Activity based costing (ABC) is a new age accounting system developed to overcome the limitations of traditional costing system, which in today’s technologically advanced world has lost its ability to provide accurate and useful cost information often required in taking various managerial decisions, like setting of selling price, ascertaining profitability of products as well as customers, taking a make or buy decision, eliminating the non-beneficial activities, and rewarding the employees. In this paper, an ABC model is developed for a government hospital in the state of Bihar in India to quantify its various public health related services. Although, there are limited published research papers related to application of ABC model in a specific department or method of a healthcare system, none of them has investigated its scope for organization-wide implementation. The results obtained from the developed ABC model in the public hospital would provide more comprehensive and accurate cost information, and radically contribute to the hospital administration in effective planning, controlling and decision making. This paper also elucidates about various obstructions and difficulties encountered during the implementation phase of ABC model in an Indian healthcare setting.