Proposal is an important stage in the broader planning works being undertaken for the future redevelopment for the RMH, should funding become available," she said in a statement on Wednesday.
Premier Daniel Andrews said he has yet to see any proposal for future redevelopment, tipped to be about $2 billion.
He said he supported the idea of a redevelopment in general, but made no commitments to fund it.
"It's a grand hospital but it's showing its age," Mr Andrews told reporters.
"But our election promises have to come first."
A spokeswoman for Health Minister Jill Hennessy said she would be happy to discuss any proposal that ensured Victorians received high-quality healthcare.
She said the ambulatory care clinic was not linked to the redevelopment of the Royal Melbourne Hospital.
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