Federer beat Ginepri in their four previous matches, winning a break-marred opening set in a tiebreaker after grabbing a 1-5 lead in the decider.
Federer continued to have trouble in the second, losing serve in the 11th game for 5-6 and only just getting it back. Once again, the match needed a tie-breaker, with the Swiss surviving to force a third set.
Suddenly, as if switching on a light, the top seed ran away to victory, with 20 aces, 78 winners but conversions on only six of 16 break points.
"With this place there's just a little bit more danger around," said Federer of the fast Cincinnait courts. "I actually played OK throughout the match.
"I just missed some opportunities. I thought I was the better player actually throughout the match. I was down a set and 5-6, you know....
"It was dangerous today no doubt, but I believed in my chance all the way to the end."
If Nadal moved into the top position, the swoop would end a phenomenal run for Federer.
With his his four and a half years in the top spot, Federer remains fourth on the all-time list behind the Pete Sampras (286 weeks, 1993-2000), Ivan Lendl (270 weeks, 1983-1990) and Jimmy Connors (268 weeks, 1974-1983).
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