I'm not sure I understand correctly, but it sounds to me as though you don't just want to render a sub-section of the page, but also draw it only onto a specific sub-rectangle of the bitmap?
Indeed, I suppose that's not possible with FPDF_RenderPage() or FPDF_RenderPageBitmap() directly.
A workaround might be to temporarily change the page cropbox using FPDFPage_SetCropBox() from fpdf_transformpage.h, which is taken into account on rendering.
Then you can use a larger bitmap and shift start_x/start_y inward for left/top margins.
There's also FPDF_RenderPageBitmapWithMatrix() which takes a `clipping` rectangle, but it seems that you want to use Windows GDI, whereas this API is for FPDF_BITMAP.
(Though, I seem to remember reading that pdfium's GDI renderer might be deprecated eventually?)