The central subject of this study is the economic analysis of Quality Assurance (QA) in the German healthcare system. With the help of the study, an estimate of the total costs in the German healthcare market shall be given. The focus of the analysis is on Companies, Political Bodies, Liberal Professions and Public Corporations which are part of the healthcare system including Certification Bodies, which lead to costs from using QA and interacting with the healthcare system. First, a systematic literature search was conducted to determine the costs. It was found that there are no articles or publications that address the topic of the total cost of QA. A continuation/update of existing studies was therefore not possible. To be able to estimate the total costs of QA in the German healthcare market, the QA costs were surveyed using a bottom-up analysis. After identifying organizations and collecting relevant data, the total costs of QA in the German healthcare market were estimated using a mathematical calculation. In general, ensuring quality is an original part of the actions of all professional groups and institutions working in the health care system. Due to this importance, it is remarkable that an economic analysis of the total costs has never taken place before. One reason for this may be the "complexity of the German health care system". Furthermore, the costs of QA are not listed separately, but as part of general administrative expenses. Controlling and transparent presentation of the costs is therefore not possible. The cost estimation and the database created for this study about the parties involved in QA in the German healthcare market can be a useful support for further studies in this field of research.