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I have a 2010 Insight and the rear passenger-side tire has been losing air.
I took it to the dealer and they said the problem is because the TPMS sensor is bad.

The problem is that just doesn't make any sense to me. Since when does a sensor have control over air pressure?
Can someone explain (ELI5 if possible) to me? They want to charge 151$ to replace it.
 

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Strange, I just came on here to look up a similar incident. My wife was driving the car to work this morning & she said she ran over some broken glass as she was pulling in to the parking lot. One of her front tires lost air, but not all of the air in the tire. She was able to drive it to a tire place across the street & they told her the TPMS was tightened & causing the tire to leak air, so they tightened the TPMS & filled the tire back up & it was able to hold air fine. She's going to pick the car up after work.

They said if the TPMS causes the tire to leak again they can replace the sensor.
 

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The sensor is on the inside, the valve stem is connected to it. You likely have a leaking shrader valve inside the valve stem or the o ring around the stem is leaking. You should see a 10mm nut at the base you can tighten.

You may want to get something like this to rebuild it assuing its sending a signal. Any tire shop can measure its output and battery level.

20216 Tire Pressure Monitoring System Kit Accessory TPMS Schrader Pacific | eBay
 

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Wife said the mechanic told her the O ring on the TPMS was loose. He tightened it for free & said if it continues to leak air that he can replace the sensor for $100 or try replacing the O ring possibly for much less.

He also noticed that I have all my tires at 41 psi & said that was way too high & set them to 34 psi. ha ha
 

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If you got an air pump you can try loosening the nut, wetting the stem area and reseating it. Dont remove the nut all the way as you can push the stem and sensor inside the wheel and have to dismount it to reinstall it.

When I purchased my new to me, used wheel sensors they came with a new packing kit for each one and I used them on it.
 

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Update: My tire continued to have a very slow leak after the trial of tightening the O ring. For the time being I just checked the tire regularly & kept pumping the tire up a few psi to the appropriate level with a bike pump once a week.

Finally took it in to Honda service this time (last time was a stand alone mechanic). Honda found a leak around the TPMS grommet & they replaced the grommet for $30. Will wait & see if this did the trick.
 

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Update:
Finally took it in to Honda service this time (last time was a stand alone mechanic). Honda found a leak around the TPMS grommet & they replaced the grommet for $30. Will wait & see if this did the trick.
I had this same repair done to one wheel, by a tire shop for $20, and it has been holding air well for the past year.
 
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