Presently there is a gross lack of information on cost and cost weights in many developing countries that implementcasemix system. Furthermore, studies that employed Activity Based Costing method (ABC) to estimate the costs of radiologyprocedures were rarely done in developing countries, including Malaysia. The main objective of this study is to determinethe costs of radiology procedures for each group in casemix system, in order to develop cost weights to be used in theimplementation of the casemix system. An economic evaluation study was conducted in all units in the Department ofRadiology in the first teaching hospital using the casemix system in Malaysia. From the 25,754 cases, 16,173 (62.8%)of them were from medical discipline. Low One Third and High One Third (L3H3) method was employed to trim theoutlier cases. Output from the trimming, 15,387 cases were included in the study. The results revealed that the totalinpatients’ charges of all the radiology procedures was RM1,820,533.00 while the cost imputed using ABC method wasRM2,970,505.54. The biggest cost component were human resources in Radiology Unit (Mobile) (57.5%), consumables(78.5%) of Endovascular Interventional Radiology (EIR) Unit, equipment (81.4%) of Magnetic Resonance Imaging (MRI)Unit, reagents (68.1%) of Medical Nuclear Unit. The one highest radiology cost weight, was for Malaysia DiagnosisRelated Group (MY-DRG®)B-4-11-II (Hepatobiliary and Pancreas Neoplasms with severity level II, 2.8301). The methodof calculation of the cost of procedures need to be revised by the hospital as findings from this study showed that the costimposed to patient is lower than the actual cost.