The Yankees dropped Alex Rodriguez down in the lineup, and banged-up Derek Jeter was penciled in at DH.
Jeter, battling an injury to his left foot, will lead off as the Yankees' designated hitter. Jayson Nix will play shortstop.
Rodriguez has been demoted two spots to fifth in the order, one day after being lifted for pinch-hitter Raul Ibanez, who belted the game-tying and the game-winning home runs in Game 3 against the Baltimore Orioles.
Yankees first baseman Mark Teixeira moves up to the third spot against Orioles left-hander Joe Saunders.
Jeter bruised a bone in his left foot when he fouled a ball off it in the first inning of Wednesday's 3-2 victory. Jeter had a noticeable limp afterward and was replaced by Nix in the ninth, but the Yankees' captain vowed after the game that he would play Thursday.
"I'm good," Jeter said Thursday. "If you are playing, you are playing. No need to talk about (the injury)."
Rodriguez went 0 for 3 with two strikeouts on Wednesday before being replaced in the ninth by Ibanez, who homered off Orioles All-Star closer Jim Johnson.
Rodriguez is 1 for 12 in the series with seven strikeouts. But the slumping slugger is 8 for 20 with two homers in his career against Saunders and will bat behind Robinson Cano.
"If they want to walk Cano to get to (Rodriguez), let them," Girardi said.